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Patient safety is a basic requirement of care delivery, but it can be a challenging issue for many hospitals.

Patient safety statistics bear this out. An estimated 160,000 people lose their lives every year due to avoidable medical errors, according to a 2019 report from The Leapfrog Group.

As patient safety awareness week 2021 draws to a close, hospitals are renewing their focus on the issue, with all the resources available to them. This includes an emphasis on technology.

Bill Cox, system director of quality at Springfield, Illinois-based Hospital Sisters Health System, has been leading a systemwide implementation of technology to enhance patient safety. He spoke with MedCity News about technology deployment, some of the hurdles the system has faced and the organizational culture change required to make it a success.

Note: Responses were edited for length and clarity. 

Question: What are your top patient care priorities this year?

Bill Cox: For HSHS, as with most organizations, we’re now coming out of the pandemic and trying to regroup and refocus where we want to put our energy for patients. In early March, we finished our systemwide implementation of electronic hand hygiene monitoring from SwipeSense at all of our 15 hospitals. Improving hand hygiene compliance to prevent hospital-acquired infections and the spread of infection will be a top focus for all of our hospitals because it is so important for patients.

We’re also continuing with a patient care priority that we launched shortly before the pandemic, which is the early recognition of opportunities to improve safety and reduce harm before it happens. We call it our ‘good catch program,’ and the goal is to empower staff to bring issues to our attention, take ownership of their role in patient safety and be active enablers of solutions to these problems. We recently had a pharmacist find the wrong medication in boxes from the manufacturer, and [they] were able to alert all of our pharmacies systemwide to prevent a very serious error on a pediatric patient. We also alerted the manufacturer who did a nationwide recall as a result of our notification.

Lastly, part of our strategy for enhancing safety and engaging patients is looking at ways to optimize our EHR. We’ve used our EHR to schedule vaccine appointments and were able to send patients a text with direct access to their medical records. We’re looking to find more patient-friendly opportunities to leverage the EHR to not only provide better care, but also to help patients to have better access to their healthcare data and scheduling options to inform their own care.

Question: What types of technology are you looking to implement to enhance patient care in 2021?

Bill Cox: We’re excited about taking a systemwide approach to our patient safety technology in 2021. We just finished our big install of SwipeSense electronic hand hygiene monitoring on March 1, and with HSHS being 15 hospitals spread across two states, that systemwide approach is very important.

We’ve really begun to try to standardize and bring our organization to a true system functionality, especially for critical new technologies like electronic hand hygiene monitoring. We knew that improving hand hygiene was the No. 1 way of preventing infection, [and] once we piloted the technology and saw its success, our team and CEO felt it was vital to have [it deployed] systemwide to protect our patients and staff.

We’re also beginning to look into ways to track assets that can keep patients safer, like tracking telemetry boxes with patients, but it is still the very early stages of that work.

Question: What have been the most challenging aspects of technology implementation amid the pandemic? How has your organization overcome those challenges?

Bill Cox: Over the past year, we quickly learned that implementing technology during a pandemic required us to be as fluid as possible. We couldn’t be locked into a strict timeline with no flexibility or willingness to shift key milestones.

Once lockdown began, we had to rethink our timing and learn to plan for uncertainty. We put the majority of the in-hospital implementation work on hold with tentative plans to restart in the fall of 2020. But then we had a new set of challenges [around] accessibility in areas because of Covid units and wanting to keep everyone as safe as possible. Again, we had to rethink some of our planning and ensure that we had open lines of communication across the hospitals in our system, technology partners and leadership. Without having open and flexible lines of communication, we couldn’t have pulled off [tech] implementation during this challenging time. We also had the buy-in of our system CEO — who was a nurse and understood the need — and from other top leadership, which was crucial for us to be able to not only move forward but also to spread the word in a positive manner.

Question: Why is organizational culture change important when new technology is being brought into a health system?

Bill Cox: Change is always difficult — and change across 15 hospitals is change magnified times 15. Since electronic hand hygiene was a new technology, the culture change and education was really about the value of moving from a manual process to an automated process. We knew that driving this organizational culture change was important to getting staff buy-in. We had to get staff [to] buy into the rationale for a new electronic process and emphasize that it’s best for our patients. We knew that without staff buy-in, we’d have to fight an uphill battle all of the time.

Question: How are you managing that culture change at Hospital Sisters Health System?

Bill Cox: Managing culture change is a very active and ongoing process. In addition to getting buy-in from leadership early, we’ve made it a priority to continue to proactively address concerns that may arise from any staff at any hospital about the technology or about patient and staff safety overall. We know that we’ll have to continue to adapt and be thoughtful about the pace of change and our expectations. We’re flexible enough to know that things will come up, but we can always work together toward the best solution.

With any technology or culture change, there will always be people who don’t like the new process and question everything. The important work is engaging in that conversation to tell them and show them how it’s valuable and how it truly changes outcomes for our patients. We put the facts and information in front of them early and often to encourage them to keep patients top-of-mind.

We’re also continuing to communicate about hand hygiene compliance goals in our monthly systemwide newsletter. We’re celebrating hospitals that become members of our ’90s club’ by achieving 90% or higher rates of hand hygiene compliance. Similarly, we’re celebrating departments with top results and sharing their successes with their colleagues to inspire them and create healthy competition.

Moving forward, we’ll continue to track results and then show how infections go down because of the increasing compliance rates — and we’ll emphasize how this is helping both patients and our organization.

Photo: ipopba, Getty Images



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