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Creating and fostering culture of patient safety

Deputy Commanding General Regional Health Command-Pacific

Published: 12:14PM February 6th, 2017
150423-D-WR005-004

U.S. Army Photo / 2015

Command teams and key staff members from the, then, Pacific Regional Medical Command, along with military and civilian medical partners from throughout the region take part in the High Reliability OrganizationSummit held at the Hale Koa Hotel in Honolulu in 2015.

Two years ago, the U.S. Army Medical Department set in motion a strategy to become a High Reliability Organization, while setting the national standard for patient safety.

By definition, HROs meet the standard for their industry by having well-established policies and systems in place that ensure consistency of practice and enable them to reach their safety goals while avoiding errors. Nonmedical examples of HROs include: Air traffic control systems, nuclear power operations and amusement parks.

Three critical components of an HRO include: An active leadership commitment, a culture of safety throughout the organization and the deployment and adoption of robust process improvement methods.

In Army Medicine, safety is everyone’s responsibility, which is why we encourage reporting, transparency and honesty. The goal is to eliminate preventable harm in our treatment facilities.

Throughout the Regional Health Command-Pacific, we continue to make progress toward implementing the tenets of HRO by successfully changing the organizational culture, enhancing safety processes, and optimizing health readiness for those we serve.

Since 2015, a variety of initiatives have been implemented to help create a shared mental model for what quality and safety in a health care organization should look like.

A key component of an HRO’s success is open and transparent communication. The teams at our facilities in the Regional Health Command-Pacific are trained on the Department of Defense-developed Team Strategies and Techniques to Enhance Performance and Patient Safety Program — often referred to as TeamSTEPPS. This program teaches teamwork and communication skills to health care personnel, and it establishes every individual as an important member of the team.

We have hosted HRO summits in Hawaii and at Joint Base Lewis-McChord to increase awareness, facilitate training and share information and best practices. Our region has also led efforts in standardizing how surgical huddles and procedures are performed by our health care teams.

In the near future, we will be implementing radio-frequency identification technology in our operating suites to ensure an accurate accounting of surgical sponges following each procedure.

More recently, representatives from the Regional Health Command-Pacific attended an Army Medicine summit on quality and safety to discuss processes as they relate to Unintended Retained Foreign Objects and Wrong Site Surgery. Among the outcomes of those discussions was the establishment of a long-term working group to capitalize on the forward progress being made in the area of patient safety.

Regional Health Command-Pacific has also seen an increase in our overall patient satisfaction scores that now exceed 90 percent. At Madigan Army Medical Center, at JBLM, and Tripler Army Medical Center, in Hawaii, the region’s largest medical centers, patient satisfaction continues to rise, alongside our expanding efforts in our patient safety program.

Also noteworthy is that all Army hospitals and clinics are fully accredited by The Joint Commission, an external agency that also accredits civilian hospitals. The Joint Commission accreditation demonstrates Army Medicine’s commitment to providing the highest quality patient care and a relentless focus on safety.

Since adopting the HRO principles, Regional Health Command-Pacific, along with the entire AMEDD, continues to make significant progress toward optimizing patient safety processes across the enterprise.

Today, Army Medicine is much closer to accomplishing its goal of zero preventable harm in a safety-focused environment.