Using the AHRQ survey to evaluate change

In 2008, to advance their agenda on fostering a culture of patient safety, Valley Medical Center (VMC) of Renton, Washington planned and implemented an online event reporting system. Launching this application after surveying staff perceptions on patient safety using the AHRQ Survey of Patient Safety Culture (SOPSC) provided a natural opportunity to evaluate the impact of this intervention and other parallel efforts by re-administering SOPSC in 2009 and comparing baseline and re-measurement scores.

Implementing the System

In December of 2008, VMC employees received training on the online event reporting system via interactive simulation. The system’s ease of access, “one-stop shopping” for reporting, and the option for anonymity were emphasized. To provide timely feedback to staff reporting events and solicit information as needed, VMC added real-time managerial follow-up on all reported events. To promote frequent data review, leaders also received hands-on instruction on how to retrieve their event trend reports independently. To foster a non-punitive culture, VMC provided clinical leaders and staff with clear structure and expectations on how to participate in root cause analyses (RCA) such that the focus is on evaluating process and reaching consensus on how to move forward.

Parallel Efforts

During 2009, VMC also presented 2008 SOPSC results at their Patient Safety Fair to solicit suggestions on how to improve the lowest scores. They instituted weekly patient safety rounds during which a patient safety specialist visits with staff to evaluate, teach, and promote issues of patient safety through observation, interview and documentation review.

See the Difference

Within 12 months of implementing of the online system, event reporting increased 290%, with nearly 100% of submissions signed by staff. SOPSC re-measurement showed a positive shift in staff perception across all composites with substantial improvement in event reporting, communication about error, and organizational support.

From Measurement to Momentum

Seeing a measurable shift in staff perception and reporting it back to staff can be powerful. At VMC, According to Elaine Lobdell, Vice President of Quality Services, “patient safety is becoming more palpable to the staff and their growing confidence in management’s commitment to patient safety serves only to pave the way for further staff engagement and innovative interventions.”