Reports From the Field

The Daily Safety Brief in a Safety Net Hospital: Development and Outcomes

Journal of Clinical Outcomes Management. 2016 February;23(2)

References

1. Joint Commission Center for Transforming Healthcare. Available at www.centerfortransforminghealthcare.org.

2. Gamble M. 5 traits of high reliability organizations: how to hardwire each in your organization. Becker’s Hospital Review 29 Apr 2013. Accessed at www.beckershospitalreview.com/hospital-management-administration/5-traits-of-high-reliability-organizations-how-to-hardwire-each-in-your-organization.html.

3. Stockmeier C, Clapper C. Daily check-in for safety: from best practice to common practice. Patient Safety Qual Healthcare 2011:23. Accessed at psqh.com/daily-check-in-for-safety-from-best-practice-to-common-practice.

4. Creating situational awareness: a systems approach. In: Institute of Medicine (US) Forum on Medical and Public Health Preparedness for Catastrophic Events. Medical surge capacity: workshop summary. Washington, DC: National Academies Press; 2010. Accessed at www.ncbi.nlm.nih.gov/books/NBK32859/.

5. TeamSTEPPS. Available at www.ahrq.gov/professionals/education/curriculum-tools/teamstepps/index.html.

It was determined that a leader and 2 facilitators would be assigned to each call. The role of the DSB leader is to trigger individual department report outs and to ensure follow-up on unresolved safety issues from the previous DSB. Leaders are recruited by senior leadership and need to be familiar with the effects that issues can have across the health care system. Leaders need to be able to ask pertinent questions, have the credibility to raise concerns, and have access to senior administration when they need to bypass usual administrative channels.

The role of the facilitators, who are all members of the Center for Quality, is to connect to the conference bridge line, to keep the DSB leader on task, and to record all departmental data and pertinent details of the DSB. The facilitators maintain the daily DSB document, which outlines the order in which departments are called to report and identifies for the leader any open items identified in the previous day’s DSB.

The team developed educational materials and began coaching the departments in February 2013 (See timeline, Figure 1 ). Our hospital began an institution-wide initiation of TeamSTEPPS (Team Strategies and Tools to Enhance Performance and Patient Safety) [5] around the same time and we have found that to be a fortuitous coincidence. Promotion of safety and quality are guiding principles of TeamStepps, an evidence-based teamwork system aimed at optimizing patient care by improving communication and teamwork skills among all health care professionals. It includes a comprehensive set of ready-to-use materials and a training curriculum to successfully integrate teamwork principles into a variety of settings. The TeamSTEPPS framework comprises 4 areas: Leadership, Situational Monitoring, Mutual Support, and Communication. As our DSB was developed, it became clear that components of TeamStepps were integral to successful communication of the new program across departments and disciplines. All departments participating in our DSB began to utilize tools from the 4 TeamSTEPPS domains.

The Daily Safety Brief

On the call, representatives from 25 departments report on any safety issues that have occurred in the past 24 hours plus any that are predicted to occur in the next 24 hours. Participants follow a template that they have customized to their area. For example, the ED reports on total traumas in 24 hours, patient’s boarding in the ED and observation unit, available pumps and IV channels, patient elopement, ST-segment elevation myocardial infarction and code stroke patients, and missing ED patient carts, along with ED operational status. The information systems department reports on patient care system outages over the past 24 hours and anticipated outages coming over the next day. One of the senior medical or administrative leadership leads the DSB, calling on each department in turn. The leader may request a brief explanation of any problems reported with an aim to either enlist the help of others on the call or to identify who will be required to follow-up with the involved department in order to problem solve following the group call. The list of departments and their routine reports is shown in Table 1

The Daily Safety Brief in a Safety Net Hospital: Development and Outcomes

References

The Daily Safety Brief

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