Published by: Laura Harrington on 3/1/2011 10:24:53 AM
Boston Medical Center (BMC) is a private, not-for-profit, 639-licensed bed, academic medical center located in Boston. The hospital is the primary teaching affiliate for Boston University School of Medicine. BMC emphasizes community-based care, with its mission to provide consistently accessible health services to all. The largest safety net hospital in New England, BMC provides a full spectrum of pediatric and adult care services, from primary to family medicine to advanced specialty care.
Based on the complexity of services, number of facilities and volume of patients, BMC senior leadership recognized that a priority focus on patient safety would require significant changes in current departmental structures. Quality and patient safety efforts were fragmented into separate risk, regulatory and quality departments. They operated independently with little interface, creating inefficiencies, information deficits and an environment lacking the necessary synergy of a high performance team.
A complete modernization and transformation of the quality and patient safety functions began, starting with the creation of a Chief Quality Officer who reports directly to the CEO. A critical outcome of the transformation was the creation of a unified Quality and Patient Safety Department, with gains in efficiency, information sharing, coordination, teamwork, analytic capability and quality and patient safety expertise. Enhancements continued with the renaming of the Risk Management function to Patient Safety and Risk Management. Staff titles also changed to Patient Safety Risk Specialists, who investigate and analyze adverse events and are now responsible for reporting serious adverse events to regulatory and safety agencies - tasks previously performed by two different directors.
In addition, the Patient Safety and Regulatory Compliance responsibilities were unified under a single Director of Patient Safety, Risk Management and Regulatory Compliance to create a coordinated and streamlined patient safety, risk and regulatory function. This position reports directly to the Executive Director of Quality and Patient Safety, who reports to the Chief Quality Officer, enabling seamless and high performing quality and patient safety operations.
The transformation also included significant enhancements to BMC’s process for organizational review, analysis and external reporting of adverse events. Previously, one person was accountable for determining whether an event was reportable to regulatory agencies. Today, a Patient Safety Steering Committee with senior level leadership, including the Chief Medical Officer, Chief Quality Officer and Chief Nursing Officer, along with the Executive Director, Director, Patient Safety Risk Specialists and Medication Safety Specialist, meets weekly to evaluate events and determine whether an event is reportable. The committee provides a blame-free unbiased forum to evaluate events, identify improvement opportunities and recommend actions to prevent recurrence.
Other efforts underway to foster a culture of patient safety include changing the risk pager from “31-RISK” to “31-SAFE.” In early spring, BMC will conduct a staff engagement survey with safety culture questions embedded in the survey. Results from the survey will provide BMC with feedback on staff’s perceptions of the quality and patient safety culture at BMC, giving us information that can help direct our ongoing patient safety improvements.
Making care safer is a journey. These changes to BMC’s quality and patient safety infrastructure have been critical building blocks to accelerating our pace on the road to ever higher quality safe patient care.
Laura Harrington, RN, MHA
Director, Patient Safety, Risk Management and Regulatory Compliance
Boston Medical Center