Archive April 2017 XVIII, No. 4

Safety Starts at the Top

Leadership is the first key to prevention.

Bill Donahue, Senior Editor


OR staff LOOKING UP Your OR staff will see how your facility's leaders prioritize patient safety and follow their example.

Anesthesiologist Kenneth P. Rothfield, MD, MBA, CPPS, can hardly wait to hand $500 to a housekeeper who tells a doctor, "You forgot to wash your hands." Some context: He's referring to a patient-safety award his employer started in 2015. The award grew out of a workplace culture designed to empower and encourage every team member — from the newly hired housekeeper to the longest-tenured surgeon — to speak up if they see something that might contribute to an adverse patient outcome.

Dr. Rothfield points to one statistic as proof that every healthcare organization needs to make the prevention of avoidable errors "not only a priority but the priority": As many as 250,000 Americans die each year as a result of medical errors — the third leading cause of death in the United States, behind only heart disease and cancer, according to the U.S. Centers for Disease Control and Prevention. But how do you go from prioritizing safety to creating a culture? It begins with a commitment from an organization's executive leadership that filters down to the OR in the form of actions staff can see, feel and experience every day.

"There's no substitute for committed leadership that's ready to walk the talk," says Dr. Rothfield, system vice president, chief medical officer and chief quality officer at St. Vincent's Healthcare in Jacksonville, Fla. "If we don't do that for our frontline staff, we run the risk of doing harm to somebody."

One brick at a time
Creating a pervasive culture of safety might sound like a monumental task, especially if you're starting from scratch. So don't try to solve everything at once, says Mark P. Jarrett, MD, MBA, MS, senior vice president and chief quality officer of Northwell Health, a New Hyde Park, N.Y., health system that includes 21 hospitals and 500 ambulatory sites.

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