Practice ForumA region addresses patient safety*
Section snippets
A design for change
Three years ago, leaders of the Jewish Healthcare Foundation, a Pittsburgh-based hospital “conversion foundation,” met with Alcoa's then-Chief Executive Officer, Paul O'Neill (now Secretary of the Treasury), to discover how his company was addressing safety, costs, and quality simultaneously and achieving remarkable results. On the basis of that encounter and with support from the Conference on Community Development, a civic organization comprised of influential business leaders, the Pittsburgh
Patient safety: a commitment to perfection
PRHI's Patient Safety Initiatives are designed to establish the means for continuously improving safety and performance in each partner organization, its units, and the teams of workers who compose those units. These initiatives are dedicated to establishing a sustainable, region-wide structure that supports the delivery of exactly what patients need, when they need it, and without waste or error. This effort rests on participants' shared belief that any time perfect patient care does not
Learning to count together
PRHI's patient safety work is performed on the basis of the dynamic use of systems-based approaches to identify and address problems as they arise. To fix and continuously improve processes of care and their resulting outcomes, PRHI partners are deploying common mechanisms for identifying, capturing, sharing, and acting on the basis of incidents in which process performance is not optimal. PRHI partners are learning to count together. Multifacility, multidisciplinary advisory committees that
Infection control: initial areas of work
PRHI's surveillance and data collection, initiated April 1, 2001, targets catheter-associated bloodstream infections on intensive care units. This starting point affords several advantages, described in the following:
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Data regarding this category of infection are already collected by area facilities. (However, before deploying NNIS regionally, the methodology was not consistent between facilities).
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The frequency of catheter-associated bloodstream infections is low relative to other categories of
Accelerating learning
On the basis of PRHI's patient safety component, the health care industry in Southwestern Pennsylvania should derive tremendous improvements in patient outcomes, operations efficiency, and worker satisfaction. To accelerate progress toward these objectives, this patient safety work will soon support broader integration with PRHI's 5 clinical areas. PRHI's clinical programs are pursuing a similar strategy, in which procedural changes are made on the basis of process and outcomes data. Initially,
References (1)
To err is human
(1999)
Cited by (11)
Point-of-care hand hygiene: Preventing infection behind the curtain
2012, American Journal of Infection ControlCitation Excerpt :This section reviews key features of POC solutions. Designing a facility’s structure and layout to promote optimal workflow can improve compliance with procedures and protocols.34,35 Failure to do so can lead to problems with efficiency and effectiveness.
How "User Friendly" Is the Hospital for Practicing Hand Hygiene? An Ergonomic Evaluation
2007, Joint Commission Journal on Quality and Patient SafetyCitation Excerpt :Ergonomics (or human factors), is defined by the International Ergonomics Association as “the scientific discipline concerned with the understanding of interactions among humans and other elements of a system” and promotes a holistic approach in which “physical, cognitive, social, organizational, environmental, and other relevant factors are taken into account” in the design and evaluation of tasks, jobs, products, environments, and systems to make them compatible with the needs, abilities, and limitations of people. A fundamental concept in manufacturing, especially in high-performing organizations such as Toyota,18 whose methods are being imported into health care, particularly for the reduction of nosocomial infections in projects such as the Pittsburgh Regional Healthcare Initiative,19 is that optimal design of the workplace and work tasks promotes workers’ efficiency, reduces waste, and increases compliance with desired procedures and protocols. Thus, there are sound reasons to believe that making hand hygiene resources more “user friendly” based on the principles of ergonomics will promote hand hygiene compliance by health professionals and reduce nosocomial infection rates.
Error-free pathology: Applying lean production methods to anatomic pathology
2004, Clinics in Laboratory MedicineCitation Excerpt :The Initiative's “patient-centered goals include zero medication errors, zero health care–acquired (nosocomial) infections, [and] perfect clinical outcomes, as measured by complications, readmissions and other patient outcomes, specifically in coronary artery bypass graft surgery and chronic conditions (depression and diabetes)” [7]. To accomplish these goals, PRHI has incorporated principles from industrial lean production models, including the TPS and Pittsburgh's Alcoa Business System, to design a model for health care called the Perfecting Patient Care (PPC) System [8]. The fundamental principles of the organization are “respect and dignity for everyone, the opportunity for health care workers to succeed in doing meaningful work and to have it acknowledged, neutral collaboration among all stakeholders and improvement based on scientific methods, applied to every patient every day” [7].
Leadership behaviors during lean healthcare implementation: a review and longitudinal study
2020, Journal of Manufacturing Technology ManagementLean management practices in healthcare sector: a literature review
2019, BenchmarkingLean thinking in health care: An overview of the research characteristics, themes and knowledge groups (1998-2011)
2012, 62nd IIE Annual Conference and Expo 2012
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Reprint requests: Edward I. Harrison, MBA, Pittsburgh Regional Healthcare Initiative, Jewish Healthcare Foundation, Centre City Tower, 650 Smithfield St, Suite 2330, Pittsburgh, PA 15222.