When leaders at Knoxville (Tenn.) Orthopaedic Surgery Center talk about patient safety, they point not to a single policy change, but to a fundamental shift in culture.
That shift helped the ASC earn recognition from The Leapfrog Group as one of the 37 ASCs nationwide recognized for patient safety. Beth Russell, vice president of surgical services at Knoxville Orthopaedic Surgery Center, joined Becker’s to discuss how the recognition reflects years of intentional work around consistency, communication and accountability.
One of the most impactful changes, according to Ms. Russell, was rethinking how staff view incident reporting.
“When I first started here eight years ago, people felt like incident reporting was punitive — like they were turning someone in for doing something wrong,” she said. “We worked really hard to shift that mindset. It’s just documenting what happens, big or small. If we don’t know about it, we can’t track it, study it, or fix it,”
Today, staff understand that reporting isn’t necessarily about mistakes or failures, but a way to capture day-to-day activity and identify opportunities for improvement.
Ensuring staff don’t fear punishment is “incredibly important” to patient safety, Ms. Russell said.
“Staff have to feel comfortable speaking to leadership and physicians,” she said. “They can’t be afraid to bring something forward—whether it’s something a physician did or something someone said. Patient care falls into place when staff feel comfortable speaking up.”
Education has been central to that transformation. Ms. Russell said leaders spent significant time explaining the purpose of reporting and reinforcing that it is a learning tool, not a disciplinary one.
She also makes it a point to personally review reports and follow up one-on-one with the staff member who submitted them.
“As staff started to see positive change come from reporting, they realized we really were listening,” she said. “That’s important to them — they know their voice is heard.”
The ASC has also embedded safety principles into onboarding. New hires are paired with a single staff member for about three months so they can learn consistent processes rather than being “bounced around and seeing things done 10 different ways,” Ms. Russell said.
New employees also follow a patient through the entire care journey, from check-in and pre-op to surgery and recovery, regardless of their role.
“Even if they work in surgery, they spend time in the business office and other areas. It helps them see how everything flows together,” she said. “We’ve gotten really positive feedback from new employees who came from places where they felt thrown to the wolves.”
