March 2012

SafetyFirst Creates a Thriving Culture of Safety


Safety is of primary importance in health, but safety events are the leading cause of harm to patients and employees. CHI’s SafetyFirst initiative creates a complete focus on safety to eliminate unsafe habits, instill safety behaviors, and grow a culture in which everyone takes responsibility and speaks out about safety. “As we look at CHI’s core values of Reverence, Integrity, Compassion and Excellence, we can’t say we fully exhibit these values unless safety is part of everything we do,” said Jeanie Mamula, vice president of clinical quality improvement.

“There is always the potential for mistakes,” said Bruce Klockars of KentuckyOne Health. “But, mistakes happen less when employees know that if they stop a process or report a problem, they will be thanked and appreciated. SafetyFirst enhances safety and well-being for everyone, including patients, visitors, employees, volunteers and medical staff. It’s changing us from an organization that’s aware of and concerned about safety to a high-reliability organization that succeeds at avoiding safety incidents, even in our complex environment.”

SafetyFirst is operational in CHI’s Kentucky facilities, and implementation is in progress in facilities in the Fargo Division, CHI Nebraska, Pennsylvania and Kansas. Implementation across CHI will continue through 2013. “We had safety programs in place, but Safety First gives us a CHI-endorsed initiative and the impetus to take our safety efforts the next step,” said Jeff Drop, senior vice president of operations and division executive officer for the Fargo Division.

Jennifer Nolan arrived as president and chief executive officer at Our Lady of Peace, Louisville, KY, three months after the introduction of SafetyFirst. “In other places I’ve worked, safety was important but not a top-of-mind kind of issue,” she said. “I was thrilled to find that CHI is building a culture of transparency for safety in order to create a safer future.”

Employees at Our Lady of Peace were receptive to SafetyFirst, but some were reluctant to bring up safety issues. “Now, they see the value of keeping co-workers and managers informed,” said Nolan. “Everyone knows it’s OK to ask questions, and it’s OK to ‘stop the line’ until those questions are resolved.”

At Our Lady of Peace, daily emails track the days since the facility’s last serious safety incident. The behavioral health hospital also posts summaries of safety incidents and “good catches.” “It’s important to discuss what goes right and what goes wrong,” said Nolan. “Every piece of information can help our staff keep themselves and our patients safe.”

Additional SafetyFirst tools and techniques include:

  • Safety coaching to encourage safe behaviors and corrects unsafe behaviors.
  • Rounding to influence to give leaders and employees the opportunity to discuss safety concerns and prevention strategies.
  • Daily safety “huddle” meetings to enable discussion of safety incidents, sharing of improvement ideas and more.

SafetyFirst is a major step toward CHI’s strategic 2020 goal of zero events that harm patients, employees or medical staff. “It’s a lot of work to implement SafetyFirst,” said Drop. “But, it helps avoid the cost of investigating and correcting errors. That’s in addition to making our hospitals safer, more welcoming places for everyone.”