Becker's Clinical Quality & Infection Control

19 QUALITY IMPROVEMENT & MEASUREMENT The system doing root cause analysis of root cause analyses By Mariah Taylor U Chicago Medicine is one of 12 hospitals in the nation with a 26-year, Leapfrog straight-"A" streak and Stephen Weber, MD, said the secret is to never be satisfied. "Whether I'm seeing patients or working in my administrative role, we constantly identify opportunities to provide safer care," Dr. Weber, chief medical officer and executive vice president for clinical effectiveness at UChicago, told Becker's. "While we are recognized as one of the safest hospitals in the country, we remind ourselves that hospitals remain inherently risky places. Our mindset is one of intolerance toward potential risks and maintaining not just vigilance, but a certain level of dissatisfaction with our current performance, is crucial — even when we are performing at the highest levels." UChicago has two main initiatives that have helped it maintain its high safety ratings. e first is called the Frontline First program, what UChicago calls a proactive approach to getting feedback from those at the bedside. Anyone in contact with patients, regardless of role, is encouraged to share their observations for improvement. "e foundation of all safety initiatives lies at the bedside, in the clinics and in the ED," Dr. Weber said. "e true heroes are the frontline caregivers making the right choices every day and putting patients first. Our role is simply to support them in delivering the safest care possible." e second initiative is UChicago's executive risk and safety committee. "Most health systems conduct rigorous root cause analyses to investigate safety events," Dr. Weber said. "What we've done is take that process a step further by creating a root-cause analysis of the root-cause analyses." e monthly meeting brings together different leaders, providers and practitioners to review all root-cause analyses and asks one question: "Are we satisfied that the work plan from this analysis will have the desired impact?" "is added layer of scrutiny ensures a higher level of safety beyond accreditation standards and what most organizations typically do," Dr. Weber said. "It's an extra level of protection and confidence." e committee allows leaders to dive deeper and draw connections between different safety events. For example, Dr. Weber said the staff may identify a link between a patient's fall and a bloodstream infection, which points to larger issues in culture, supervision, communication or expectation. "is approach helps us see patterns and address root causes from a broader perspective," he said. ere has never been a meeting without leaders identifying a new thread to explore, and the issues are ever-changing. What was identified two or three years ago is not the same as what the committee is identifying now. "at's exactly how it should be — continuously peeling back layers to get to the root root causes, refining our approach and driving ongoing improvement," Dr. Weber said. n Access tops list of Americans' healthcare concerns: 4 survey findings By Erica Carbajal A quarter of Americans rank healthcare access and affordability as the top public health priority they want government leaders to focus on, according to poll findings from Gallup and Emory University's Rollins School of Public Health. A greater percentage of respondents — 52% — placed access and costs among the top three public health priorities. The Rollins-Gallup Public Health Priorities survey asked 2,121 U.S. adults about their biggest public health concerns, how the government could most effectively address them and what sources of information they trust most. The online survey was conducted between Dec. 2-15. Four key findings: • Twenty-five percent of respondents selected access and affordability as their highest priority when asked about 15 issues. Eighteen percent chose food and water safety as their top priority issue while 11% chose reducing chronic disease. • Overall, 37% of respondents included food and water safety among their top three public health priorities; 32% said addressing chronic diseases was among their top three. • Most Americans agree that the federal government could more effectively address these issues than state governments, the findings showed. For instance, 75% of respondents who chose access and affordability as a top priority said the federal government is better suited to address this issue than state governments. The same was true among those who identified pandemic preparedness, strengthening safety net programs and addressing health effects of climate change as top priority issues. • When asked about their most trusted sources of public health information, respondents chose their healthcare providers (54%), scientific research (42%) and the CDC (37%) as their top three. Political officials were among the least trusted sources of information on public health issues. "The survey reinforces that Americans, across demographics and party lines, mostly agree on the public health issues that touch their daily lives," Stephen Patrick, MD, chair of the Department of Health Policy and Management at Atlanta-based Emory University, said in a Feb. 4 statement. "Public health is at a crossroads, but the survey is clear — Americans think we have more work to do. Prioritizing these issues in the new administration could be unifying." n

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