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Coordination

“I knew all along that this is what I enjoyed doing, and I have a passion for taking care of our patients…. I can’t do it all.”

– Lynn Eschenbacher, Medication Safety Officer, Duke University Hospital, in Profiles in Improvement from the Institute for Healthcare Improvement

Decide who is responsible for coordination

Having a clear structure that sets out who oversees patient safety tasks is key. Ensure that staff at your organization know whom they can contact with concerns and suggestions. While everyone plays a part in safety, decide who will set goals, test ideas, and track progress.

  • Designate a patient safety coordinator
    • While everyone at your organization holds responsibility for keeping patients safe, one person will act as coordinator. At a small organization, this person will likely have other responsibilities in addition to patient safety.
    • This individual will:
      • Lead a conversation about a patient safety topic at regular staff meetings
      • Serve as a point person for concerns about patient safety
      • Follow up with staff who make suggestions
      • Organize the response to adverse events
      • Set patient safety goals, test ideas, and track progress
    • Depending on your organization’s structure, the coordinator may report to an administrator, CEO, or executive director.
  • Work as a team to keep safety on the agenda
    • Everyone in the organization can be encouraged to bring attention to so-called ‘near misses’ or ‘close calls,’ adverse events, or ideas for improving patient and colleague safety. Consider organizing a daily or weekly safety huddle where concerns and recent events can be discussed.
    • Include patient safety considerations as a part of other changes in your organization. For example, when re-designing forms to collect updates to patient information in the waiting room, consider how to highlight any changes to medication history so it is readily visible to the doctor or other practitioner during the visit.
    • When undertaking an initiative to improve safety, gather a set of people to work on a concrete task. For example, changes to patient check-in procedures to avoid misidentifications will be more effective if front desk staff are included in the planning.
    • Simplify participation for other members of the staff not involved in a particular project. For example, staff may report a concern and then responsibility transfers to the patient safety coordinator and a small team for follow-up.
    • Depending on the size of the organization, a designated team of colleagues may work with the patient safety coordinator on a regular basis.
  • Engage patients and families
    • Post signs or share pamphlets encouraging patients and families to bring concerns and suggestions to the attention of the patient safety coordinator. This tip sheet has more ideas for patient and family engagement.
    • Survey patients and families from time to time to hear what they think about how well your office works together as a team and help you identify areas to improve. This could be as simple as having the patient safety coordinator ask a few questions of patients waiting for the start of their appointments, , or use this survey developed for use by primary care practices in Massachusetts as part of a recent study called the PROMISES project. Feel free to adapt it to serve your organization's needs.
    • Consider including a patient/family representative in regular meetings of the patient safety team and other committees. Talk to people with both positive and negative experiences at your organization.