Carol Danielson has many responsibilities as senior vice president and chief nursing executive of Gwinnett Health System, but she considers patient safety her biggest role.
“The IOM report was a wake-up call for all of us,” said Danielson, RN, BSN, MHA, FACHE, NEA-BC. “When you consider up to 98,000 deaths caused by errors every year, that’s the equivalent of three 747s crashing every week. If that were the case, no one would ever get on an airplane.”
Hospitals like Gwinnett are learning from the safety-conscious cultures and practices that make aviation a high-reliability industry. “We know that culture creates a safer environment. So my biggest challenge is to change the culture, to get caregivers to think about safety in a different way.”
Three components affect patient safety, Danielson said. One is hiring leaders who set high expectations for employees. Two is hiring employees who hold themselves accountable and take their job seriously. The third is people holding each other accountable or peer accountability.
“The third is the hardest for nurses. No one wants to point out other people’s weaknesses or rat on them, but when someone says, ‘hey, you broke the sterile field,’ you’re speaking up for patient safety. That’s powerful coming from a peer.”
Errors happen, that’s a fact, Danielson said. “But everyone thinks that won’t happen to me.
When we can change that attitude to ‘that could be me next time,’ then we can see speaking up as a way of watching out for each other, as well as the patient,” said Danielson.
Gwinnett has been on its safety journey for two-and-a-half years. All employees receive safety education and training. Directors meet for a safety check every day to review the past day’s safety events and concerns from every unit. “When we hear a recurring theme, we assign a team to address that issue. We review a top 10 list of safety concerns every week,” she said.
Posters promote SAFE Behaviors. Safety coaches and leaders rounding to influence safety and talking to patients and clinicians keeps safety on people’s minds. Every unit is aware of safety stats for their unit and the hospital. “They get excited when it has been many days without an infection or event, but they really relate to the personal stories,” she said. “A time out in the OR may seem redundant and time-consuming, but you realize how important it is when you hear about a save.”
Gwinnett has seen its serious safety event rate decrease and will continue to implement new initiatives. Danielson finds something to get excited about every day. “I can see a difference in the units. There’s more awareness and we’re reporting more catches and less harm,” said Danielson. “This is the most fulfilling part of my job, because I know it will make a difference.”
