AdventHealth Surgery Center Innovation Tower in Orlando, Fla., was recently named one of 37 ASCs recognized by The Leapfrog Group for excellence in quality and patient safety, with honors reflecting strong performance in areas such as infection prevention, medication safety, ethical billing and informed patient consent procedures.
Kara Harmon, RN, the center’s administrator and director of operations at the AdventHealth Surgery Center Innovation Tower, joined Becker’s to discuss how the ASC sustains a high-reliability safety culture through daily huddles, open communication and a non-punitive approach to reporting near misses and “good catches.”
Editor’s note: This interview was edited lightly for clarity and length.
Question: How does your ASC approach quality and patient safety on an ongoing basis?
Kara Harmon: Of course, we approach it as the utmost importance, and it’s really why we do what we do. We have daily communication with our team and our surgeons, and we also make sure that we’re communicating with the patients. I think that communication is key in keeping our patients safe.
Q: Is there anything specific in terms of workplace culture that you think plays into that?
KH: Really having a culture of an open-door, non-punitive environment where staff feel safe bringing forward any incidents or near misses. Good catches are huge for us. Making sure staff know the importance of those so we can share them is critical. We do little incentives — if someone submits a near miss or a good catch, especially a good catch, their name goes into a monthly drawing. It incentivizes staff to take the time and reinforces that culture of honesty and non-punitive reactions.
Q: Is there a specific safety practice or approach you’re most proud of — something patients might not notice but that makes a big difference?
KH: We do daily huddles with our team. Before shifts start, each department has a huddle where we talk about anything a physician has communicated regarding a patient, any concerns anesthesia may have for the day, and anything else relevant. Again, it goes back to communication. We also have monthly team meetings where we pull out information that’s pertinent across departments.
Q: Looking back over the last year or so, what’s the biggest thing you’re proud of regarding your team and your ASC?
KH: I was the first employee here three years ago when we opened, and now we have 60 employees. I’ve truly handpicked everyone on this team, and I feel like a mama bear. I’m so proud of the collaboration and the culture we’ve built. If our team can’t work together, our patients won’t get the focus they deserve. That collaboration, camaraderie, and open communication — where no one feels intimidated to speak up — directly adds to patient safety.
Q: How do you integrate new hires into your safety and work culture?
KH: It goes back to culture. A lot of places have intimidating cultures with old-school, set-in-their-ways teammates, which makes it hard for new hires to acclimate. We don’t tolerate that. When staff start, they sign what we call a promise — it covers everything from bullying to speaking up. It’s a full page. My motto is that everyone is 200% accountable: 100% for yourself and 100% for your teammate. If you see something concerning, you’re accountable for speaking up.
Q: What has your recruitment process been like over the last three years?
KH:. I’m not your typical administrator — I’m a nurse by trade and worked as a circulator and scrub tech. There’s nothing I’ll ask my team to do that I wouldn’t do myself. Out of our 60 employees, we’ve only had to actively recruit about 10. The rest has been word of mouth. People want to work here for the patient satisfaction, safety, and team engagement. We also hold physicians to the same behavioral standards — we don’t tolerate negative behavior from anyone.
