Using Culture in Your Organization

This article is an excellent read!  Patient safety culture and patient safety are the buzzwords these days, but what are some actions to help you improve your patient safety culture?

  • First, understand the culture of your organization. This is truly the foundation for prioritizing patient safety.
  • Involve your patients and their family members as active participants in their care. This helps increase their health literacy, which contributes to improved patient outcomes.
  • Reinforce that reporting events is necessary so you can continually evaluate and improve systems—-not to provide fuel to blame the healthcare providers. Providing a user-friendly reporting system that is integrated into your organization’s daily processes will increase the number of reported events and unsafe conditions.

To sum it up:  “In the long run, patient and workforce safety will not only be a moral imperative but will likely be critical to sustainability and essential to delivering on value.”   (Gary Kaplan, MD)

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Administering a Culture Survey

IF IT’S EASY, YOUR PROBABLY NOT DOING IT RIGHT.

Why assess your culture?

You can improve what you measure. Without measuring, you have no way to know if you are improving.

These statements are especially true when it comes to assessing your culture. It may be easy to take a quick poll of staff and infer their perceptions to that of the rest of your organization’s employees, but there’s no certainty in your results. Using a standardized survey tool can provide measurable and meaningful feedback.

Another reason to assess your culture is because many regulatory and certifying bodies now require or recommend measurement of an organization’s patient safety culture. This is because they, too, recognize the clear connection between strong cultures with open communication and the effective implementation and sustainability of patient safety and quality improvement programs.

  • The Joint Commission
  • Leap Frog
  • CMS Merit-based Incentive Payment
    System (MIPS)
  • CMS Quality Assurance and Performance Improvement (QAPI)

The Center for Patient Safety has been administering culture assessments since 2010, and we understand the most successful organizations have a fine-tuned process for administering the survey and analyzing their results. In this article, we’ll discuss some of the most pertinent planning details when preparing to launch a survey. Subsequent articles will include diagnostic tips for evaluating your survey data.

While standard online survey templates may ease the burden of survey administration, there are four key areas that, if addressed upfront, can save time, resources, and frustration in the long run.

1. Which Tool.
The Center has always supported the Agency for Healthcare Research and Quality’s (AHRQ) Survey on Patient Safety (SOPS) tools though there are many other surveys that can provide a similar analysis. The SOPS tools have been developed for a multitude of healthcare provider types with specific, relevant questions asked, based on varying care settings, such as nursing homes, hospitals, ambulatory surgery centers, pharmacies and medical offices. These surveys have also been psychometrically tested and validated and are available in more than 40 languages.

2. Which Medium.
How do you normally administer surveys to your staff? Are they at ease with an online version, or are they most comfortable with a paper survey? While this seems like an insignificant question, it is quite important. If staff are fearful, they will hesitate to write unfavorable feedback on a paper survey because they think their handwriting will be recognized. However, they may also think the organization will track their online response back to them for purposes of punishment. Using a third party vendor often works best and creates a neutral environment for staff to respond. Consider offering a combination of online and paper surveys. Allow staff to take the survey in a confidential environment with varying options for submitting them. Providing options other than submitting them to their manager increases anonymity, resulting in truer results.

3. Custom Questions.
We often get question-happy when it comes to surveys. It’s efficiency at its finest: “While we have our staff’s attention, let’s just go ahead and ask a few more questions, like what they thought about the EHR implementation, their employee engagement for the year and what sport the organization should have at the next company picnic.” This is a big no-no. If you’re using a standardized survey, keep the list of questions short and relevant. The AHRQ SOPS ask about 45-50 questions and can take up to 15 minutes to complete. Limit additional questions to no more than five and keep it related to culture. More than five questions on an unrelated topic will cause confusion and create survey fatigue.

4. Promotion.
Staff won’t do something if they don’t know they need to do it. Put a little effort into marketing the survey and you’ll get a very valuable return. The more staff that take your survey, the more accurately your results will reflect the culture of your organization. This in turn gives you better data to analyze. Plan with your marketing department, do a search on Google, or harness your creativity to develop posters and email templates. Ask your CEO or President to write a brief memo about the value and importance of all staff taking the assessment and their desire to see honest feedback. Put a link to the survey on your Intranet; distribute surveys at a monthly staff meeting; offer a certificate for a free drink for turning in a completed survey; or host a pizza party if you reach your target response goal. These are small tokens of appreciation that can have a big impact on getting valuable insight.

