It's really easy to make statements like “patient safety is our top priority.” That same statement can be applied to hospital staff, as well.
Or, it should.
When a hospital executive makes the “safety is always our top priority” statement, is it REALLY true? Is that statement backed up by action and integrity or does it just sound good?
The top priority comment is predictably almost always present in any news story about a medical error.
Listen to Mark read the post (Learn More):
From some recent stories:
“In response, UC San Diego Health System submitted plans of correction to the California Department of Public Health which were accepted and implemented. We remain vigilant in training employees to communicate quickly and effectively with our hospital security team so that responses to patient needs are timely, with safety as the first priority.”
Mark Twain Medical Center's statement on the matter, emailed by hospital spokeswoman Nicki Stevens, said “Patient care and safety is our top priority.”
“The hospital is doing its best to minimize inconveniences for its patients and visitors; moreover, there has been absolutely no compromise to patient safety, which is always the top priority of the JGH,” the hospital said in a news release issued Friday morning.”
Keeping in mind that an increase in “reported errors” doesn't mean that the actual occurrence of errors has increased. It could mean more honesty and more transparency.
“Patient safety is a top priority for our hospitals and we continually implement changes that result in significant improvements in patient care,” she said in a statement. “As part of our High Reliability Organization work recently, we have focused on encouraging staff to report any potential safety issues, which allows us to make improvements in our work and provide highly reliable care. “
So they admit that it hasn't ALWAYS been the top priority that staff haven't always been safe to speak up? Better late than never.
“Nancy Seck, director of quality management for Glendale Memorial, said in a statement that patient care and safety are the hospital's top priority and that doctors, nurses and caregivers work together to improve care every day.”
Improving together every day. That's the goal of Kaizen and some organizations have that culture. But, how does Glendale Memorial demonstrate that they are really improving every day? Do reporters press them on this? How can they demonstrate that they make safety a top priority over cost?
Sharing my view is Dr. Ashish Jha, professor of health policy at the Harvard School of Public Health and a top expert on patient safety:
“To be frank [safety] really isn't anyone's top priority — except maybe the patient,” Jha told me. Hospital CEOs generally don't get fired because of the hospital's infection rates. Salaries are tied to things like fundraising and having high-tech equipment. “There's no evidence that having a high infection rate or a high mortality rate has any effect on CEO salaries,” Jha said.
Compare this to the Toyota philosophy that safety is the gateway to all work. That's also a meaningless statement if it's not backed by action.
— Bret Burton (@BurtonBret) February 5, 2015
But, statistics show that manufacturing (even heavy industry) has done a better job of protecting employees from injury. Former ThedaCare CEO John Toussaint, MD pointed out that, at the start of their Lean journey, an employee at the hospital was more likely to get hurt than somebody working in a paper mill.
See this chart from a recent NPR story (which is a must read / must listen):
Whether it's patient safety or staff safety, leaders shouldn't make excuses about how these things are just bound to happen. We can do better – it's a combination of the right staffing levels, the right technology, and the right training… but is probably starts with the right leadership.
Hospitals are far too often not “walking the walk.” Even surveys of hospital executives show that they SELF REPORT that financial issues are more of a “top concern” than safety.
This is shameful. At least the spokespeople have figured out to SAY that patient safety is a top priority. But the CEOs don't. Some would say the CEOs think they have delegated safety to another leader. But, I think a Lean thinker would agree it's not possible to delegate safety or quality. Safety and quality starts at the top, as it does with ThedaCare's current CEO Dr. Dean Gruner, who I think sets a good example.
If I were to ask your hospital, “Tell me a story about a time recently where you demonstrated that safety really is the top priority, even over short term costs” — what stories would there be?
Come back Thursday as I'll share one hospital executive's story of a time safety was put first. I'd love to hear your stories. Post a comment below…
Do you want to see what a “culture of continuous improvement” looks, sounds, and feels like? Check out this workshop (more of a mini conference) that Joe Swartz and I are holding in April at his health system in Indianapolis. Please come join us.