Norfolk, VA – July 21, 2004 – There are few peer awards more prestigious for a hospital to win than the Quest for Quality prize by the American Hospital Association. This year, that national recognition goes to Sentara Norfolk General Hospital for its Culture of Safety initiative. Runners-up include Johns Hopkins and Advocate Health of Chicago.
"This prize culminates two years of hard work by leadership and staff to create a culture of safety," said Rodney Hochman, M.D., Chief Medical Officer for Sentara Healthcare and Administrator of Sentara Norfolk General Hospital. "Sentara’s Culture of Safety is about making Best Practices our common practice every day,"
Gary Yates, M.D., Sentara’s Vice President for Clinical Effectiveness, adds that the Culture of Safety, piloted at Sentara Norfolk General, will soon be employed system-wide in Sentara’s six hospitals and other sites of care. "It’s about every employee learning our systems to prevent errors, patient injuries and workplace accidents, and actively applying that knowledge in their work," Yates says.
"The committee was impressed by your culture of safety and strong leadership and staff commitment," said Gail Lovinger, Director of the Quest for Quality Prize in a congratulatory letter to Sentara. "Congratulations …on this achievement."
"No system is perfect," says Dr. Yates. "We are not error-free. But, this award recognizes Sentara’s commitment to patient safety as a systematic discipline."
Culture of Safety is both process, mindset
Sentara Norfolk General Hospital has always employed a three-pronged approach to patient safety including Technology, Processes and People. Technology includes innovations like e-ICU, SUNRISE pharmacy software and PACs digital image archiving with TALK voice transcription. Our Culture of Safety initiative adds a new foundation of Behavior Based Expectations (BBEs) for error prevention, Red Rules that cannot be ignored without consequence and enhanced Root Cause Analysis that brings timely systematic improvements.
BBEs and Red Rules come from nuclear power industry Sentara Norfolk General Hospital began its Culture of Safety initiative by retaining industrial safety consultants Performance Improvement International. PII has a reputation for safety improvements in the nuclear power and airline industries. With their guidance, Sentara Norfolk General Hospital accelerated the pace of change in a collaborative process with physicians and hospital staff.
There are five Behavior Based Expectations; Pay attention to Detail. Communicate Clearly. Have a questioning attitude. Hand off effectively. Never leave your wingman.
Red Rules are safety fundamentals enforced in every hospital department. In a clinical setting, Red Rules include positive identification prior to any action with a patient and site verification before surgery. For housekeeping staff, it’s never mixing chemicals. In dietary, it’s maintaining safe food temperatures. Failure to observe these rules brings consequences.
Hospital staff makes Culture of Safety a reality
People are the lynchpin in the Culture of Safety at Sentara Norfolk General Hospital. Leadership is tasked with keeping the culture front-and-center. There are ‘safety coaches’ in every department. Staff at every level have been educated and trained in technologies and processes, assigned to oversight committees, and are regularly reminded that ‘Patient Safety Starts with Me’. Staff are recognized and rewarded for practicing BBEs and catching potential errors before they reach the bedside. Sentara promotes a philosophy of fairness that encourages systematic improvements based on learning from errors, yet demands accountability for job performance.
Culture of Safety is expanding
The above are just a few examples of how the Culture of Safety brought the Quest for Quality prize to Sentara Norfolk General Hospital. These principles are now being implemented system-wide in Sentara Healthcare’s six hospitals, seven nursing centers, three assisted living centers and other sites of care. They will be shared nationwide through a cover article in the AHA’s Hospitals and Health Networks magazine.