*Article as appeared in Hospital News

Through Patient Safety Rounds, a new process launched last December, our Senior Leadership Team goes directly to front line staff, physicians and volunteers to find out how we are doing to provide a safe care and work environment for staff and our patients at St. Joseph's Health Centre. Obtaining feedback from staff on safety issues that can improve patient care and enhance their work environment is key to creating a culture of safety.

"In terms of safety here at St. Joe's, our motto is that patient safety is everyone's business," explains Lisa O'Drowsky, Patient Safety Manager at St. Joseph's. "What that really means is we all have a role in ensuring quality and safe patient care." Patient Safety Rounds conducted by our senior leaders "demonstrates our commitment to Put Patients First, helps build our culture of safety and gives staff a voice (in seeking) improvements," said O'Drowsky. "And as 'step one' in building an effective patient safety program, you need to really mold the culture of the organization to be one of safety and lead by example."

The Rounds are conducted weekly, where two members of the Senior Leadership Team and a Patient Safety Manager visit the various areas in the Health Centre that are directly and indirectly providing patient care, to meet with staff to discuss safety. This process enables staff to voice their concerns around safety and gives our senior leaders the chance to let our staff know what is being done to address their concerns.

"If we don't have people talking about the issues, we will never have the opportunity to put corrective measures or system changes in place to prevent recurrence. For us to stimulate the dialogue and get this information from people who live these issues day in and day out I think that it's essential to improve patient safety," said O'Drowsky.

O'Drowsky also explains that St. Joseph's is aiming to provide a just and accountable culture that continually examines the system to review why and how safe guards fail that put patients and staff at risk. "We use a lot of the information from staff, physicians and patients about near misses and adverse events and it's this knowledge that helps us put these preventative strategies in place to strive for continuous quality improvement," O'Drowsky said. No matter how small or large the issue may seem, the key thing is that safety is being discussed, addressed and is at the forefront of everyone's mind, she added.

A number of issues that have been identified through the Rounds (which may not have been identified otherwise) include:

• Constant observation rooms in our Mental Health areas need to be equipped with dimmer switches to allow staff and camera surveillance at night without waking patients
• Staff are unaware of the supports that exist for them - for example, our Furniture Removal Services have an email account directly linked to Environmental Services department, which helps them to coordinate and facilitate timelier response to staff when they need to have old, broken, or obstructing furniture removed from their working areas
• Highly polished floors may contribute to slips and falls (for staff and patients)

Our corporate risk management tool, the Improvement Priority Matrix, is used to summarize the information collected at the Rounds. Issues are placed into the matrix, grouped by key themes and ranked by the consequence and likelihood of the event occurring – the higher the ranking, the sooner action is required. The assessment is then shared with the Manager of the area to follow up with their direct reports and communicate with other associated managers of areas that may be involved. "The most senior leader then goes back to that area (within five days) to say, 'here's what you told us, here's what we are doing about it'," said O'Drowsky. "Even if they don't have all of the answers at that time, they can go back to provide an update."

So far, feedback from staff indicates that this process is a positive experience and one that will be successful in continuing to move patient safety forward at St. Joseph's. "It is important for staff to know that they a part of the solution and that together, we can improve safety for our patients," said O'Drowsky. "We will know we are successful with Patient Safety Rounds when we don't need to ask the questions, but when people just openly come without any prompting to discuss issues, raise their concerns and suggest solutions (to improve safety)."

In addition to Patient Safety Rounds, St. Joseph's Quality, Safety, and Performance Excellence Program encompasses a number of initiatives aimed at improving quality and safety including our falls prevention initiative, hand hygiene program, work to reduce hospital associated infections, and the implementation of smart infusion pumps to reduce the risk of medication errors.

Click here to go to the Patient Safety section of our website

Click here to read our feature article on St. Joseph's receiving the 2009 BD Diamond Safety Award

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Page last updated: April 30, 2010