A new PowerPoint template for external presentations

1
Walking the Talk at Toronto Rehab

Katarina Stanisic, RN, BN, MN (Student) Patient
Safety Officer QHN Open House Patient Safety
Leadership Walkarounds Sunnybrook Health Sciences
Centre, Tuesday May 27, 2008
2
Our goalsWhat might a transformed safety
culture look like?
Reporting of safety events and near misses-
promptly and without fear of repercussion leading
to greater safety for all. Enhanced employee
and patient satisfaction through trust in being
open about error in an environment that does not
seek individual blame, supports individuals and
patients involved in safety issues and
demonstrates accountability for improvement.
More effective relationships internally between
departments and programs who must work together
to resolve safety issues.
3
Six areas of focus for creating a strong Safety
Culture
4
Leadership Role

• Develop clear communication lines for reporting
  safety issues and incidents
• Launch leadership walks to demonstrate senior
  commitment to safety, generate dialogue with
  staff, nurture openness and build trust
• Support front line leaders to model a safety
  culture (e.g. leadership resource toolkit
  incident reports on RAD watch list escalate
  major safety issues and follow more minor
  improvements local interim solutions in a timely
  manner)

5
Phase 1-Prep Work

• Held two leadership half-day sessions on patient
  safety and culture
• Preparing for leadership walkarounds
• Culture Campaign (built on key principles of
  openness, disclosure, improvement and follow-up)
  
• Shared key messages-staff newsletter, broadcast
  emails, monthly leadership and staff meetings
• Developed the Managers Guide to Leadership
  Walks (outlining the purpose, objectives, walk
  team, scheduling, format, roles and
  responsibilities, etc)
• Developed walkabout and follow-up process
• Developed scribing form.

6
Phase 1-Walk Process (During)

7
Phase 1 A Closer Look

• CHALLENGES
• Moving beyond merely venting to the real
  patient safety issues
• Critical self analysis of practice as well as
  support services
• Involving support staff (non-clinical staff)
• Staff were waiting for a walk to raise concerns
  that resulted from processes either being poorly
  designed or poorly understood
• Follow-up
• Accountability (two-fold)
• Issue Repository
• Feedback to staff.

• SUCCESSES
• Staff were openly communicating about their
  concerns
• Identified many process barriers that were
  stalling improvement work
• Identified some more major issues which required
  escalation and a corporate response (i.e. falls)
• Allowed senior leaders to engage with front-line
  staff in their environment
• Allowed senior leaders to gain a better
  understanding of safety concerns.

8
Phase 2 Enhancements

• Developed escalation policy
• Developed e-Alert process
• Developed Excel database (while exploring other
  possibilities)
• Developed a shared drive and safety leadership
  distribution list
• Refined the Follow-up process
• Provided Pre-Walk Summaries (of the resolution of
  issues from the 1st phase of walks)
• Scheduled walks in non-clinical areas
  (maintenance, nutrition, CPD), while reiterating
  importance of the inclusion of housekeeping staff
  in clinical walks
• Revised manager guides (creation of non-clinical
  manager guide)
• Senior Leader's Tool to Promote Dialogue at
  Walks.
• Format 20-25 minutes with 5 minute debrief to
  review the follow-up plan (included travel time)
  bi-annual (excluding December and summer months).

9
Phase 3 Enhancements

• More narrow focus on issues only regarding
  patient or staff safety
• Revised escalation process and e-Alert process
• Move to database using Feedback Monitor Pro from
  rL Solutions
• Increase the content on the shared drive
• Better align and communicate the follow-up
  process with existing lines of accountability
• Revise the scribe form to include a section
  outlining the issues and plan of unresolved
  concerns raised at past walks
• Add pharmacy to the list of non-clinical areas
• Support services to be visited annually
• Secured time for walks in corporate calendar
  every April and October.

10
Take Home Messages

• Authentic support from the top-down is absolutely
  required (both for conducting the walks and
  consistently and insistently overseeing progress
  to resolution of issues and sustainability of
  improvements)
• Leadership walkabouts are one way by which senior
  leaders walk the talk (model the attitudinal
  shift required of other leaders and staff)
• Leadership walks do help uncover issues while
  showing a strong commitment to the values
  underlying culture (most notably, the concept of
  the learning organization).

11
Contact Me

• Katarina Stanisic
• 550 University Avenue
• 11th Floor, Suite 11036
• 416-597-3422, Extension 3815
• Blackberry 416-457-7587
• Pager 416-372-4992
• Stanisic.Katarina_at_TorontoRehab.on.ca