Workforce Safety: We have a problem and we can solve it
Stephen E. Muething, MDChief Quality OfficerProfessor of PediatricsCo-Director, James M Anderson Center for Health Systems Excellence
Disclosure
• Dr Muething receives some salary support from Solutions for Patient Safety
• Dr Muething is a member of a group of faculty who contributed intellectual property to HIVE Networks
Objectives:
• Participants will understand current state of healthcare workforce safety and the compelling reasons to address this problem.
• Participants will see an example of potential solutions at the local level and national level.
• Participants will hear potential steps that can be taken by every hospital leaders almost immediately.
Cincinnati Children’s Snapshot Over 15,000 employees and 678 Beds More than 20 sites of care, >120 mental health
beds >1.2 million patient encounters Patients from 50 states and nearly 70
countries, employees from >90 countries >2600 students; >380 residents; >640 fellows >1200 new employees every year >100 continuous clinical trials
Vision:To be the leader in improving child health
OSHA recordable injury: Injuries requiring more than first aid. Also includes blood-borne pathogen exposures.
DART Injury:Days Away,
Restricted duty or Transfer
6000 36001500 10
17104
$33 million
Respect Belief and Buy-In Inextricably Linked
Employee and Patient Safety
16
Pyramid of Harmpatient and employees
SSE’s & Lost-time injuries
Serious harm index & OSHA
recordable injuries
Events of minimal to moderate harm & all
employee injuries
Near-miss eventsPatient and Employees
17
SSE’s & Lost-time injuries
Serious harm index & OSHA
recordable injuries
Events of minimal to moderate harm & all
employee injuries
Near-miss eventsPatient and Employees
Pyramid of Harmpatient and employees
SSE’s & Lost-time injuries
Serious harm index & OSHA
recordable injuries
Events of minimal to moderate harm & all
employee injuries
Near-miss eventsPatient and Employees
Pyramid of Harmpatient and employees
0 10 20 30 40 50 60 70 80
Slip, Trip or Fall
Overexertion
Other
Motor Vehicle Accident
Exposure
Caught / Struck
BBP Exposure
Aggressive Patient
Fiscal Year ComparisonJuly - April
FY17 FY18 FY19
21
Creating the Culture
RESPECT Members
Darin EnglandOP MRI
Susan SharpRadiologist
Jordan BrownBase Radiography
Michelle GramkeUltrasound
Kyaira WaltonNuclear Medicine
Alex TowbinRadiologist
Ethan SmithRadiologist
Meg CareRadiologist
Carl MerrowRadiologist
Jonathan DillmanRadiologist
Abbey SzabadosCT
Bernadette KochRadiologist
Catherine LeopardChild Life
Steve KrausRadiologist
Yinan LiFellow
Cathy WielandBase Radiography
Abby SchmitzBase MRI
Rachel SmithQI
Billie HowardOP Radiography
QI
Stephanie SnellingReading Room
Theresa VogelsangOP Ultrasound
Beth WiesmanOP Radiography
255 frontline employees, managers, and faculty
PathologicalWho cares as long as we’re
not caught
ReactiveSafety is important - we do a lot every time we
have an accident
CalculativeWe have systems in place to manage all
hazards
ProactiveSafety Leadership and values drive continuous
improvement
High ReliabilityIt is how we do business
around here
Radiology Safety Culture Curve
Radiology Themes
Communicatio
Safety Reports
Frontline Involvement
Training and Onboarding
Radiologist-Technologist Interactions
Radiology Action Items
• Interactions:– Active work to improve interactions between faculty/fellows and frontline staff
• Communication:– Daily Pulse Survey, Radiology Round Tables, Town Halls, etc.– Implementing new process for trying patients without anesthesia in MRI
• Training and Onboarding:– Active work on improving our onboarding and training for new hires– Implemented fellow proficiencies in Fluoroscopy
• Frontline Involvement:– New equipment ordered after frontline trial and feedback– Frontline representation on all improvement initiatives
Faculty/Fellow and Frontline Interactions
Radiologist Coverage
during Conference
Established…
PDSA 1: Fellow Observations in CTPDSA 2: Phone scriptsPDSA 3: Go-to …
PDSA 1: Fellow Observations in RadiographyPDSA 2: Shared individual feedback with Radiologists…
40%
50%
60%
70%
80%
90%
100%
% V
ery
Goo
d an
d Ex
celle
nt In
tera
ctio
ns
Bi-Weekly
% Very Good and Excellent Interactions betweenFrontline Staff and Radiologist/Fellow
% Very Good and Excellent Interactions Median Goal
Food ServiceSafety Culture Curve Exercise
Employee Safety Culture
Collaborative:
“Making Safety Safe”
Where do you all feel that your department/division falls on the curve?
1
2
3
4
5
Frontline Staff Score Manager Score
ReactiveSafety is important - we do a
lot every time we have an accident
CalculativeWe have systems in place
to manage all hazards
ProactiveSafety Leadership and values drive continuous improvement
Food Services Results
PathologicalWho cares as long as we’re
not caught
High ReliabilityIt is how we do business
around here
Average Frontline staff score: 3.23Average Leadership score: 3.68
Communicatio
Lack of Trust
Work Environment
Fear of Repercussion
FOOD SERVICE THEMES
Communication and Trust:• Refresh the Safety Committee to allow new members
to join and request continued commitment from current members
• Communicate a safety update at each all employee staff meeting monthly
• Implement new programs promoting safety-focus item each month, safety concern box
FOOD SERVICE ACTIONS
Workforce Safety Across SPS
33
Working together to eliminate serious harm
across all children’s hospitals in the United States
OUR MISSION:
34
Employee Safe Safety-DARTSPS Network Aggregate
Year 1 Key Drivers
oStrategic goal to reduce work force injuriesoSenior leadership review of workforce safety data
as close to real time as possible (at least monthly)oRobust injury review and reporting processoMulti-professional team chartered to improve
workforce safetyoLearn from other organizations via site visits or
comparative opportunities
Questions? Pushback? Discussion?
38
Workforce Safety: We have a problem and we can solve itDisclosureObjectives:Slide Number 4Cincinnati Children’s SnapshotSlide Number 6Slide Number 7Slide Number 8Slide Number 9Slide Number 10Slide Number 11Slide Number 12$33 millionSlide Number 14Slide Number 15Slide Number 16Pyramid of Harm�patient and employeesPyramid of Harm�patient and employeesPyramid of Harm�patient and employeesSlide Number 20Slide Number 21Creating the CultureSlide Number 23Slide Number 24Slide Number 25Radiology Action ItemsFaculty/Fellow and Frontline Interactions Food Service�Safety Culture Curve ExerciseFood Services ResultsSlide Number 30Slide Number 31Slide Number 32Slide Number 33Slide Number 34Slide Number 35Slide Number 36Year 1 Key DriversSlide Number 38
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