How MetroHealth's safety chief uses engineering to boost medicine

Joseph Golob, MD, went to college to become an engineer because he loved working with standardization. It did not take him long to realize he could apply the same passion to medicine.

Dr. Golob is the chief quality officer at Cleveland-based MetroHealth. He studied engineering as an undergraduate before ultimately going to medical school and becoming a surgeon. He also holds a master's in healthcare systems engineering. 

"I wanted to separate myself a little bit because my life is about continuous improvement, performance improvement and the introduction of standardization, which is the one of the keys to improvement," he said.

During a recent interview with Becker's, Dr. Golob discussed current quality improvement efforts at MetroHealth.  

Staff retention

Dr. Golob said his department is adapting clinical care improvement strategies to improve staff retention and workplace conditions.

"We're focusing on ways to improve the quality of staffing by improving retention strategies using the same techniques that you use to improve clinical care," he said. Creating those protocols while managing other safety measures can be challenging, but he said they have been effective.

One area that concerns Dr. Golob is staff safety.

"What scares me most about the healthcare field now is we focus so much on patient safety, which is important, and put very little attention into keeping our staff safe," he said. "Across the country there is an increase in patient-to-staff assaults, an increase in harm identified at the doors as patients come in with weapons. We as a healthcare industry need to turn our attention to staff safety just like we turned attention to patient safety."

Dr. Golob said MetroHealth mitigates some of these safety issues through communication. 

"When patients or staff say they feel unsafe in a certain place or area, that triggers us to do a risk assessment of all our areas," he said. "We've increased security by forming contracts with security services to ensure our staff feel safe. But communication with staff is key. You have to let staff know what you're doing and pull all the different initiatives together so people see what's actually going on through the whole hospital."

Failure as a teaching tool

When Dr. Golob started his career, he said he believed failure was not an option. But he learned that failure, which for trauma surgeons in an operating room can often mean patient deaths, is unavoidable. 

"Patients are the first victim, but the second victim are the clinicians," he said. "Failure is an opportunity for us to get better."

MetroHealth has embraced this concept by creating an alert system across its intranet sites. When there is a patient event, hospital-acquired infection or other safety event, staff receive a personal email regarding the event "so they can keep it top of mind and think about what they did differently this time compared to the last one."

Staff members also receive personal emails regarding incidents with which they were involved. The emails include documentation of the case with other quality metrics.

"It's been very welcoming from the providers because then they can ask questions," Dr. Golob said. "Alerting them in real time as a collaborative engagement shows we want to work together to help them." The emails also provide clinicians with the information needed to think about what to change in the future. It does not require an action plan or even a response; it is designed only to alert clinicians to an issue before it becomes a trend. 

The system has reduced harms by 30%, in part due to this approach. 

"What's nice about doing quality improvement is that you can shotgun approach and do many changes," Dr. Golob said. "You're not doing research. You're not having to say, 'Did this actually make a difference?' As long as there's a difference and it can be considered sustained, then we'll keep doing all the things that triggered that improvement."

Copyright © 2024 Becker's Healthcare. All Rights Reserved. Privacy Policy. Cookie Policy. Linking and Reprinting Policy.


Featured Whitepapers

Featured Webinars