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9 Interactive Approaches to Emphasize Patient Safety and Compliance With Accreditation Standards Print E-mail
Written by Rob Kurtz   
Wednesday, 01 October 2008
Finding effective means to engage staff and physicians in making safety and accreditation a priority can be a challenge. But it’s certainly not impossible. To help with safety education and ensure greater buy-in from staff and physicians for meeting accreditation standards and creating a safer environment, Surgery Center of Des Moines (Iowa) has implemented a variety of creative educational tools, interactive games, and many other practices throughout the year to achieve this engagement.

“We have found that through repetition and making safety fun, you achieve more compliance with rules and regulations,” says Christy Field, RN, a quality/risk manager for the center.

Here are just nine of the methods the center has used over the past year to keep accreditation and patient safety at the top of its priorities list.

1. Super Bowl safety. The center works to tie a big event related to safety at least every other month. For example, it will host a safety-themed Super Bowl party.

“We provide lunch for staff and physicians, order a cake with team names on it, and then do some (safety-related) trivia and decorate the lounge with safety-related football terms,” says Ms. Field. These include:

  • “Tackle” problems before they occur — “We remind staff to always use two patient identifiers, confirm the correct procedure and site, and complete medication reconciliation forms,” says Ms. Field.
  • “Hand-off” — “We use this common football play to remind staff about proper hand-off communication.”
  • “Time outs” — Involve the whole team in the surgical time out.
  • “Score points” (goals) — “We use this to encourage the staff to learn the Joint Commission’s National Patient Safety Goals.”
  • “Get to the goal line” — This focused on ways to meet Joint Commission’s National Patient Safety “Goal” for medication safety, such as labeling all syringes and medication on and off the sterile field.
  • “Safety” — “We address issues such as not recapping needles or passing instruments in the safe zone” for sharps safety, she says.
  • “Defense” — Remember proper hand hygiene as a good preventative measure.
  • “Promote teamwork” — “We say that unsportsmanlike-conduct is a penalty,” says Ms. Field

The staff and physicians have enjoyed the event and found value in the safety theme surrounding it, she says.

2. Valentine’s Day theme. In February, to go along with Valentine’s Day, the center held a special lunch and reviewed CPR and EKG interpretations.

This is also the month when the facility holds an annual education day. This includes stations set up in our conference room to review important policies and hands-on refresher training, such as looking up what to do in the MSDS book if someone swallows a cleaner.

“We also review OR fire prevention, hand hygiene with the glo-germ product and hold a small group discussion on safety issues and review incident reports, adverse drug reaction, etc.,” says Ms. Field.

3. National Patient Safety Awareness Week. In March, the the center observed national deep venous thrombosis awareness. The ASC held a weeklong event celebrating and promoting national Patient Safety Awareness Week.

“Over the years we have always come up with a theme for the week,” says Ms. Field. “This year we had a baseball ‘spring training’ theme and tied safety themes to baseball-related movies and foods.” Here are just some of the safety ideas the center tied to baseball.

  • Relating to the movie “Fever Pitch,” the staff planned a day around infection prevention and focused on hand hygiene.
  • “We held a ‘Bad News Bears’ day, and spread the message of working hard to avoid being the bearer of bad news by following the Joint Commission’s Universal Protocol to prevent wrong-site surgery,” says Ms. Field.
  • For the film “Field of Dreams,” the center focused on the importance of having a sterile field (of dreams) with all items properly labeled.
  • “We threw out ‘safety pitches’ on a few days, which were baseball-themed safety messages for staff,” says Ms. Field. The safety pitches would follow the movie theme of the day. For example, Cracker Jacks were offered on “Fever Pitch” day, and were offered to staff along with the training message of, “Just like a prize in the box of Cracker Jacks, germs can hind anywhere. Remember proper hand hygiene and environmental cleaning.
  • Different baseball-themed snacks were put the lounge with a safety message each day of the week. For example, on one day, Baby Ruth candy bars were left out with the message: “Babe Ruth or Baby Ruth — This is why we have two patient identifiers.”
  • “We put out bowls of peanuts and included the message, ‘Don’t forget the peanut gallery — Involve patients and families in their care,’” says Ms. Field.

To add an element of fun to the theme week, the staff was treated to hotdogs for lunch and a mascot from the local, minor league baseball team visited the center and took pictures with the staff.

“It is something different and out of the normal routine, and people stop and think ‘why is he here’ and that opens the door to repeating the safety message,” says Ms. Field. “It is also a morale booster. It just seems to get people to (especially the docs) to buy-in. They loved to have their picture taken with the mascot. We put the pictures in the lounge and this continued the safety week discussion for weeks after safety week was over.” 

