Rochester Regional Health – Daily Safety Check

What is it?

Early identification and mitigation of risks is critical to ensure safety in any environment, particularly in health care where the dimensions of safety are substantially complex. Developed in partnership with the Rochester Institute of Technology, the Daily Safety Check (DSC) is a high-reliability huddling technique that accesses the perspectives and wisdom of frontline team members by providing an actionable and operations-linked forum for identifying risks with impact to outcomes and patient or staff safety. The health system has furthered this huddling model by incorporating a tracking database to trend these events and efforts in mitigating them.

Facilitated by senior leaders, Daily Safety Check uses a reporting structure that sets a non-punitive tone to encourage candor and an open exchange of ideas. It guides system improvements through proven High Reliability Principles that specifically identify potential challenges in order to best address them (these include preoccupation with failure, reluctance to simplify, sensitivity to operations, commitment to resilience, and deference to expertise). The effectiveness is bolstered by additional huddles convened by area leaders where potential risks are gathered from as broad a cross-section of team members as possible. Any variations from the norm are reported at these huddles; then, with all leaders present, strategies to mitigate harm can quickly be recognized, implemented and cascaded.

Who is it for?

The health system itself, its patients and its staff.

Why do they do it?

Despite the focus of thought leaders and regulators on high reliability in health care, few tools currently exist that have been adapted to the health care setting, and little guidance exists for their implementation and sustainment. The increasing complexity of the hospital and health system environment creates systematic vulnerabilities by disconnecting clinical and operations leaders, relying on electronic communication, eroding cooperation, and slowing the pace of risk reduction. A system-wide culture survey in 2013 suggested a need for improvement in staff perception of communication, teamwork and safety within the health care system. At the same time, high reliability was identified as a core system goal.

Impact

Through the incorporation of the DSC model and tools, the health system has seen a decrease in patient harm events, falls and team member injuries. One of the system’s acute care hospitals, which has been using DSC for over a year, has seen significant outcomes:

• 50 percent reduction in total harm events

• 30 percent reduction in total falls rate

• 23 weeks without a serious safety event

In addition, risk reporting within the health system’s facilities has increased, which may speak to a shifting culture – one with a transparent, system-based learning approach to events.

Contact: Bridgette Wiefling, M.D.
Chief Quality and Innovation Officer
Telephone: 585-922-4430
Email: bridgette.wiefling@rochesterregional.org