Patient Safety Awareness Week 2022: embedding patient safety into HCA Healthcare’s culture

Culture of Safety

Safe, quality care doesn’t happen by accident; it must be embedded into an organization’s culture.

Across HCA Healthcare, patient safety and care experience teams are responsible for managing a federally chartered patient safety organization, and overseeing event reporting, patient experience, barcode medication administration and medication diversion prevention, among other programs.

These teams also are responsible for clinical pharmacy surveillance software, implemented to prevent life-threatening medication errors, improve patient outcomes and reduce drug waste.

“By assessing our practice locations, studying our outcomes and fine tuning our care processes, we continue to raise the bar for both our patients and our caregivers,” said Dr. Christopher Ott, chief medical officer of HCA Healthcare Physician Services Group. “Maintaining this culture of safety allows us to continuously improve the quality of patient care across our organization.”

Patient Safety Organization

HCA Healthcare’s Patient Safety Organization (PSO) was established eight years ago and has seen significant growth. The mission of HCA Healthcare’s PSO is to improve patient safety and the quality of healthcare delivery by partnering with its members to build systems, refine processes and foster a culture of safety. To fulfill this mission, HCA Healthcare:

• Established focused taskforces to address patient safety concerns
• Actively looks for opportunities that allow our front line experts to openly discuss, analyze and take action on patient safety concerns
• Conducts proactive risk assessments, process investigations and improvement initiatives
• Partners with clinical experts to disseminate “Calls to Action” regarding significant patient safety concerns
• Shares lessons learned from analyses of serious safety events in order to make improvements across HCA Healthcare
• Supports transparent patient safety event reporting and associated investigation and improvement

“Seeing the care, effort and time that HCA Healthcare invests into ensuring our patients are safe during their care experience is powerful,” said Dr. Karla Miller, HCA Healthcare’s chief patient safety officer.

“I am so proud to work in an environment that empowers our colleagues to reduce harm and provide safe care for our patients in a meaningful way,” adds Dr. Miller.     

Good Catch Program

Creating a culture of safety where our colleagues feel empowered to speak up is a key component to HCA Healthcare’s patient safety efforts. Our “Good Catch” program encourages and celebrates the reporting of potential errors, adverse events and close calls regarding patient safety. Reporting of close calls allows facilities to intervene and correct weaknesses in processes or systems before harm occurs. We scale the learnings from these events across our organization to improve patient safety and the quality of healthcare delivery.

While patient safety is at the forefront of all of our colleagues’ interactions with patients, three HCA Healthcare facilities stood out in 2021 for their efforts to reduce harm and provide safe care for their patients. The 2021 frontrunners of HCA Healthcare’s “Good Catch” program were:  

• Centerpoint Medical Center (Independence, Mo.)
• Largo Medical Center  (Largo, Fla.)
• Medical City Surgical Center Calloway Creek (North Richland Hills, Texas)

Christy Gudenkauf serves as the Director of Patient Safety and Risk for Centerpoint Medical Center in Independence, Missouri. In her role, she works to understand the “why” behind a patient safety event. She collaborates with every department and colleague in her hospital to determine how to improve processes.

“We strive to build trust as an integral part of our culture. Each person in our facility is responsible for patient safety and for the safety of their colleagues,” Christy said. “Some catches are small, some are big, but they all make a difference.” 

Caregiver Strategy

HCA Healthcare’s nursing strategy, which was developed entirely from the feedback of nurses, is the foundation of our nursing practice and an important part of our effort to keep patients safe.

Dr. Sammie Mosier, senior vice president and chief nurse executive, leads our nursing strategy and helps to ensure that patient safety is at the heart of everything we do at HCA Healthcare. She and her teams are highly focused on equipping nurses with the latest tools and resources to provide safe and effective care for every patient we serve.

As part of the nursing strategy, initiatives like new models of care to create more capacity and deliver the quality, safe outcomes our patients deserve are a center stone. With many new programs underway in our hospitals, HCA Healthcare is leveraging different skill mixes and ancillary models to support safe care, including testing new technology solutions to drive better care processes.

“Open communication among colleagues is key and sharing best practices is an important part of our patient safety strategy,” said Greg Beasley, president of the HCA Healthcare Ambulatory Surgery Division. “We guide discussions that identify potential risks and share lessons learned to ensure high-quality, patient-centered care is always top of mind.”

The HCA Healthcare Ambulatory Surgery Division consists of a comprehensive strategic quality team including Medical Directors at national, regional and surgery center levels, a Medical Executive Committee at each surgery center and a team of leaders dedicated to patient safety and quality. This comprehensive team works together to promote a culture of safety, proactively seek out risk opportunities and recognize colleagues who contribute to our patient safety initiatives.

Collaboration with Family

An important part of HCA Healthcare’s efforts to foster a culture of safety is a collaboration with patient families. We believe family is part of the care team and an important part of patient recovery, so we work hard to keep them connected to their loved ones. Even throughout the COVID pandemic when we have needed to limit traffic in our facilities, we have ensured that we keep family members connected through telehealth and many other safety-first protocols, and we have worked to revise and relax those protocols as soon as it has been safe to do so.

“Family members are an essential part of recovery, healing and a patient-centered approach to care,” said Jackie Blanchard, vice president of infection prevention. “Despite challenges of the pandemic and necessary restrictions, essential caregivers, especially those who play a critical role in the patient’s well-being, are provisioned for visitation, while we ensure that all infection prevention standards are followed.”

Our infection prevention team works closely with other teams such as neonatal intensive care units (NICUs) and home health and hospice agencies to maintain family connections in difficult situations while ensuring compliance with safety protocols.

In the NICU, we work hard to foster a nurturing environment for babies to bond with mothers, fathers and siblings, and families play a key role in keeping their babies stay safe while in our care. We make sure they know the importance of hand hygiene, other infection prevention measures and encourage them to notify the care team if something seems out of the ordinary with their baby.

Our Home Health teams provide care to allow patients to recover at home instead of at a hospital, and it is critical that we work with families to keep patients safe. We provide education on how to care for their family members in their own environment, arranging for needed equipment and training family members to use it. We also assist with finding community resources for patients in need.

In the Hospice environment, we provide education to families on helping to keep their loved ones safe in our care and offer volunteers to support families and give them a break when needed. Our Chaplain Services team provides counseling for patients and families, and we provide support for a year after a death to the family to help them through the grieving process. In this case, helping to keep patients and families as emotionally and mentally safe as possible is part of our commitment to caring like family.

Thank you to all HCA Healthcare colleagues for your steadfast focus on providing the best possible care for our patients. There is nothing more important than providing a safe experience for the people who entrust HCA Healthcare with their care.