4. National Time Out Day. “In June, we always celebrate and observe National Time Out Day,” says Ms. Field. “We hold a variety of fun activities during the week and this year — along with a special lunch menu We had thyme pork roast, minute potatoes, five-hour salad, and ‘clock-o-late cake’ (a cake with a clock design on it). Everything had a ‘time’ theme. “

The center also had a massage therapist come to the facility and give five-minute massages to remind staff about the importance of taking a time out and staff were given the opportunity to complete a time-out crossword puzzle for a chance to win a prize.

5. Eye safety month. June is eye safety month, and the center reminds staff to wear their protective eye wear by putting notes about eye safety in the center’s newsletters and staff mail boxes, and also placing eye safety-related articles in the lounge.

“We have also held a ‘Tour de Surgery Center;’ staff members go on a scavenger hunt (of sorts) in the center,” says Ms. Field. “Staff completed the ‘ride’ by locating MSDS books, policies, fire pulls, emergency eye wash stations, reviewing the contents of malignant hyperthermia, checking crash carts, etc., for a chance at a prize.”

6. Olympics theme. In August, the center held Olympic-themed activities related to safety. Shawn Johnson, the gold-medal gymnast, is from West Des Moines, so it seemed logical to Ms. Field and the staff to highlight the Olympics for a safety activity.

“We did a large bulletin board and had Iowa Olympians on it,” she says. “It had the National Patient Safety Goals all around the Joint Commission’s ‘Gold Seal of Approval.’ The bulletin board also had the ‘one team, one dream’ theme from the Olympics on it and stated, ‘let’s all be champions for safe, quality patient care.’” The staff and physicians were also treated to catered Chinese food catered one day to help with promoting the Olympics-themed safety message. 

7. International Infection Control Week. This past October, the center observed International Infection Control Week, and created a special menu for the week. Items on the special menu included:

  • Monday —  “Salmon”ella cakes; “pee” and “mold” salad (pea salad with cheese cubes]; “bacillus” potatoes; and gummy “worms”
  • Tuesday — Microbe “soup” a monas (bean and pasta soup, with pseudomona as the play on words); “yeast” rolls; and “petri”-dish salad (‘frog-eye’ salad, which contains tiny pasta, mini-marshmallows , pineapple and mandarin oranges)
  • Wednesday —  Fried “lice” (rice) with a side of fungus (mushrooms); Jell-O “mold”; and black dirt (chocolate) cake
  • Thursday — “Pan”icillin-resistant fried chicken; “candida”(candied) yams; “lyme”a beans; and “germ-an” chocolate cake
  • Friday — “Club”siella sandwiches with assorted meats and “molds” (various types of cheeses); Sides of “TB” (tomato and bacon); and bug-shaped cookies

8. Fire safety. In October, the facility also focused on fire safety. By completing a fire safety quiz, staff had their name entered into a drawing for a free home fire extinguisher. “We also provided candy-filled, plastic fire extinguishers to staff and physicians, and labeled them with the ‘P.A.S.S.’ message,” says Ms. Field. P.A.S.S. stands for:

  • P — Pull the pin.
  • A — Aim at the base of the fire.
  • S — Squeeze the trigger.
  • S — Sweep side to side.

9. Spontaneous rewards. “I always try to have a basket of goodies — purchased from a local dollar store — in my office to reward employees randomly when I catch them in the act of proper patient safety practices,” says Ms. Field. “We also have other giveaways and prizes throughout the year to encourage an ongoing focus on safety.”

The center holds many other events throughout the year, such as a safety poster contests for the staff. Staff members team up in groups of four or five and develop educational poster on various selected safety topics. The posters are displayed in the waiting room and patients, visitors and doctors are asked to vote for their favorites. Prizes are awarded for first, second and third place.

“It’s just another fun event, and the posters were saved to be used in the future for safety fairs and annual education,” says Ms. Field.

Praise for creativity
The efforts undertaken at the Surgery Center of Des Moines sets an excellent example for other facilities, says Michael Kulczycki, executive director of the Joint Commission’s Ambulatory Care Accreditation Program.

“This ASC has addressed the single factor often overlooked when an ambulatory care organization attempts to make changes to improve patient safety — changes usually require changing behavior,” Mr. Kulczycki says. “And behavior change is not easy. By using humor, creativity, and even ‘crazy’ ideas, the Surgery Center of Des Moines has succeeded where others may fail in engaging all ASC staff, their surgeons and anesthesiologists, and even their patients. I have observed first-hand how their staff get engaged through these tactics, and it really works. So the next time you are puzzling about how to educate your staff about National Patient Safety Goals, get ‘crazy.’”

Note: To learn more about these activities, contact Ms. Field at This e-mail address is being protected from spam bots, you need JavaScript enabled to view it .
 
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