1. A Primer For Providing Highly Reliable Care Bill Berry, MD, MPH

3. Add new checklist

4. Safe Surgery: South Carolina Program
Engagement:
Leadership Team and Hospitals
Hospital Checklist Implementation: Three Waves of Education Series
Building a Stronger Healthcare System:
Hospital Site Visits, OR Team Training, and In-Person Meetings
Measurement:
Monitoring the impact of the checklist at a state level and in individual hospitals

5. South Carolina Program Activities
Hospitals that participated in the webinar educational series 52
Number of clinicians trained over 6 OR Team Training Sessions
223
Number of clinicians trained over 6 in-person meetings
392
Hospital visits by Safe Surgery 2015 team
131
56 unique facilities

6. 63 Safe Surgery Participating Hospitals
Pelham Medical Center
Piedmont Medical Center
Providence Hospital
Providence Hospital Northeast
Ralph Johnson VAMC
Regional Medical Center
Roper Hospital
Roper St. Francis Mount Pleasant Hospital
Self Regional Healthcare
Shriners Hospitals for Children
Spartanburg Medical Center
Springs Memorial Hospital
St. Francis Downtown
St. Francis Eastside
Summerville Medical Center
Tidelands GMH
Tidelands WCH
Trident Medical Center
Union Medical Center
Williamsburg Regional Hospital
Wm. Jennings Bryan Dorn VAMC
Abbeville Area Medical Center
Aiken Regional Medical Centers
Anmed Health Medical Center
Baptist Easley Hospital
Beaufort Memorial Hospital
Bon Secours St. Francis Hospital
Cannon Memorial Hospital
Carolina Pines Regional Medical Center
Carolinas Hospital System - Florence
Carolinas Hospital System - Marion
Chester Regional Medical Center
Clarendon Memorial Hospital
Coastal Carolina Hospital
Colleton Medical Center
Conway Medical Center
East Cooper Medical Center
Edgefield County Hospital
GHS Laurens County Memorial Hospital
GHS Oconee Memorial Hospital
Grand Strand Medical Center
Greenville Memorial Hospital
Greer Memorial Hospital
Hampton Regional Medical Center
Hillcrest Memorial Hospital
Hilton Head Hospital
KershawHealth
Lake City Community Hospital
Lexington Medical Center
Mary Black Health System: Gaffney
Mary Black Health System: Spartanburg
McLeod Loris
McLeod Medical Center Dillon
McLeod Regional Medical Center
McLeod Seacoast Hospital
Medical University of South Carolina
Moncrief Army Community Hospital
Newberry County Memorial Hospital
Palmetto Health Baptist
Palmetto Health Baptist Parkridge
Palmetto Health Richland
Palmetto Health Toumey
Patewood Memorial Hospital
Chesterfield hasn’t done anything
Marlboro Park Closed

7. Program’s Impact Across The United States
1200+ Healthcare Facilities Across The United States

9. Each Participating Hospital Has A Better Process Than When We Started…Even If They Aren’t Using The Checklist Perfectly

10. Post Surgical Mortality

12. 107 lives saved

13. We have been working together since 2010… Why Are We Still Talking About Safe Surgery?

14. This Is A Journey That Takes Time
Talk about providers wearing gloves….how long it took

15. 15 SCHA Quality Improvement Initiatives
Birth Outcomes Initiative
Care Transitions
Cardiac Arrest Registry to Enhance Survival (CARES)
CDC HAI Reduction
CLABSI CAUTI Initiative
Hospital Engagement Network (HEN) 2.0
Just Culture Certification for SC Hospitals
Newborn Screening Initiative & Regional Training Workshops
Heart & Stroke Care Alliance
Safe Care
Safe Surgery
Surgical Quality Collaborative
Safety Program For Ambulatory Surgery
Transforming Health Symposium
Zero Harm Awards
You are Becoming A Highly Reliable Organization
Disappear – You are becoming a highly reliable organization

16. “A high reliability organization (HRO) is an organization that has succeeded in avoiding catastrophes in an environment where normal accidents can be expected due to risk factors and complexity”

17. Steps Hospitals Need to Take To Become Highly Reliable Organizations
Leadership needs to be committed to zero harm
A fully functional culture of safety needs to exist at all levels of the organization:
Workers recognize and report issues and unsafe conditions
The organization makes workers feel comfortable reporting issues
The organization acts on what is reported in a timely manner
The changes/improvements are communicated to workers
Changes/Improvements are implemented using proven methods
Lean, Six Sigma, PDSA, etc
Chassin MR, Loeb JM. High-Reliability Health Care: Getting There from Here. Milbank Q. 2013;91(3):459–90.

18. High Reliability Organizations The Surgical Safety Checklist
Need a “Just culture”
Levels the hierarchy and improves culture in the OR
Are committed leadership to zero harm
A first step towards reducing harm to zero in the OR
Have a pre-occupation with failure…forsee potential issues and fix them
Through briefing and debriefing it attempts to prepare and prevent failure
Require ongoing monitoring
Requires to “never stop looking”

19. Safe Surgery Hospital Designation
Hospitals self-certify that the checklist is used for every patient that undergoes surgery
18 hospitals have certified to date
Next round of designations will be announced at the 2017 TAP Meeting.
The application deadline will be announced the summer 2017.

20. New Safe Surgery Hospitals
Hilton Head Hospital
Mary Black Health System: Spartanburg

21. The Next Stop On The Checklist Journey & The Journey To Becoming Highly Reliable: New Webinar Series September 29, 2016
Celebrate where your hospital is…it has been hard work
Know that the checklist work has been the beginning of becoming a highly reliable organization
Understand how teams are using the checklist
Pick a part of the process to improve
Learn how to make meaningful improvement and keep the work going

22. We Need Your Help
Check-in with your hospital’s checklist implementation team and see how the work is going
Encourage your checklist implementation team to:
Watch how the checklist is used in the operating room and to keep meeting as a team
Attend the new checklist webinar series, September 29, 2016
Apply for the Safe Surgery Designation next summer… if your hospital uses the checklist for every patient

23. Thank You
For More Information: