Healthcare IT: Patient Safety, Engagement Relies on Crafting a Culture of Change

patient safety improvements through IT

What role does IT play in the improvement of patient safety? This article from Health IT Analytics helps to spread some light on the culture of change that will be needed to improve healthcare engagement outcomes:

Health IT Analytics Article Excerpt:

“Improving patient safety is primarily a matter of responsibility, says Dr. James Merlino, President and Chief Medical Officer of the Strategic Consulting Division of Press Ganey.  Healthcare organizations must take on the challenge of creating a “culture of care” that encompasses every member of the care team – including patients.

By broadcasting bold patient safety goals, engaging providers, and enacting patient-centric strategies for process improvement, healthcare organizations have the opportunity to make meaningful progress in the fight to reduce preventable patient harm.

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“Organizations really need to adapt a strategic objective of patient centricity,” Merlino toldHealthITAnalytics.  “They have to get across to everyone that works in healthcare that they exist for the patient, and that their purpose is to deliver on the promises that they implicitly make with their patients: providing a safe, high-quality, human environment where the patient feels cared for.”

To do this, organizational leaders have to be sure that their staff members are not only educated about patient safety risks, but fully committed to eliminating preventable harm all together. “You must set the goal at zero,” Merlino stated. “Patient safety must be an uncompromisable core value of your organization.” “What I find in some of the organizations that we work with is that they have differing degrees of alignment around the topic.  Obviously, nobody comes to work in healthcare because they think about wanting to harm a patient.”

“But accidents do happen, because we’re human.  We just need to think about how to integrate the best possible processes into the care system, and it has to start with a commitment from leadership to model these practices and create a culture that is deeply patient-centric.”

Read the full article on the Health IT Analytics website!

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How to Evaluate Effectiveness of Simulation

medical simulation evaluation

Evaluating the effectiveness of your medical simulations is a crucial component of building a successful long-term program.  On numerous occasions, the raw data we captured at the Clinical Simulation Center of Las Vegas over a period of many years eventually became critically important for arguments when requesting operational changes our lead administrators.  Not only this, but the use of a tool to gauge how simulations have performed is a necessary step in molding and shaping future experiential learning experiences.

Simulation scenarios should not ever be considered “final drafts” for the following reasons:

1) New clinical procedures or information may shift scenario goals.
2) New faculty may wish to modify existing templates to better angle their learning objectives.
3) Annual review by a simulation committee may provide for refined scenario designs which further empower learners.

The last point is best explained through the Japanese philosophy of Kaizen, which means “never-ending improvement”, a passion for making things better, the drive for perfection. In his book, “Kaizen”, Masaaki Imai says, “It means continuing improvement in personal life, homelife, social life, and working life. When applied to the workplace Kaizen means continuing improvement involving everyone–managers and workers alike.” Healthcare is a dynamic process, one that is always changing and reaching for improvement – and so should our simulation scenarios!

Check out this book I’m reading on Healthcare Kaizen:

“Healthcare Kaizen focuses on the principles and methods of daily continuous improvement, or Kaizen, for healthcare professionals and organizations. Kaizen is a Japanese word that means “change for the better,” as popularized by Masaaki Imai in his 1986 book Kaizen: The Key to Japan’s Competitive Success and through the books of Norman Bodek, both of whom contributed introductory material for this book.

In 1989, Dr. Donald M. Berwick, founder of the Institute for Healthcare Improvement and former administrator of the Centers for Medicare & Medicaid Services, endorsed the principles of Kaizen in the New England Journal of Medicine, describing it as “the continuous search for opportunities for all processes to get better.” This book shows how to make this goal a reality.”

So how to evaluate our healthcare simulations? CAE Healthcare is hosting this free reliable and validated Simulation Effectiveness Tool – Modified (SET-M) which was updated in 2015 by Kim Leighton and Team: Leighton, K., Ravert, P., Mudra, V., Macintosh, C. (2015). Updating the Simulation Effectiveness Tool: Item modifications and reevaluation of psychometric properties. Nursing Education Perspectives, 36(5), 317-323. Doi:10.5480/1 5-1671.

simulation effectiveness tool

Evaluation Tools like this that are handed out to your concluding simulation participants can help track the effectiveness of the engagement from the learners perspective. Use the Simulation Effectiveness Tool – Modified as a guide to building your own surveys which reflect the specific evolutionary needs of your program.

To really measure effectiveness, however, your program will need to invest in a learning management or audiovisual system that integrates real-time performance analysis software.  Most of the major simulation product companies provide for some level of performance tracking in their recording systems, but unless your simulation educators are actively recording this data while it occurs there will be no long-term program effectiveness evaluation. Administrators MUST understand the importance of capturing data as much as possible with everything possible in their simulation programs.

The types of data and how to capture them were covered really well during the 1.5 hour “Research” session of HealthySimAdmin – an HD-recorded two day event which sought to provide solutions for the “how-to” of managing a simulation program. You can still watch this and the remaining 13 hours of administrative content straight to your office or home. Get instant access to the opening session by subscribing to’s free newsletter, and learn more about how HealthySimAdmin can guide your program today!

Do you have another way to evaluate medical simulation effectiveness? Leave a comment at the bottom of this post’s webpage!

‘The Power of Video-Recording’ by JAMA Helps Demonstrate Why Simulation Will Become Defacto Healthcare Training Platform

Martin Makary, MD, MPH recently wrote an article entitled The Power of Video Recording: Taking Quality to the Next Level earlier this month for The Journal of the American Medical Association (JAMA).

video recording in medical services

Dr. Makary writes “At Indiana University, Rex et al2 decided to use the recording feature of colonoscopy video equipment to address the long-standing problem of quality variations in colonoscopies. Over several months, the investigators performed a blinded review of 98 colonoscopy videos performed by 7 gastroenterologists who were unaware that their procedures were being recorded. Procedure quality scores and mucosal inspection time data were collected based on established criteria. Wide variations in quality were found. The researchers then informed the gastroenterologists that their procedures were being video recorded and peer reviewed. Following the announcement, mean inspection time during colonoscopy increased by 49% and quality of mucosal inspection improved by 31%,2 suggesting a substantial improvement in quality because of the Hawthorne effect.”

Whether we like it or not, the increasing affordability of video-recording technology means 1984’s “Big Brother” is already here.  Cameras and recording technology will eventually become so cheap that video-surveillance will be utilized in all service-based engagements. Legal issues will simply become a matter of “lets watch the tape”.  To prevent malpractice suits, healthcare systems will eventually understand that an investment in training and video-recording will be the best ‘preventive maintenance’ possible against such claims.  This will obviously mean system providers will be forced to ensure competency as well as adherence to policy and procedure as all future services will be recorded.  Simulation, therefore, will be better understood by CFO’s to be an underlying training requirement to minimize risks, improve performance outcomes and maximize returns.  Mackay says this process is already underway:

“At the Brigham and Women’s Hospital, a coaching program was developed in which surgeons spent 1 hour reviewing their procedure videos with an expert. The video-based peer review informed the surgeons about alternative approaches to problems they encountered during their operations and how they could be more efficient. The expert reviewer also suggested ways to better position the patient, surgical assistants, the surgeon, as well as the surgical retractors for optimal exposure. All of the surgeons who participated in the program found the personalized feedback to be valuable. Such video-based quality improvement intiatives could be offered remotely and even draw on the collaborative efforts among multiple institutions in a patient safety organization. Developing independent coaching networks will require an investment by hospitals, professional physician associations, and a new infrastructure, but the potential reward of improving procedure quality and safety may be substantial.”

Read the complete JAMA article today to learn more!


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