For the past several years, we’ve seen the value of assigning a Hospital executive to support a unit’s patient safety efforts. The leaders who participate in executive safety rounds, including Dean Ed Miller, Judy Reitz and me, regularly meet with caregivers in our adopted units. We examine trends, discuss improvements needed after patient-harm events, and look proactively to reduce risks. These units know that when they want to make changes in the name of safety, they’ll have an advocate who understands their needs.
Yet this successful strategy should be just a piece of a broader effort to get more managers increasingly involved in patient safety and quality improvement. As the next logical step in this evolution, our functional unit administrators need to play a larger role by making themselves more available to solve problems and provide critical support to safety initiatives in the clinical arena.
Based on my experience as an executive champion, I’ve found that nurses and other care providers sometimes don’t know whom they should contact for problem resolution. It wasn’t like that when I joined Hopkins in 1973 as an administrative resident and later as a clinical administrator. Admittedly, those were much simpler times for those of us in health care administration. I was able to spend considerable time on the units and came to know all of the nursing unit managers on a first-name basis. They understood that they could seek me out if there were issues that went beyond their immediate sphere of influence. However, over recent decades, through no fault of their own, clinical administrators have become more office-bound, increasingly focused on the financial aspects of running a unit and less involved in clinical operations.
There are several things that administrators can do—and several already have—to reverse this trend. They can help ensure that accurate and timely safety measures, such as infection rate statistics, are readily available so caregivers can track progress. Administrators can help units get the resources they need, financial or otherwise, to support their safety agenda. And they can help solve problems by serving as the interface between the clinical units and other central departments upon which they depend.
Finally, I’d like to see more of them become experts in the science of safety by getting training in techniques, such as Lean Sigma, for streamlining processes, reducing waste and cutting down on errors. Training is available here through the Center for Innovation in Quality Patient Care. This kind of leadership can help units develop tools they need to reach a higher goal: undertaking safety projects on their own and feeling empowered to do so.
