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To improve patient safety by encouraging healthcare providers to speak up about their concerns, risk managers should focus on the influences that have the strongest effect on behavior, suggest the authors of The Silent Treatment, conducted by VitalSmarts, a corporate training company in Provo, UT, the American Association of Critical-Care Nurses, and the Association of periOperative Registered Nurses.
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When a surgeon at Cayuga Medical Center in Ithaca, NY, performed a procedure on the wrong side of a patient's back in 2008, the sentinel event stunned the hospital's administration. But it wasn't long before hospital leaders were formulating a plan to make sure it never happened again.
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In response to a task force's recommendations following a wrong-site surgical error, Cayuga Medical Center in Ithaca, NY, implemented these changes:
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CEO Rob Mackenzie, MD, used his leadership position to help drive the culture change at Cayuga Medical Center in Ithaca, NY.
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Hundreds of obstetrical nurses, midwives, residents, and doctors completing an intensive continuing education program focused on risk management are helping their hospitals lower professional liability costs through an obstetrics-intensive patient safety program.
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A mother took her 4-year-old daughter to the emergency department with symptoms of gagging and watery diarrhea. The physician caring for the child determined that the child was not suffering from dehydration and provided a prescription for the child's nausea. The child's symptoms worsened. After the parent was told by the hospital to allow the medicine additional time to work, the child died. A verdict was entered against the hospital in the amount of $200,000.
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Saints Medical Center in Lowell, MA, announced recently that it will pay $579,000 to settle alleged Medicare billing violations, the first settlement since the publication of the Centers for Medicare and Medicaid Services (CMS) voluntary self-referral disclosure protocol (SRDP).
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For years, risk managers and other healthcare leaders have been pushing physicians and staff to speak up when they see a dangerous situation, but new data suggests the effort has been only moderately successful at best. The focus on providing tools to improve patient safety might have overshadowed what really matters most: behavioral changes.
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Saying you put patient safety first is good, but you won't see any results until you specify what behaviors you expect to see, says Ann Rhoades, former chief people officer for Southwest Airlines and Doubletree Hotels, and one of the five founding executives of JetBlue Airways.
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When the OB safety initiative sponsored by BETA Healthcare Group (BETA) started two years ago, it addressed the most important issues indicated by the company's OB claims, says Heather Gocke, RNC-OB, LNC, CPHRM, C-EFM, director of risk management and quality assessment at BETA's Glendale, CA, office.
