Issue link: https://beckershealthcare.uberflip.com/i/1161749
58 CMO / CARE DELIVERY 150+ employees potentially exposed to dangerous bacteria at Seattle hospital By Anne-Marie Kommers O ne hundred and fifty-eight employees at Seat- tle-based Harborview Medical Center received tests and treatments after potential exposure to the Bru- cella bacteria, which can cause an infectious disease called brucellosis, according to KIRO 7. A patient was transferred to Harborview from another hospi- tal in late June, and tests later showed the patient had bru- cellosis. A lab worker also dropped a test tube with the Bru- cella bacteria in it on June 25, which may have exposed other lab employees. The Harborview employees have been offered antibiotics and blood tests and informed of the symptoms, which include fever, headache, and muscle and joint pain. Brucella can be deadly if left untreated. The disease does not spread person to person, however, so hospital patients, other employees, and exposed employees' families are not in danger of catching it. At the time of publication, employees' blood tests for Brucel- la bacteria had come back negative. n Over half of adverse surgical events due to human error, study finds By Anne-Marie Kommers O ver half of adverse surgical events are due to human error, meaning those events could have been pre- vented, according to a study published July 31 in JAMA Network Open. Researchers collected data from three adult teaching hospitals over six months. The hospitals performed over 5,300 surgeries during this period, 188 of which resulted in adverse events, including death and major complications. Of the 188 adverse events, over 50 percent, or 106, were due to human error. The researchers also organized the errors by type. They were surprised to find that errors related to communication, team- work and systems were relatively low. In contrast, over half of the errors were cognitive, involving lack of attention, lack of recognition and cognitive bias. "This means our efforts to optimize communication, team- work and system-related safety in our work culture have succeeded," said James Suliburk, MD, associate professor of surgery at Baylor College of Medicine in Houston and the study's first author. To further decrease preventable medical errors, the study suggests healthcare organizations should shift their focus to cognitive training and teach medical staff to recognize their own mental pitfalls. n how we got to our suite of best practices. We organized them around three different themes: • e first is creating a culture of wellness, so how can we create a workplace environment that really supports well-being and en- gagement? Some of the best practices in that area relate to having an organization focus, like a clinician well-being committee, or creating a mentoring or coaching program that allows folks to handle burnout or some of the stress you see in day-to-day life. • e second was about practice efficiency. As you talk to doctors, some of their biggest frustrations are with the EHR, and not hav- ing enough time to spend with patients because of the admin- istrative burden of practicing medicine. We have best practices to elevate the entire care team, so everyone is working at top of their license; to turn the EHR into a partner, so they can automate certain activities. We talked about how to do pre-visit planning or how to have a better rooming strategy or daily huddles to make sure everyone on the team is in the same place, or how to better manage your inbox so you don't get unnecessary messages. • e last section is on personal resilience. I think of this as how you make sure you have enough gas in the tank. You are always going to have good days and bad days, but you want to have reserve in your tank for those bad days. is is how to practice mindfulness, stress management. We are a mission-driven organization, so a lot of this has to do with community-building and how you give back to your communities, which restores individuals as well. Q: As a physician and hospital leader yourself, what strategies work really well to manage stress for clini- cians? BY: As organizations start to focus on this, one of the most im- portant things is to start talking about it and put it out there that this is an issue. We established clinician engagement and well-be- ing as a priority, and we put people, processes and technology be- hind it. One of the first things is recognizing it and talking about it. You would be surprised at how that elicits a lot of positive feed- back. en the issue is you must take it to the next step. It actually could backfire if you talk about it and don't do anything or offer things that are the "bare minimum" and very superficial, like doing a community-building event or offering yoga classes. You miss the root cause of the burnout, which is really how you create a better culture and a more efficient practice environment. at's what's really important for organizations: Start to speak about it and make it a priority, but also really invest in some of the tactical activities that relate to improving the efficiency of practic- es and the EHR, and specific things to improve the culture. Stress management courses and yoga are helpful, but not sufficient to re- ally move the needle in this area. Q: Is there anything else you think is important to men- tion? BY: e one other thing that comes up a lot in this area is we first focus on doctors, nurse practitioners, physician assistants, resi- dents and fellows, but really this work is for many people working in the healthcare space. While there is more literature and evi- dence-based best practices surrounding the physician community, this impacts nurses and other care team members. Over time, there needs to be more resources for other care team members, not just our clinical leaders and physicians. at's something we are look- ing at very closely because they are in similar stressful situations that require resources and strategy to support them as best as we can. n