In Summary 

Your time will be most efficiently spent analyzing the results and preparing action plans post-survey, so addressing these four areas upfront will remove many of the headaches that can go along with planning and administering a survey. If a third-party option is a better choice for you, please contact the Center for Patient Safety to discuss our custom options. We’ll even help in the analysis of your survey results. Find out more information about our survey services.

CPS Safety Culture Assessment

“I am very impressed with the reports. I know my leadership team will be thrilled to have the individual reports by their division. This
has been a very positive experience for me.”

“We love the Center’s patient safety culture survey feedback reports. The department level reports give a level of granularity we
were lacking with previous surveys.”

The Center focuses heavily on culture to support patient safety improvement. A punitive environment discourages open communication of events and near misses, creating a barrier to learning about the mistakes that are occurring.

The Center has been administering the AHRQ Surveys on Patient Safety (SOPS) since 2011. Since then, we have administered hundreds of thousands of surveys and provided survey support, feedback reports, and consultation to hundreds of organizations.

A select group of 42 hospitals were selected from the 2016 database. These organizations were selected based on their activity level and extended use of the Center’s resources and services for PSO participation, webinar attendance, resource usage, and consulting. An analysis of their patient safety culture scores are compared to the national compare database from AHRQ. More than 14,000 surveys were analyzed.

  • 7 dimensions were equal to or higher than the 50th AHRQ Percentile
  • “Nonpunitive Response to Error” ranked in the 75th AHRQ Percentile
  • 23 questions were equal to or higher than the 50th AHRQ Percentile
  • “We are actively doing things to improve patient safety” ranked in the 90th AHRQ Percentile

The top strengths for these organizations align with the top strengths from the 2016 AHRQ Hospital Compare Database:

However, the areas with potential for improvement, or the lowest scoring dimensions, indicate variation in two of the composite scores:

The Center has had a long history with a focus on creating a nonpunitive environment. The dimension includes the question “Staff worry that mistakes they make are kept in their personnel file.” The higher score for the composite “Nonpunitive Response to Error” is statistically significant (>5%). Compared to the national average, the organizations in our select group are in the 75th percentile nationally.  While most of the respondent emographics for the hospitals included in the Center’s summary align with the AHRQ Compare Database, it is worth noting:

  • 15% of staff indicated they report 11-20 event reports per year; 29% indicated they report 3-5 events per year (statistically significant variation from AHRQ National Compare Database)
  • Higher numbers of reports suggest an environment that supports open communication without a fear of retribution or punishment.

Additional notes:

  • 85% of respondents had direct patient care
  • 41% of staff worked 1-5 years in the current work area
  • 36% of staff worked 1-5 years in the current hospital; 13% worked 21 years or more in the current hospital
  • 44% of staff indicated they were a Registered Nurse

Click here to download the full data report.

Interested in receiving reports like this for your organization’s departments or locations? Request a no obligation price estimate with a summary of the Center’s survey administration services.

The Joint Commission released Sentinel Event Alert #57

The Joint Commission released Sentinel Event Alert #57 this week:  The Essential Role of Leadership in Establishing a Patient Safety Culture.

The Center for Patient Safety supports the 11 patient safety tenets and provides services and supports to help health care providers across the continuum improve patient safety.  For additional information contact us.

It’s Patient Safety Awareness Week – #PSAW2017

The Center for Patient Safety encourages providers to use the week as a great way to remind the staff and community of their commitment to safety.
It should be a time of celebration of successes, but also a time of reflection.

In recognition of the week, and the efforts that continue every day throughout the year, the Center for Patient Safety is offering a 20% discount on the already affordable safety culture survey services. Download a proposal with sample feedback reports and an online sample survey link. We encourage the use of the survey as a diagnostic tool to assess your culture. Get started today and take advantage of the offering!

