Patient safety goals at the top-ranked hospitals for nurses

Patient and staff safety goals are top of mind for many nurse leaders, with hospital-acquired infections and fall prevention being two of the most common measures leaders are tackling.

In August, Nurse Journal, a career and education resource website, ranked 15 hospitals as the best for nurses to work at. They determined the top 15 hospitals by using rankings from CMS, the American Nurses Credentialing Center Magnet Recognition Program, and the Hospital Consumer Assessment of Healthcare Providers and Systems Patient Survey, as well as the following criteria: patient satisfaction scores, safe staffing levels, hospital safety measures, nursing career opportunities, benefits, workplace environment and ratings from nurse reviewers.

Here, six leaders from some of the recognized hospitals and health systems discuss their top patient safety priorities in 2023:

Note: Responses have been lightly edited for length and clarity.

Margarita Baggett, MSN, RN. Chief Clinical Officer for UC San Diego Health:  At UC San Diego Health, there is continual work happening to improve our safety culture and to empower all team members to raise safety concerns and be supported and acknowledged for doing so. Through the nurse-led threat assessment and management subcommittee, team members are able to discuss new and unique strategies to promote safety and reduce workplace violence.

The nurse-led falls prevention committee is working to reduce falls with injury using targeted patient education and supporting patient adherence to evidence-based fall prevention interventions.

The interprofessional team of infection prevention specialists, physicians and nurses on the Central Line Infection Prevention Committee, are leading efforts to reduce these infections by focusing on insertion training and reinforcing evidence-based strategies to reduce the use of central lines.

Dina Dent, DNP, RN. Vice President and Chief Nursing Officer at Inova Health System (Falls Church, Va.): A key safety priority for us is to find better ways to reduce workplace violence. Within the last few years, workplace violence has become an epidemic in healthcare. Inova has been especially proactive on this issue. In the emergency department, our health system has deployed a weapons detection system to help prevent the most egregious types of violence toward patients and team members. But our commitment to safety extends far beyond the ED and includes:

  • Implementing hospital-wide "Safety Pauses" if we start to notice trends in our patient safety reporting. We literally stop the line to conduct a series of all-hands meetings with our teams to talk about what's going on and how we can work together to reverse it. In this way, small trends are identified early, and lessons learned in one area are shared across the house, so our patients stay safer.

  • Hosting twice-daily safety meetings where the management team gathers to go over, in real time, safety related issues, whether facilities or operation-related or patient safety-related. Depending on the need and severity, these can be elevated each day to Inova system safety leadership during Inova's daily system safety call.

  • Strongly supporting team member wellbeing and safety by offering an on-site EAP resource who is readily accessible to any team member; in addition, we offer an online resource called Lyra.

  • Seeking to assure, literally, that nothing is "lost in translation" when providing care and assuring patient safety, and place an emphasis on interpreter services, technology and community education.

  • Enhancing health-related education in the community, to provide patients and families with the resources they need to understand preventative measures they can take, encourage early detection of illness and promote healthier lifestyles.  

Some of our direct patient safety priorities include a focus on harm reduction (including HAIs such as CAUTI, CLABSI, C. diff, surgical site infections, falls and pressure injuries), and decreasing length of stay. We firmly believe that the most efficient care is also the safest care.

Brandee Fetherman, MSN, RN. Chief Nursing Officer at Morristown (N.J.) Medical Center: Patient safety is our number one priority, so healthcare-associated infection prevention measures remain a priority. In addition, we monitor nurse sensitive indicators to ensure our care is exceeding national benchmarks. We encourage team members to identify near misses, which allows us to make process improvements.

Ryannon Frederick, MSN, RN. Chief Nursing Officer at Mayo Clinic (Rochester, Minn.): This year, we're focusing on what we call "back to basics." We've seen tremendous growth in our patient volumes, and we've needed to increase our staff to accommodate more patients. So, we've recentered on processes that create reliable and safe patient care. We're beginning with communication because that's the main place staff struggle and where things can slip through the cracks. To resolve this, we are piloting communication huddles at the unit level to reinforce fundamental processes. We're also working with our new staff to reinforce basic practices — like hand hygiene and intentional rounding — so we can focus on quality metrics like reducing hospital-acquired infections and decreasing our fall rates and pressure injuries.

Joye Gingrich, BSN, RN. Chief Nursing Officer and Vice President of Patient Care Services at UPMC Harrisburg (Pa.): Our patient safety priorities for the year are focused prevention of hospital-acquired infections, including central-line associated bloodstream infections, catheter-associated urinary tract infections, c. diff and surgical site infections. Fall prevention and prevention of hospital-acquired pressure injuries are added safety priorities. 

As a result of our culture of safety survey, opportunities were identified to improve communication among the care team. Through partnership with physician leaders and nursing, an action plan was created to build camaraderie and improve communication between nurses and physicians. To promote a courageous environment, where staff are comfortable to speak up, Just Culture education is being offered at the staff level. 

Shannon Pengel, MSN, RN. Chief Nursing Officer of Cleveland Clinic: Our patient safety goals involve first renewing our commitment to our expectations around delivering safe patient care. Specifically, standardizing the way care is delivered around interventions to prevent hospital-acquired infections, hospital-acquired pressure injuries and patient falls. All of these nursing specific indicators greatly influence outcomes and we as leaders need to make sure evidenced-based interventions are followed to restore our prepandemic performance. 

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