Putting the ‘safe’ in safety: Kellogg Eye Center engages staff in high reliability work
On a recent weekday morning when Kellogg Eye Center (KEC) clinics would normally be filled with patients, the waiting rooms were empty and the halls were quiet. Every KEC clinic postponed daily operations for one hour to host a “safety morning” for faculty and staff.
As Michigan Medicine celebrates National Patient Safety Awareness Week, here’s a closer look at the efforts KEC has made to improve patient safety — and how they can be translated and implemented in your area of the organization.
This was the second annual safety morning held by KEC, with the goal of providing faculty and staff with dedicated time to have conversations about safety and speak up about possible process improvements.
“This year, we had a higher rate of attendance and greater participation by faculty and staff at all of our clinics,” said Jennifer Weizer M.D., Professor of Ophthalmology and Visual Sciences at Michigan Medicine. “We were very pleased to see our colleagues’ level of engagement and thoughtfulness. Their open discussions led to several improvements that we have already started implementing across our clinics.”
Due to the COVID-19 pandemic, each clinic hosted a meeting with virtual participation in which faculty and staff discussed high reliability principles and patient safety protocols specific to their clinic’s needs.
“Faculty and staff in each clinic see different patients and perform different procedures, so each clinic experiences its own frustrations,” said Weizer. “While we try to keep standard processes and procedures across clinics, we wanted to give our teams the freedom to discuss issues specific to their experiences and maybe tweak processes to better meet their needs.”
Hosting each session virtually enabled Weizer and other KEC leaders to join individual groups and engage in conversation with each team. At the end of the day, they were able to gather all of the feedback they heard and identify common themes that they could address.
“It was really important for us to spend time with each clinic, listening to the suggestions that our teams raised,” said Weizer. “We want everyone to know that we hear them and take their feedback seriously. Our team members are committing their time to attend safety morning, so we want to respect that by demonstrating our commitment to listening and addressing issues and concerns.”
A common theme identified this year was finding ways to integrate high reliability principles into everyday work.
“All of us have taken high reliability organization [HRO] training and we talk about the principles, but putting them into action is more difficult,” said Amy Duoxi Zhang, M.D., Assistant Professor of Ophthalmology and Visual Sciences, who helped facilitate the safety morning at the Northville clinic. “For example, during our session, one person spoke up and said it is difficult to adhere to some HRO principles because they are uncomfortable asking a question or raising a safety concern when the patient is in the room. Several other participants agreed and it sparked a really important, thoughtful conversation.”
The team shared the issue with leadership who took the suggestion to the KEC Safety Committee for further discussion.
“Thanks to one person speaking up, we were able to identify a solution that helps all of our team members feel more comfortable asking questions and clarifying protocols, even when a patient is in the room,” said Zhang.
Results from the morning were compiled and shared with teams from every clinic, enabling all areas to learn from one another.
“It was important to pull together highlights from what we learned and share them across clinics to ensure we aren’t working in silos,” said Weizer.
Making ‘safety mornings’ work for you
The team plans to keep focusing on patient safety and continue providing faculty and staff with dedicated time to address issues or concerns they have.
“We are looking at expanding existing huddles a few times a year to keep the conversation going, and we will continue to hold safety mornings annually,” said Weizer.
Weizer and Zhang also offered suggestions for other areas interested in holding a safety morning.
“The KEC Safety Committee put together a lot of materials ahead of time, identified a facilitator for each clinic, and shared an agenda for the day that clearly outlined goals for the morning,” said Zhang. “This was incredibly helpful for helping us understand the purpose of safety morning, but also allowing flexibility to focus on items specific to our needs.”
Having dedicated time for faculty and staff to attend is also important.
“Delaying appointment times for an hour gave our teams time to have meaningful conversations because no one felt pressure to get back to work immediately,” said Weizer. “We can be so rushed in our day-to-day work that it’s difficult to focus on improvements and make sustainable change. Safety morning is a helpful solution!”