Issue link: https://beckershealthcare.uberflip.com/i/626854
9 PATIENT SAFETY A hospital's safety culture — not just a sur- geon's skills or the equipment available — has a measurable effect on surgical out- comes, according to a study in the Journal of the American College of Surgeons. Martin Makary, MD, a professor of surgery and health policy and management at Johns Hopkins University School of Medicine in Baltimore and an author of the study, says the piece "affirms what many of us have known for a long time" — that orga- nizational culture matters for patient outcomes. Dr. Makary and the team of researchers partnered with seven hospitals from the Minnesota Hospital Association to evaluate their safety culture and sur- gical site infections for colon surgeries as a measure of surgical outcomes. e study is one of the first to evaluate the effect of an organization's safety culture on outcomes. To determine the level of safety culture in each hospital, employees in each hospital's surgical unit responded to the Hospital Survey on Patient Safety Culture, available from the Agency for Healthcare Research and Quality. e survey measures 12 safety culture factors. e study found that hospitals with a higher pa- tient safety culture score had lower SSI rates. Addi- tionally, it found that of the 12 factors in the survey, 10 were found to influence SSI rates aer colon surgery in hospitals: • Overall perceptions of patient safety • Teamwork across units • Organizational learning • Feedback and communication about error • Management's support for patient safety • Teamwork within units • Communication openness • Supervisor or manager expectations of actions promoting safety • Nonpunitive response to error • Frequency of events reported For hospitals looking to improve safety culture, the study suggests efforts such as OR briefings, pre- operative checklists, TeamSTEPPS and the Compre- hensive Unit-based Safety Program. However, Dr. Makary says, "e No. 1 driver of good safety, in my opinion, is the leadership of a unit or service line and the hospital." When leaders are frequently on the unit and helping solve disputes or interacting with staff and acting on their recommen- dations, that indicates a hospital is invested in safety, he says. n Workplace Culture Proves Essential to Improving Surgical Outcomes By Heather Punke Report: Unsafe Injection Practices a Serious Patient Safety Issue By Max Green M ore than 9 percent of primary care organizations and 10 percent of ambulatory surgery centers have deficien- cies in their safe injection practices, according to the Accreditation Association for Ambulatory Healthcare Insti- tute for Quality Improvement's Quality Roadmap. This is the first time in the three-year history of the report that injection practices have been flagged as a top deficiency. "Now that we have determined the prevalence of this problem, AAAHC and the AAAHC Institute are committed to raising awareness of proper injection practices and providing education to the field," Naomi Kuznets, PhD, vice president and senior director at the AAAHC, said in a statement. The report cites newly mandated CMS reporting related to reuse of needles, syringes or multidose vials as one possible reason for the high rate of deficiency. The mandate may have made unsafe injection practices more visible and increased surveyor scrutiny of providers for the report. To address the issue, the AAAHC has partnered on the CDC's One & Only Campaign, which focuses on eliminating infections linked to unsafe injection practices. The AAAHC plans to release educational resources in the form of a toolkit aimed at ambulatory providers in 2016 to supplement materials the CDC has released in conjunction with its campaign. n