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The Intersection of Safety, Quality & Operations


ACHEMT Kicks off 2019 Educational Programming

ACHE of Middle Tennessee held its first educational program of 2019 this spring at the Tennessee Hospital Association. Keynote speaker Kenneth Sands, MD, MPH, chief epidemiologist and chief patient safety officer for HCA Healthcare, focused on the intersection of safety, quality and operations in healthcare organizations. His call to action referenced a recent Navy disaster corrective action plan that emphasized the danger to organizations that stop being a "questioning culture" and thus miss significant risk factors that lead to bad outcomes.

Sands drove home the need for healthcare organizations to build upon the traditional approach to safety, which emphasizes standardization, by adding a systems approach to mitigate the impact of unanticipated events. The expanded approach acknowledges that the entire environment cannot be controlled, and accidents are prevented by people being able to adapt to changing conditions. He recommended using the ACHE Blueprint for Safety to guide organizations through an assessment of their safety culture. Additionally, Sands reiterated the need for senior leadership to establish and support a questioning culture.

Additionlly, Dawn FitzGerald, CEO of QSource, moderated a panel discussion that included perspectives from Pam Womack, CEO of the Mental Health Cooperative; Rachael Kurzer Givens, chief quality and compliance officer with BrightSpring Health Services; Jim Geraughty, MD, chief medical officer for Unity Physician Partners; and Jenny Slayton, vice president of Quality, Safety and Risk Prevention for Vanderbilt University Medical Center.

FitzGerald invited the panelists to discuss how their organizations give priority to quality and safety. Givens reported that the first topic on the board meeting agenda for their newly merged organization was quality and safety everywhere they deliver services. Slayton noted, "Attention is the currency of leadership." She shared her organization has leadership rounds on the clinical units that are intentional and focused on meaningful dialogue.

Womack works with an organization where she and her staff, alongside clients with behavioral health and substance abuse issues are all working together in one large area. She noted that MHC's staff is trained in therapeutic options so they can comfortably respond to unexpected needs. Geraughty presented the view of quality and safety from the perspective of population health based on his years of experience with managed care and payer organizations.

The panel tackled the question of how to address quality and safety concerns in specialty populations like behavioral health. One of the key factors considered is the possibility that behavioral health and substance abuse clients could create a safety risk for employees, as well as other clients. OSHA is becoming more active with investigations of organizations where workplace violence includes patient to employee encounters. The panelists noted proper training and protocols are essential.

The panel agreed that in addition to traditional investigation and improvement activities, celebrating success is essential to sustaining a culture of safety. Meetings should begin with discussion of success stories. Panelists said the key, when working to motivate healthcare workers, is to humanize the discussion as much as possible. Instead of discussing only rates for example, they recommended telling a specific patient story, or a specific accomplishment like 30 days without a single CLABSI infection.

The day's event ended with the attendees having the opportunity to welcome the new National ACHE Chairman Heather J. Rohan, FACHE. Rohan is a member of ACHEMT and is president of HCA TriStar Division. She reiterated the opportunity for healthcare leaders to take advantage of the Safety Blueprint made available by ACHE by visiting

Sharon Stewart, MSHCAD, FACHE is senior director, Information Systems for Quorum Health Corporation. For more information on ACHE Middle Tennessee, including upcoming events, go online to



ACHE Safety Blueprint


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