The 2023 safety priorities for 11 straight-'A' hospitals

As hospitals continue to face pandemic-related challenges, it's no surprise that many of The Leapfrog Group's straight-"A" hospitals are doubling down on efforts to reduce and prevent healthcare-associated infections.

Hospital-acquired infections rose in 2020 after years of steady decline. In 2021, four of six infections tracked by the CDC had increased by as much as 14 percent compared to 2020. With the worst of the COVID-19 surges over, hospitals are refocusing on returning HAI numbers back to pre-pandemic times.

Hospitals are also adding diversity, equity and inclusion strategies and workplace violence prevention programs to their 2023 patient safety strategies.

The Leapfrog Group released its fall 2022 Hospital Safety Grade on Nov. 16, assigning "A" through "F" letter grades to nearly 3,000 general acute care hospitals in the U.S. for patient safety performance. Twenty-two hospitals have achieved 22 consecutive "A" grades since 2012.

What 11 hospitals are focusing on in 2023:

Editor's note: Responses have been lightly edited for brevity and clarity

Armin Rahmanian. President of OhioHealth Grady Memorial Hospital and OhioHealth Dublin Methodist Hospital (Columbus): 

While we are fortunate to come from a position of strength, being a multiple-time Leapfrog straight "A" hospital, we are not resting on our laurels and realize there is always more we can do to ensure the safest possible experience for our patients, visitors and staff. To that end, we are on our journey toward becoming a high reliability organization (HRO). This investment will enable us to continue to build upon the great foundation of safe care we have already established. We will be doubling down and enhancing existing processes like surgical safety checklists, safety huddles and root cause analyses and introducing concepts that are novel to our environment like formal team training. We are excited to engage all of our associates, leaders, physicians and other team members in this journey.

Kenneth Hedley. President of Northwestern Medicine Central DuPage Hospital (Winfield, Ill.): 

Our focus for 2023 is on staff wellness, patient experience and reducing hospital-acquired infections, pressure injuries and falls.

Mark Gendreau, MD. Senior Vice President and Chief Medical Officer at Beverly (Mass.) Hospital: 

Our team's unwavering commitment to providing the highest quality, safest care — such as through careful monitoring and prevention of healthcare-acquired infections and patient falls — contributes the safest experience possible for our patients, and we look forward to continuing this important work in the new year.

Julia Woodson. Associate Vice President of Quality & Performance Improvement of UNC Rex Health (Raleigh, N.C.): 

UNC Health Rex takes tremendous pride in our continuous efforts to improve quality and safety. That strategy has helped Rex earn top marks from Leapfrog and others. We are the only hospital in North Carolina to get straight "A's" since Leapfrog began its hospital safety report card in 2012. 

In 2023, we will continue to work on our patient flow, reducing patient harm and improving quality. Our commitment to improving patient flow through our hospital will provide timely and effective care for our patients. This will allow us to serve our growing community and ensure we can meet the demand for our services. According to the National Institutes of Health, the risk of adverse events increases the longer patients wait in the emergency department. Therefore, we have several projects ongoing in our emergency department and with our hospitalists to increase throughput and efficiency with an emphasis on safety and quality. Another top 2023 quality priority is patient mobility. Mobility provides our patients a way to maintain their muscle mass, improve blood flow, reduce risk of obtaining a pressure injury or blood clot and improve their chances of returning home. Lastly, UNC Health Rex is developing its diversity, equity and inclusion strategy with particular attention on social determinants of health, accurate data collection and analyses.

Carole Billington, MSN, RN. Chief Operating Officer/Chief Nursing Officer of Saint Anne's Hospital (Fall River, Mass.): 

Saint Anne's Hospital is focusing on expanding its "Transitions in Care" initiative in 2023.

A safe and effective transfer of each patient's care depends on reliable communication that includes caregivers on both the transferring and receiving side, as well as the patient at the bedside. To solidify communication practices, nursing at Saint Anne's has implemented a safety checklist for transitions in care, which ensures the receiving nurse has all necessary information about the patient. Reviewing the checklist in the patient's presence provides a level of confidence to the patient that their new nursing team is fully informed. It also fosters teamwork across units. Staff use the checklist when a patient is transferred from one unit to another and at change of shift. Creating this model for all transitions will improve patient safety and patient participation, foster relationships, and improve communication across the continuum.

Charleen Tachibana, DNP, RN. Senior Vice President and Chief Quality, Safety, Patient Experience Officer of Virginia Mason Franciscan Health (Seattle): 

For the last few years, healthcare facilities across the country, including our own, have worked hard to maintain quality and safety standards while continuously grappling with the COVID-19 pandemic and related challenges. As we head into 2023, increasing the reliability of our core safety practices and identifying innovative methods to achieve reliability are top priorities. In addition to strengthening our practices, we are investing in recruiting and retaining staff members who are crucial to driving our high quality and safety standards and who have the innovative ideas needed to achieve our goals.

Tom Jackiewicz. President of the University of Chicago Medical Center: 

Our sights are set on three broad categories for 2023 safety priorities:

1. Increasing our capacity and building access to our services for patients from the communities we serve. We've seen time and time again that providing safe care for patients means providing timely care for patients.

2. Expanding our in-progress efforts to review all quality and outcomes metrics with an eye toward diversity, equity and inclusion. You can't fix what you don't see, which is why we're committed to diving deep into the datasets to identify inequities and health disparities. Then we can develop plans and processes to close those gaps.

3. Using "lean" principles and other industry-leading best practices to drive toward becoming a "zero-defect" organization.

Sherri Leahy, PhD, RN. Associate Vice President of Clinical Excellence & Patient Safety at Edward-Elmhurst Health (Warrenville, Ill.): 

In 2023, we will continue to focus on training our employees in high reliability safety practices which, in part, encourages all team members and physicians to "speak up" if they see a potential safety hazard. Our safety culture also empowers everybody at Elmhurst Hospital to deliver on our "zero harm" commitment.

Todd Steward. CEO of St. David's Medical Center (Austin, Texas): 

As we look forward to 2023, we will continue to maintain patient safety by consistently using evidence-based practices with every patient, during every encounter, every time. The dedication to our patients of our long-tenured clinicians and staff makes this possible. Providing quality care is ingrained in our culture, which has helped significantly during the COVID-19 pandemic and will continue to carry us through future challenges.

Mayo Clinic Hospital (Phoenix): 

A focus for 2023 is to assure a safe atmosphere for our patients and staff through patient and visitor conduct programs. One key effort is a pilot led by the Mayo Clinic Workplace Violence Prevention Program for the proactive screening of patients to identify behavioral concerns that may lead to violent episodes. Based on findings from the screenings, individualized care plans are developed to prevent events that could result in injury.

"As a healthcare institution, we cannot assume that the patients and visitors entering sites have the capacity and intent to participate safely, and so we must take steps to prevent violence and de-escalate situations that may lead to harm," Katherine Noe, MD, PhD, chair of Mayo's quality subcommittee in Arizona, told Becker's.

Kaiser Permanente Orange County-Anaheim (Calif.) Medical Center:

The psychological safety of our clinicians and staff remains foundational to our patient safety journey. Leadership rounds, labor management partnerships, clinician-nurse communication teams and an overall paradigm of "seeking first to understand" are critical pillars of our safety culture. 

Given the current surge of influenza, respiratory syncytial virus and COVID-19 yet again, our strategic patient safety focus continues to center around reducing hospital-acquired infections. 

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