Several available toolkits can support your improvement efforts. It’s easy to start with tools that have already been developed and proven successful:  10 Patient Safety Tips for Hospitals

We also want to remind you that consumer involvement is important to ensure a successful patient safety program. The Agency for Healthcare Research and Quality provides several flyers and videos that can complement your events and programs during Patient Safety Awareness Week:

Patient Safety Awareness Week Approaches, March 12-18th

The Center for Patient Safety (CPS) encourages all healthcare organizations to use Patient Safety Awareness Week, March 12-18th, as a way to remind staff and community of your commitment to safety. It should be a time of celebration of successes, but also a time of reflection.

Free Toolkit for Patient Safety Awareness Week 2017

CPS reminds you to plan in advance for Patient Safety Awareness Week. Plans don’t have to be time consuming or extravagant, but a little planning can go a long way. We recommend hosting an event or several events to recognize patient safety efforts at your organization.

For example:

  • Recognize staff and committees that work every day to provide safe care
  • Launch a patient safety culture assessment during the week (mention this blog and receive 10% off your survey services through CPS!)
  • Have leadership, patient safety/risk/quality department and/or safety committees host events in the cafeteria with snacks or dessert or something special to celebrate safety at their organization
  • Ask departments to develop poster presentations of their successful safety efforts. Display in hallways.
  • Hang a safety awareness week poster in the foyer of the organization with signatures from all staff
  • Hold safety-focused training during Patient Safety Awareness Week
  • Publish safety-focused articles for the organization’s internal newsletter, professional newsletters, local newspapers, local consumer groups
  • Contact a local radio station to host a spokesperson to share patient safety tips and highlights
  • Launch a new safety awareness effort – a “good catch” program, implement a new “CUSP Team”, announce an upcoming “Safety Culture Survey”, etc.

Several available toolkits can support improvement efforts. It’s easy to start with tools that have already been developed and proven successful:  10 Patient Safety Tips for Hospitals

We also suggest you consider consumer involvement to ensure a successful week. The Agency for Healthcare Research and Quality provides several flyers and videos that can complement events and programs during Patient Safety Awareness Week:

Visit www.unitedforpatientsafety.org for more information and resources about #PSAW2017.

CPS FREE WEBINAR: Leadership, Louder than Words: C-Suite Ambassadors of Patient Safety

Committed c-suite leadership to inspire a shared vision is the most critical element in a successful patient safety program. This non-delegable responsibility sets the example by supporting an open and transparent environment, fostering a patient safety culture among all caregivers.

Learn how senior leaders use these steps to provide and support a safer care venue for all patients:

  • Assessing the Culture
  • Integrating patient safety into your strategic plan
  • Supporting your patient safety plan
  • Improving your care processes
  • Sustaining the gains with redesign and high reliability

Thursday, February 16 from 12-1 pm (Central)

To Register, Click Here.

FREE WEBINAR – Safety Culture Assessment for LTC

Culture impacts everything we do. And it’s no different in health care organizations. The strongest cultures support employee engagement, promote open communication and the sharing of mistakes to foster improvement.

Learn about how the Center’s administrative survey can save you time and money and why measuring your culture is so important to improve patient safety.

Webinar – Tue, Nov 1, 2016 1:00 PM – 2:00 PM CDT

Register Here!

Focusing on Both Deaths and Harm from Medical Errors

Focusing on Both Deaths and Harm from Medical Errors

In his latest post to the “Line of Sight” blog, IHI President and CEO, Derek Feeley, reflects on the controversy and criticism surrounding a recent British Medical Journal article, which asserts that medical errors would rank as the third leading cause of death in the US if government calculations included these errors. Feeley welcomes the debate on how best to calculate the number of lives lost as a result of such errors, and he proposes that focusing on preventable deaths is necessary but not sufficient. It’s equally important, he says, to better understand and address the myriad types of preventable harm patients suffer from medical errors.

Cultural Transformation

A study completed at The Ohio State University, and published in the American Journal of Medical Quality, shows a patient safety cultural transformation after implementation of Crew Resource Management.  AHRQ’s Survey of Patient Safety (SOPS) tool was used to measure progress of the culture improvement.  The Center for Patient Safety offers low-cost, high-value administration and department-level analysis of the AHRQ safety surveys.  Contact us!

 

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RESOURCES:

The Center for Patient Safety believes that collaboration and sharing are the best ways to drive improvement. We strive to provide the right solutions and resources to improve healthcare safety and quality.