The leadership team in Mamawetan Churchill River Health Region (MCRHR) has made safety a top priority for their organization. By implemented safety huddles and daily safety visual management, safety is talked about every day. These are two of the 17 key elements of the Safety Alert/Stop the Line Initiative. And, they are evidence-based processes that strengthen the culture of safety.
Prior to November 2015, the region’s directors were not always getting together to discuss safety events when they occurred. This meant that at times, some directors were not aware of a safety issue, or were unsure of how to resolve a problem. Safety reporting forms could sit on a director’s desk for a long time while she attempted to resolve or investigate a safety event.
During a Rapid Process Improvement Workshop (RPIW) in November 2015, the RPIW team trialled a new daily Directors’ Safety Huddle. An improvement coach from Prairie North shared a video of a similar model used in that region, and the idea immediately resonated with the team.
The intent of this huddle is to gather the region’s senior leaders for 10 minutes a day to discuss safety issues and events that occurred, and to proactively anticipate any challenges that the teams could face.” – Cindy Greuel, Director of the Quality Improvement office in MCRHR.
Today, the daily Directors’ Safety Huddle is part of Mamawetan’s standard work. At 10 a.m. Monday through Friday, the entire team gathers in a hallway on the lower level of the La Ronge Health Centre to report out on events from the last 24 to 72 hours (including weekends). They also discuss upcoming and emerging activities or issues that teams may face.
Representatives from every clinical and support department hear reports from across the region, and participate in a short dialogue to clarify information or solve challenges brought forth by the group. Each program area has a report-out sheet where they track information daily. This includes standard measures such as safety events, harm that occurred, sick time, and short staffing, along with other program-specific data. This information – along with reports about other pertinent activities, challenges, forecasts, and celebrations – help support safety and daily operations of the region.
Justin Galloway, Director of Therapies, explains: “One positive aspect of the safety huddles is that they serve as a valid venue that has improved safety incident awareness throughout the region by having them reported to the leadership team soon after the incidents have occurred.”
The safety wall is not just for leadership: it is located in a common area that is accessible to staff, patients, regional Board members, and visitors to the La Ronge Health Centre. All regional employees are encouraged to attend the daily huddle. Visitors – including the Health Quality Council (HQC) and Saskatchewan Association of Safer Workplaces in Health (SASWH) – drop by when they are in the facility.
Since last November, Mamawetan has seen an approximately 80% decrease in the time from when an event is reported, to when the safety report form arrives at the Quality and Safety office. Follow-up on critical incidents has been cut to less than 14 days (from 65-120 days). Interdisciplinary communication at a leadership level has improved, and the need for formal meetings has decreased, as leaders frequently gather immediately after the huddle to quickly discuss pressing issues.
MCRHR’s quality improvement office tracks the region’s safety data daily, and a monthly rollup of trends and leaders’ attendance is posted on the regional safety wall. This data has already proved to be insightful, according to Greuel.
The region continues to look for ways to improve the flow of safety information.. Recently, during a Kaizen Basics training session, a Special Care Aid asked if information could be brought back from the safety wall to her department’s huddle. There was an assumption that this was occurring. “Our point of care staff have taken notice and are interested in what’s happening,” says Greuel.
Over the next few months, Mamawetan will continue to strengthen the consistent flow of information from the program level to the Directors’ Safety Huddle and back to front-line staff.