Sentara Norfolk General Hospital: Accelerating Improvement by Focusing on Building a Culture of Safety

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Background: To accelerate progress in improving patient safety, Sentara Norfolk General Hospital (SNGH) supplemented its improvement programs with an initiative to strengthen its organizational culture of safety.

Creating a Culture of Safety: SNGH established and internalized behaviors in the organization that would result in safer and more reliable and productive human performance. Four areas of focus were identified: (1) creating Behavior-Based Expectations (BBEs) for error prevention for all positions, (2) establishing Red Rules to focus employees on rules with the highest level of consequence and risk if not followed exactly, (3) developing a technically based Root Cause and Common Cause Analysis process, and (4) implementing an approach to focus and simplify policies and procedures.

Keys to Success: The senior leadership made the safety initiative the number-one priority; operational goals were prioritized to ensure the availability of time and resources for the safety initiative. A team of five operational leaders led implementation and ensured effective communication across the organization. Medical staff provided support to the safety initiative; for example, it developed and implemented its own BBEs list. Finally, employees were engaged in all phases of the initiative. SNGH's largest challenge remains to continue to accelerate improvement while simultaneously holding gains previously made.

Document Type: Research Article

Publication date: October 1, 2004

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  • Published monthly, The Joint Commission Journal on Quality and Patient Safety is a peer-reviewed publication dedicated to providing health professionals with the information they need to promote the quality and safety of health care. The Joint Commission Journal on Quality and Patient Safety invites original manuscripts on the development, adaptation, and/or implementation of innovative thinking, strategies, and practices in improving quality and safety in health care. Case studies, program or project reports, reports of new methodologies or new applications of methodologies, research studies on the effectiveness of improvement interventions, and commentaries on issues and practices are all considered.

    Also known as Joint Commission Journal on Quality Improvement and Joint Commission Journal on Quality and Safety
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