1. The Evolving Culture of Safety Dr. Ami Hiatt Keatts MD, FACOG, CPPS

2. Why do we care about safety? It affects our institution’s reputation and referral patterns It improves outcomes for patients It improves worker satisfaction It affects payment It is the right thing to do 2

3. Goals of this talk: Review history of the patient safety movement Present quality metrics facing physicians Teach systems thinking for healthcare Review ways to assess providers safety attitudes (when recruiting to your institution) Answer questions 3

4. Quality Measures for Physicians Medicare: readmission, acute and chronic prevention Commercial insurers also have forms (Anthem Q-HIP) These will impact payment Shift from volume to value Transparent outcomes on the internet (check out vhi.org for my cesarean rate) 4

5. 5 “Humans will always make mistakes…the universal constant is that human infallibility is impossible” Why Hospitals Should Fly, by John Nance, J.D.

6. Swiss Cheese Model, by James Reason 6

7. Traditional Medical Model vs Aviation Senior knows best Individual interactions Savior model Blame individuals Secretive Everyone has input Team-based interactions All work for goal Accountability Transparency 7

8. What is your institution doing to become safer? Safety Training Pre-procedure Time-outs Computerized Physician Order Entry Handwashing Bedside Barcode Medication Verification Fall prevention Pharmacists makes rounds too 8

9. A word about the Generations Generation Name Births StartingBirths Ending Youngest Age Today Oldest Age Today The Silent Generation192319446990 Baby Boomer Generation194519644968 Generation X 196119813252 Generation Y - The Millennials Gen Next 197519951838 Generation Z19952015018 9 http://www.careerplanner.com/Career-Articles/Generations.cfm

10. Things to look for: Awareness of safety in healthcare (ask!) Team player Good listener Values communication, even if not perfect at it Accountable Looking for JOY and Meaning at work Through the Eyes of the Workforce: Creating Joy, Meaning, and Safer Health Care (Download at www.npsf.org/lli) 10

11. Questions? 11