Patient Safety at Sentara
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Patient Safety at Sentara 

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Quality and Patient Safety
Quality & Safety Measures
Asking the Right Questions

Sentara Healthcare's focus goes beyond the basics of making healthcare safe for its patients. Sentara has built a strong "Culture of Safety"  to reduce medical errors by modeling successful programs from the nuclear power and aviation industries. This culture of safety promotes behaviors which result in safe, reliable and effective care.

For its dedication, Sentara has received numerous awards for patient safety and quality of care standards.

Safety Champions
Some Sentara doctors have been designated a “Safety Champion” because they’ve committed to additional education and training specific to keeping patients safe. Doctors and healthcare providers at Sentara continue to work together to focus on the individual needs of patients to keep them safe in the fast-paced and sometimes complex system of healthcare. We are committed to Always Keep You Safe.

Behavior Based Expectations

The foundation of this culture is a strong accountability to perform habitual behaviors that reduce medical errors. Sentara staff uses guidelines known as "Safety Habits" to ensure the highest level of care. The goal is to make these tools and techniques a habit.

Attention to detail – Staff should use a self-checking technique called the “STAR” method. This stands for:  

Stop for a few seconds to concentrate on the particular task;
Think about the task;
Act or perform the task;
Review or double check to ensure that the task was completed correctly.

Communicate clearly – To make sure that information is passed on correctly and that it is understood, staff use several techniques.
One method is a three-way technique called repeat back and read back. To accomplish this, people receiving directions repeat back what they heard. Then the person who initiated the directive verifies what the speaker has said by adding, “That’s correct.”

In high-risk situations or incidences involving unclear information, staff should ask one or two clarifying questions to ensure that they understand the information.

When sound-alike numbers or words are spoken, staff use phonetic or numeric clarifications. For example, they would spell out a word by saying “S as in Sam” to make sure the other person didn’t acutally say “F.” They would clarify similar sounding numbers, such as 14 and 40, by saying “That’s 1-4, not 4-0”.

Have a questioning attitude – Whenever staff members are unsure of a procedure or instruction, or see something that doesn’t make sense to them, they learn to “Validate and Verify” by checking with an expert source to get the right information.

Handoff effectively – In a 24-hour business, both patients and tasks are handed off from one person to another frequently. Staff members are expected to use a tool that helps them remember the five categories of information that are important in a good handoff. These are called the “5P’s.” They stand for the Patient or Project that is handed off; the Plan that is to be implemented; the Purpose of the task; any Problems that can occur and any Precautions that should be taken with the patient or project.

Never leave your wingman – Borrowing from our Navy-based environment, staff are expected to support their co-workers or their “wingman”. This includes peer checking to prevent a co-worker from making a mistake. Another aspect is peer coaching to encourage and praise co-workers for performing correct behaviors and discourage incorrect behaviors.

Other parts of the initiative to build a strong culture of safety include:

Focus and Simplify Policies and Procedures – A typical hospital has stacks of procedure manuals. Sometimes procedures involve too many, often unnecessary, steps that may increase risk.

The process called “focus and simplify” involves  removing duplicate or unnecessary steps and documenting new procedures in a clearer and simpler format. It also includes creating quick-reference job aids for staff to use right at the place where they are giving the care, not back in a procedure manual in an office. 

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