Article type
Year
Abstract
Background: The Children’s Hospital of Philadelphia (CHOP) has created an infrastructure to foster patient safety (PS) and communication across disciplines, across units, and between unit-based and executive leadership.
The patient safety program at CHOP: Patient safety programs must be designed to consider the following organizational factors: Structures (formal reporting relationships and grouping of individuals). The Chairs of the Academic Departments and hospital Chief Operating Officer (COO) supported the formation of Departmental Patient Safety Officers (d-PSOs) from the key clinical areas who work with both hospital leaders and unit-based clinical leadership. Systems (ways tasks are organized and completed). To support collaborative work and learning, multi-disciplinary micro-systems were created at the unit level with nurse/physician partnerships, Quality and PS Committees, quality coordinators, and systems which allow staff of all levels time to participate in PS meetings and walk-rounds. Leadership (support from multiple champions from different areas of the organization). Physicians, key members of PS teams, were provided with protected time and financial support to partner with nursing staff at the unit level and to create d-PSOs to promote communication between the units and the hospital administration. Culture (beliefs and assumptions that guide activities). A 'just culture,’ where individuals feel free to report and learn from safety events (without feeling threatened by the consequences), has been introduced. The Unit-based PS walk-rounds and unit-based Quality and Safety Committees allow all staff, clinical and non-clinical, to identify safety issues and practices, foster communication, and promote analysis of problems. Politics (use of power to accomplish particular goals). The PS program was facilitated by recognizing and working with varying power levels within units (micro-system) and the hospital leadership (macro-system).
Conclusions: At CHOP, the alignment of organizational structures, systems, leadership, culture and power have established the foundation for becoming a high reliability organization in regards to patient safety.
The patient safety program at CHOP: Patient safety programs must be designed to consider the following organizational factors: Structures (formal reporting relationships and grouping of individuals). The Chairs of the Academic Departments and hospital Chief Operating Officer (COO) supported the formation of Departmental Patient Safety Officers (d-PSOs) from the key clinical areas who work with both hospital leaders and unit-based clinical leadership. Systems (ways tasks are organized and completed). To support collaborative work and learning, multi-disciplinary micro-systems were created at the unit level with nurse/physician partnerships, Quality and PS Committees, quality coordinators, and systems which allow staff of all levels time to participate in PS meetings and walk-rounds. Leadership (support from multiple champions from different areas of the organization). Physicians, key members of PS teams, were provided with protected time and financial support to partner with nursing staff at the unit level and to create d-PSOs to promote communication between the units and the hospital administration. Culture (beliefs and assumptions that guide activities). A 'just culture,’ where individuals feel free to report and learn from safety events (without feeling threatened by the consequences), has been introduced. The Unit-based PS walk-rounds and unit-based Quality and Safety Committees allow all staff, clinical and non-clinical, to identify safety issues and practices, foster communication, and promote analysis of problems. Politics (use of power to accomplish particular goals). The PS program was facilitated by recognizing and working with varying power levels within units (micro-system) and the hospital leadership (macro-system).
Conclusions: At CHOP, the alignment of organizational structures, systems, leadership, culture and power have established the foundation for becoming a high reliability organization in regards to patient safety.