Cedars-Sinai Medical Center

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A BI-WEEKLY PUBLICATION FROM THE CEDARS-SINAI CHIEF OF STAFF September 7, 2018 | Archived Issues

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Frontline Staff Play Vital Role in Promoting Safety

When new oxygen tanks appeared on 8 Saperstein earlier this year, clinical partner Jennifer Valdez thought something about them looked odd. Valdez helps attach the portable tanks to the gurneys of patients from her unit who must stay hooked up to oxygen while getting an MRI scan.

Because these imaging machines use strong magnetic force, nothing magnetic can be brought into the MRI room. Patients must enter the space on special gurneys with equipment that won’t be attracted to the machine’s magnetic field. The wrong equipment could harm a patient or even collide with the machine.

When Valdez noticed that the new portable oxygen tanks on her unit might have magnetic handles, she immediately warned her supervisor, and hospital staff removed the tanks.

"If you don’t report problems, that could affect somebody’s life," said Valdez, who’s worked at Cedars-Sinai for nine years. "I understand why people sometimes feel nervous about speaking up, but I know my team won’t judge my decisions. I am my patient’s voice."

Frontline staff like Valdez play a critical role in promoting a culture of safety at Cedars-Sinai. The medical center relies on these bedside professionals to identify flaws in clinical processes that can lead to mistakes and may result in patient harm.

"I’m happy and encouraged that Jennifer felt emboldened to speak up," said Bryan Croft, senior vice president of Operations at Cedars-Sinai. "We aspire to have all of our staff members feel comfortable enough to do that. Ultimately, we all want what’s best for the patient."

Croft and other members of hospital leadership have worked to reinforce a transparent and constructive environment for reporting patient safety issues, and it appears to be yielding positive results.

A recent tally of last year’s Culture of Safety survey results showed an increase in positive perceptions about Cedars-Sinai’s safety efforts. The hospital also saw a 20 percent jump in incident reports this past year. That’s a good thing because those reports included useful information from incidents like near-miss events, which can uncover potential system issues and improvement opportunities. The medical center also saw an uptick in Safety Star submissions—recognizing employees who go above and beyond to keep patients safe—from areas including Environmental Services, Security, Food and Nutrition services,  and Central Transport.

"Hospital staff from any area can make a big impact when they identify issues that can potentially compromise safety," said Edward G. Seferian, MD, chief patient safety officer. "It takes a team, including physicians, nurses and other staff, to work together to continuously improve patient safety. Issues identified through incident reporting are taken seriously at the highest level."

To further encourage reporting, a new patient safety training course launched in March and has rolled out to frontline leaders in 19 different units. The course includes a new checklist meant to guide leaders through a standardized set of immediate actions after an adverse event. The checklist helps pinpoint where a breakdown occurred and whether the affected service is safe for the next patient.

The course also aims to overcome one of the biggest barriers around patient safety engagement—the misperception that the process is intended to be punitive, said Rekha Murthy, MD, vice president of Medical Affairs and acting chief medical officer at Cedars-Sinai.

"Our staff are the most knowledgeable sources about potential flaws in our processes of care and ideas to further improve safety," Murthy said. "It’s essential that they feel empowered to report safety issues or near misses to help identify opportunities to improve systems that otherwise could lead to patient harm."

In the year ahead, Cedars-Sinai will focus on many of the same Patient Safety priorities: encouraging incident reporting, expanding the patient safety curriculum rollout and eliminating repeat events.