Each quarter, in the spirit of a learning culture inherent to high reliability organizations, MedStar Health Quality, Safety & Risk Management leadership, Dave Mayer MD and Larry Smith, host a retreat for quality and safety professionals, inviting outside speakers to share their expertise and discuss topics related to patient safety, risk management and improving healthcare quality. Those topics have included:
- Care for the Caregiver
- Human Factors Engineering
- High Reliability Organizations
- Patient & Family Stories
- Open, Honest Communication & Transparency
- Patient Engagement
- Baldrige Journey
MedStar Health has created a Video Learning Library on their website which includes a full recording of many of these sessions. The intention is to share the knowledge with all healthcare colleagues so that others can also benefit from the experience shared by these safety and quality thought leaders. The Library can be found on the MedStar Health website. Following is an example of the content, as Dr. Bill Neff, CEO & CMO, University of Colorado Health, shares the Baldrige Journey as experienced by Poudre Valley Hospital. Please share this resource with others!
For the last twelve months, our health system has undertaken a system-wide initiative to join the ranks of healthcare organizations like Cincinnati Children’s Hospital, Poudre Valley Hospital, and Mainline Health on a journey that seeks high reliability. We have already seen the fruits of this journey, and believe that when the benefits of a High Reliability culture are combined with the expertise provided by our National Center for Human Factors in Healthcare, led by Terry Fairbanks MD, MS, along with the guidance provided by our National Patient and Family Advisory Council for Quality and Safety, exciting opportunities to improve quality and safety while reducing cost can be realized.
An important part of this journey includes creating a learning culture built on transparency that many in healthcare are still uncomfortable with. Overcoming these barriers requires consistent and repetitive role-modeling and messaging around core principles that help instill and reward open and honest communication in an organization. One of the ways we continue to reaffirm these important messages is through our “60 Seconds for Safety” short video series, which highlights different high reliability and safety principles. Each week, a video from the series is attached to our “Monday Good Catch of the Week” email, delivered throughout our system. The video highlights one important safety message all our associates can become more familiar with, and hopefully apply as they go about their daily work that week. Similar to starting every meeting with a safety moment, we want all of our associates to start each new week with an educational message reminding us that safety is our number one priority. The videos are available on MedStar’s YouTube Channel, under the Quality & Safety playlist. Please feel free to use any of these videos in your own Quality & Safety work — and please share ways you are getting the quality & safety message out to your front line associates.
The American Medical Association has created a funding opportunity for changes to medical education that reflect the needs of future patients, providers and students (see AMA press release). Exciting stuff for those who have been watching and waiting for adoption of new educational technologies, mlearning, MOOCs and more to catch fire in medical education! Specifically, the AMA has pledged funding be awarded to medical schools that:
- Develop new methods for teaching and/or assessing key competencies for medical students and fostering methods to create more flexible, individualized learning plans.
- Promote exemplary methods to achieve patient safety, performance improvement and patient-centered team based care, and improving understanding of the health care system and health care financing in medical training.
- Enhance development of professionalism throughout the medical education learning environment.
Can medical schools of the future really embrace a new culture of learning (see ETY post A New Culture of Learning by John Seeley Brown), or a learning environment that looks like this (see ETY post Medical School and Classrooms of the Future):
Having just returned from a week visiting the good folks at Virginia Mason Medical Center (VMMC) in Seattle, WA, a group of us listened as VMMC associates broke down the benefits of using their Virginia Mason Production System (VMPS), which is essentially the Toyota Production System, or Lean methodology with a touch of Boeing’s expertise thrown in, and then adapted to their own healthcare environment. The skill sets involved to execute Lean effectively are taught at some B-Schools, but definitely not medical school as a rule, and while applied with restraint and awareness of the ripple effect when changing complex systems, can have real benefits to the financial health of a healthcare system. But those who had graduated through different levels of the VMPS training, shared how the first year was a blur as they studied the concepts, and learned the language of Kaizen and going to the Gemba. How the VMPS intentionally and consistently improves patient safety for the long haul remains a little unclear, leaving additional training and educational voids addressing a just culture, care for the caregiver, full disclosure, shared decision-making, patient-centered care and engagement…the list goes on.
Some additional food for thought:
- What if a proven cost-savings and quality improvement method for major manufacturers was taught universally to care providers as the scaffolding by which they plan-do-study-act?
- What if human factors engineering and the science of safety were taught in every medical school across the country, as well as an understanding of what it means to be a high risk organization, but still be a highly reliable organization?
- How do you fit all this on top of a basic science and clinical curriculum?
- And this is just innovation to the curriculum. Now how do you deliver the education in a way that engages students versus having the one drawing the short straw at happy hour show up to take notes during lecture the next day?
- And what about pharmacy, nursing and allied health curriculums? How will we connect all care providers, as caring for patients in teams becomes the new gold standard?
To develop a 4-year medical school curriculum that includes a working knowledge of all these topics is most likely not humanly possible to complete, but if the culture of healthcare business was defined, instead of recreated at every institution across the country, perhaps young students and residents would enter into their new positions with some of the guess work removed from the mix. What if multi-disciplinary teams were already in place, care for the caregiver programs the norm, unsafe condition-near miss-and-incident reporting celebrated, rules, regulations, respect and joy in their work environments were all givens at every hospital across the country? This same guess work not only has a direct impact on job satisfaction, but also on patient care. I’m just throwing ideas out as a starting place in hopes that those much more qualified will join this conversation! Time is of the essence too–in the AMA’s January 17th press release, they share that:
…Across the continuum of medical education, the gap between how physicians are trained and the future needs of health care continues to widen…