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Developing a systemwide approach to patient safety: the first year
Susan Penn Ketring1, James P White
1INTEGRIS Health, 3300 NW Expressway, 100-4390, Oklahoma City, OK 73112, USA. Susan.Ketring@integris-health.com
The Joint Commission Journal on Quality Improvement
|June 18, 2002
Summary
INTEGRIS Health developed a patient safety framework focused on a culture of safety, moving from blame to systems improvement. This initiative identified numerous potential patient safety risks and system flaws, with ongoing challenges in implementation and measurement.
Area of Science:
- Healthcare Management
- Patient Safety
- Organizational Culture
Background:
- Healthcare organizations must prioritize patient safety.
- INTEGRIS Health initiated a patient safety framework in 2001, emphasizing a culture of safety.
- The framework's foundation is built upon leadership understanding and organizational buy-in.
Purpose of the Study:
- To establish a robust patient safety culture.
- To transition from a traditional blaming approach to a systems-focused error prevention strategy.
- To encourage open communication regarding errors and near misses.
Main Methods:
- Implementing a patient safety framework across ten acute care organizations.
- Educating leadership and staff on the importance of patient safety.
- Encouraging staff to identify and report potential safety issues and system flaws.
Main Results:
- Identification of multiple potential accidents and system flaws.
- Staff engagement in proactively addressing safety concerns.
- Development of both simple and complex solutions to identified issues.
Conclusions:
- Key challenges include maintaining visibility of patient safety initiatives.
- Effective communication and consistent implementation of solutions across facilities are crucial.
- Developing meaningful metrics to measure the success of patient safety efforts remains an ongoing task.