Reports From the Field

The Daily Safety Brief in a Safety Net Hospital: Development and Outcomes

Journal of Clinical Outcomes Management. 2016 February;23(2)

References

1. Joint Commission Center for Transforming Healthcare. Available at www.centerfortransforminghealthcare.org.

2. Gamble M. 5 traits of high reliability organizations: how to hardwire each in your organization. Becker’s Hospital Review 29 Apr 2013. Accessed at www.beckershospitalreview.com/hospital-management-administration/5-traits-of-high-reliability-organizations-how-to-hardwire-each-in-your-organization.html.

3. Stockmeier C, Clapper C. Daily check-in for safety: from best practice to common practice. Patient Safety Qual Healthcare 2011:23. Accessed at psqh.com/daily-check-in-for-safety-from-best-practice-to-common-practice.

4. Creating situational awareness: a systems approach. In: Institute of Medicine (US) Forum on Medical and Public Health Preparedness for Catastrophic Events. Medical surge capacity: workshop summary. Washington, DC: National Academies Press; 2010. Accessed at www.ncbi.nlm.nih.gov/books/NBK32859/.

5. TeamSTEPPS. Available at www.ahrq.gov/professionals/education/curriculum-tools/teamstepps/index.html.

At the conclusion of the call, the DSB report is completed and posted to a shared website on the hospital intranet for the entire hospital to access and read. Feedback from participant indicated that they found it cumbersome to access this. The communications department was enlisted to enable easy access and staff can now access the DSB report from the front page of the hospital intranet.

Outcomes

Our DSB has been in place for almost 3 years. Surveys of particpants before and after introduction of the DSB have shown that the DSB has led to increased awareness of safety issues among participants ( Table 2 ). Twelve months after DSB implementation, participants were asked to indicate average number of their staff who join the DSB, if they had a standard process for sharing information from the DSB with their staff, and knowledge of DSB information being available on the hospital intranet. Most departments had an average of 3 staff listen or participate in the daily calls, 64% had a standard process for sharing information with staff, and 75% were knowledgeable about accessing DSB information from the intranet. Participants also identified what they found most helpful about the DSB. Responses included the readily available information on hospital census, surgeries, and planned visits, overview of potential safety concerns, the ability to follow up on issues with key stakeholders immediately after the call, and the improvement in hospital throughput as a result of the interdisciplinary calls.

Since initiation of our DSB, we have tracked the average number of minutes spent on each call. When calls began, the average time on the call was 12.4 minutes. With the evolution of the DSB and coaching managers in various departments, the average time on the call is now 9.5 minutes in 2015, despite additional reporting departments joining the DSB.

A final outcome that is important to highlight is time to issue resolution. Outstanding issues are tracked and recorded on a living document for follow-up. Reporters are expected to update the issues daily until resolved and will be asked by the leader to provide an update if the information is not provided during their report. Figure 2 shows the number of outstanding issues and the number of days to issue resolution over a 30-day period.

Summary

The DSB has become an important tool in creating and moving towards a culture of safety and high reliability within the MetroHealth System. Over time, processes have become organized and engrained in all departments. This format has allowed issues to be brought forward timely where immediate attention can be given to achieve resolution in a nonthreatening manner, improving transparency. The fluidity of the DSB allows it to be enhanced and modified as improvements and opportunities are identified in the organization. The DSB has provided opportunities to create situational awareness which allows a look forward to prevention and creates a proactive environment. The results of these efforts has made MetroHealth a safer place for patients, visitors, and employees.

Corresponding author: Anne M. Aulisio, MSN, aaulisio@metrohealth.org.

The Daily Safety Brief in a Safety Net Hospital: Development and Outcomes

References

Outcomes

Summary

Pages

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