Growing A Culture of Safety

The Beginning Landscape

County-Run Level I Trauma Center, Lion’s Burn Center, Transplant Center, and Teaching Hospital with the largest free-standing trauma center west of the Mississippi26 Operating Suites and Procedure Rooms

1500+ cases per month (24/7, 365) Approximately 210 full-time employees

Affiliation with Univ. School of Med. So. NVFour-state catchment, includes: SW Utah; NW Arizona;

parts of Southern California; and Nevada Las Vegas: Major transient and tourist population

Recent EHR implementation

Presentation Objectives

Structural SupportTeam selectionLeadership SupportExpert Champions

Developing and growing SUSP conceptsStaff engagement

Enacting changeLessons Learned

Structural SupportTeam SelectionIdentify Team Requirements

Members: Strengths Technical Knowledge Personality Characteristics

Member Availability: Heavy OR days / times

Leadership Foster support at all levels of leadership

Procure Expert Champions Physicians, ancillary department heads, etc.

Develop educational opportunities relevant to employee populationEducation Day(s)

Identify windows of opportunityWeekend In-ServicesContest(s) with incentive(s)Partner with professional organization(s)

Offer CEU’s

Growing SUSP ConceptsStaff Engagement - Learning Can Be FUN!

Growing SUSP ConceptsStaff Engagement - Learning Can Be FUN!

Staff Education Day12 Education stations

Science of Safety Video Staff Safety Assessment Survey Numerous other educational opportunities

Staff volunteered for presentations at stations Employee-driven subject matter

Certificates of Appreciation awarded

Growing SUSP ConceptsStaff Engagement - Learning Can Be FUN!

Tidbit Trivia ContestTidbits of SUSP information emailed weeklyMonthly “Trivia Contest” about emailed tidbits

Score 100% to be entered in drawing Entrant name placed in drawing for $25 gift card Winners drawn at monthly staff meeting

Handouts with trivia questions and answers available at staff meeting

Partnered with local AORN ChapterEncouraged educational awarenessOffered free CEUs

Patient Positioning Safety Normothermia Sterile Technique

Growing SUSP ConceptsStaff Engagement - Learning Can Be FUN!

Staff Engagement OutcomesLearning Can Be FUN!

Education Day Reinforced team concepts and boosted morale Employee enthusiasm and participation

Tidbit Trivia Apathetic response

Decreased quantity of trivia and question complexity Posted hard copies of trivia and questions

Cancelled due to lack of participation Workstation access?

AORN Partnership / Educational Seminar Employee enthusiasm and participation

Weekend In-Services Employee enthusiasm and participation

Nurturing New Growth Adding Nutrients

Utilize Staff Safety Assessment Survey Results Act on issues identified by staff

Share evidence-based SUSP informationKnowledge improves acceptance

Develop Cheerleaders!Garner employee support to promote SUSP concepts

Watching It Grow!Added physician championsIncorporated new WHO timeout guidelinesIncorporated Central Line Bundles in ORImproved Hand-off Communication

Beta BlockerIsolation

Moved clipping from OR to Pre-OpImproved patient education Easier access to hand sanitizersIntegrated charge RN meetingsImplemented PUP in pre-op holding

Watching It Grow!Senior leadership empowers RN’s as patient

advocate

Distribution of SUSP ConceptsSurgery ResidentsMonthly Meetings

Surgery Committee Meeting CAUTI Meetings

Weeding Out The UnwantedHasty departures from pre-op holding

Poor communication habitsPPE excursions outside the ORPoor hand hygieneKnowledge deficits“Silo” mentalityOperative positioning tissue injuries

What Have We Learned?SUSP Project

Success = Dedication! Initial enthusiasm begins to wane in 2nd year Need revitalizing booster shot

Not everything works as planned i.e. Tidbit Trivia

Surgical Site Infections (SSIs)↑ Rate of CABG SSIs after EHR implementation

Suspect: WOW usage / Inadequate hygieneImproved knowledge [may not] translate to practice (SSI’s can ↑)

Expect Resistance - Old habits die hard !

UMC’s Future Landscape

Sprouted new initiatives!SUSP “Tidbits” Repurposed

Infection Control Committee Meetings

Skin Council Meeting Articles in

WOW pop-up hygiene reminders

More To Come….Posters promoting xxx days

without an SSIPosters promoting xxx

procedures without an SSIService Line Incentive

Competition

Thanks for joining us!

Questions?