Since its development in 2012, the MEDNAX High Reliability Organization (HRO) patient safety initiative has grown in size and sophistication. This fall, it achieved a new milestone with its largest rollout to date, launching the MEDNAX HRO program at White Plains Hospital in New York. In addition to anesthesia, the program spans nine clinical divisions and hundreds of providers at the facility.
Mitchell Reuben, MD, Medical Director of American Anesthesiology of White Plains, a MEDNAX affiliate, learned about the MEDNAX HRO program last November during a presentation by Jeff Shapiro, MD, Director of the HRO program. Dr. Reuben and his team joined MEDNAX in 2016; the practice has provided anesthesia services at White Plains Hospital for decades. Dr. Reuben knew the hospital leadership was actively pursuing a patient safety initiative, and he felt the MEDNAX HRO program might be the solution they were seeking.
“I brought the program back to the administration at White Plains, and they immediately recognized its value to our patients,” said Dr. Reuben.
“The MEDNAX HRO patient safety initiative incorporates high reliability theory into the workplace to optimize patient care,” said Dr. Shapiro. “The initiative promotes development of a reporting culture without fear of retaliation, which allows incident reporting to improve system components of patient care. By instituting protocols to standardize the patient care processes and creating a proactive mindset to forestall and contain errors, we develop a culture of reliability that puts patient safety first.” First launched in anesthesiology, the MEDNAX HRO program has continued to evolve across other medical specialties and departments in institutions where MEDNAX partners.
Embracing a patient safety program
White Plains Hospital is a progressive community hospital, with the highest levels of leadership taking an active role in all aspects of quality and safety. “We evaluated the formal programs available to our clinicians, and we preferred the MEDNAX HRO program,” said Alecia Torrance, Assistant Vice President of Surgical Services at White Plains Hospital. “In part, because it doesn't just include nurses; it makes all members of our team accountable for patient safety.” She also saw value in the interdisciplinary approach and the tools MEDNAX offered that could be tailored to meet their needs, specifically the Clinical Safety App. With the touch of a few buttons, any clinician can use the app on his or her tablet or smartphone to report a safety concern in seconds, receive updates on reported incidents and gain access to resource documents.
“It is a great opportunity for teamwork, a chance to bring heightened awareness to anesthesia and an instrument to help us manage day-to-day operations,” said Torrance. Beginning in October, White Plains Hospital formally implemented the MEDNAX HRO program across the nine surgical and procedural divisions, including Pre-Surgical Testing, Pre-Op, OR, PACU, Cardiac Cath Lab, Endoscopy, Interventional Radiology, Labor and Delivery and Critical Care departments. “Anywhere anesthesia goes, the MEDNAX HRO program will go,” she said.
The program was rolled out to hospital personnel during five training sessions over several months. Each member of the participating clinical divisions was required to attend one session. In addition to the training sessions, White Plains Hospital identified and empowered Champions, received individualized safety tools and made the safety app available to all team members who completed the training.
The overall response to the HRO program by White Plains Hospital clinicians has been optimistic. “It's important that our providers know they all have the power to advocate for patient safety,” said Torrance. “Through the HRO training, we emphasize that all members of the team at all levels are being held to the same standard. The tools and philosophy of the MEDNAX HRO program help us carry out that promise,” she said.
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