Juran Healthcare works with hospitals to measure their ability to develop programs and initiatives that will lead to a strong patient safety culture. We also conduct behavioral observations, interviews, and process assessments in order to gauge the organization’s ability to adopt behavior-based expectations, as well as scientific approaches to problem solving; including Six Sigma,Lean, PDSA, Root Cause Analysis and A3 Problem Solving. Our assessments include the following:
Patient Safety Culture Survey: Juran recommends a comprehensive assessment of the patient safety culture of the organization by using tools such as the survey created by the Association for Healthcare Research and Quality (AHRQ). The purpose of the survey is to provide leadership with the understanding of the behaviors and beliefs of the members of the organization in regards to certain patient safety culture aspects. These aspects include communication, empowerment and accountability, senior leader and management commitment to safety, the organization's ability to detect and learn from mistakes, disclosure, and overall patient safety grading. The results and comments that are captured in the survey can provide a platform for identifying opportunities for improvement in human performance and process improvement.
Behavior-Based Observations:This phase entails an observational assessment based on known patient safety standards set by the organization and regulatory agencies. Observations capture the true essence of culture by capturing the real behaviors of caregivers at the bedside. Although behavior-based observations are a powerful assessment tool, they also provide the cornerstone of human performance improvement and sustainability through the implementation of leadership rounding and peer coaching programs.
Executive and Staff Interviews:Interviews provide a platform for key members of the organization to provide feedback and elevate important issues of safety. These interviews also provide a useful avenue for generating and extracting ideas for improving key patient safety processes.
Incident Reporting System Analysis: The purpose of this phase is to identify key system issues and process breakdowns that are the potential root causes of serious safety events for the organization. High-risk departments such as Emergency and Surgical Services should report at least 25 variances for every serious safety event. This ratio indicates a culture capable of detecting error precursors and potential root causes of serious safety events before they happen. Healthy variance reporting provides the capability of the organization to proactively reduce errors and the likelihood of events rather than relying just on reactive Root Cause Analysis when serious safety events occur. Juran offers strategies to improve incident reporting and management follow-up, such as the Reporting Occurrence Severity Index or ROSI.
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