On Feb. 5, Press Ganey recognized the system with its HRO Foundation Award for its sustained reduction in serious safety events, achieved through a range of safety initiatives as part of its commitment to high reliability.
“It really is in everything we do, every day,” Jason Golbin, DO, Catholic Health’s chief medical officer, told Becker’s. “Every patient, every encounter, every time you have to live and breathe those high-reliability principles.”
Dr. Golbin recently spoke with Becker’s about how the system has built and continues to sustain its culture of safety and quality, bringing the goal of zero harm closer to reality.
An early adopter of high reliability
Catholic Health launched its high-reliability journey in 2015 under the leadership of then-CMO Patrick O’Shaughnessy, DO, now the system’s president and CEO.
As a licensed pilot, Dr. O’Shaughnessy strove to understand and implement the principles that drive aviation safety at Catholic Health. At the time, the integration of high-reliability principles into healthcare was just starting to take hold, according to Dr. Golbin.
After gaining approval from its board, Catholic Health partnered with Healthcare Performance Improvement, a consulting firm now owned by Press Ganey, to kick off its high-reliability journey.
The first step was defining patient safety as a core value across the organization. Leaders developed a list of daily principles related to that goal that staff members all agreed to learn, adopt and live by every day.
From there, Catholic Health spent a little more than a year training its entire workforce — at the time 16,000 employees — on these principles. This training was not just a requirement for employment, but a condition for credentialing among all clinicians. These actions were crucial to gaining buy-in among team members, as it signaled that the effort was not just “a flavor of the day” but a deep-rooted commitment within the organization.
“Some of the physicians and staff who initially said, ‘I don’t know. This is just another initiative,” they became our biggest advocates after their training and learning,” Dr. Golbin said. “So I think you need to push through it and make sure it becomes culture.”
The health system also focused on flattening its organizational hierarchy, encouraging any and all staff members to speak up about potential safety concerns using a shared language.
“We call it ‘cussing’ — C-U-S,” Dr. Golbin said. In this communication model, staff members follow a three-step approach: first, they express their concern (C), then state why they feel uncomfortable (U), and finally, stop the line if they believe a safety issue (S) exists. Dr. Golbin noted that this language has become so engrained in the organization’s culture that it even surfaces in administrative meetings, regardless of whether the discussion is related to quality, safety, experience or engagement.
The health system also designated leaders across the organizations as safety coaches to champion the program and implemented daily safety huddles at each hospital campus. These huddles have since expanded to its medical groups, physician offices, home care and hospice services.
“As this took hold, we started to see a real shift in culture,” Dr. Golbin said. “We started to look at every single safety event or near-miss, raising that culture of high reliability throughout our organization. This culture has helped us grow and prosper on our journey to zero harm.”
Sustaining improvements
Building a culture of high reliability is a notable accomplishment — maintaining and evolving that culture is a whole other challenge.
Catholic Health has sustained its high-reliability culture through a consistent and deliberate leadership focus, paired with clear and unified messaging across the organization. The commitment to delivering the highest-quality and safest care is reinforced at every level of leadership, with Dr. O’Shaughnessy embodying this mission daily as CEO. This unwavering attention ensures that the principles of high reliability resonate throughout the organization, from executives to front-line staff, fostering a shared sense of accountability, according to Dr. Golbin.
The results speak for themselves. Catholic Health has seen a more than 80% reduction in safety events since 2018.
“We have many campuses and units that are at truly zero harm, ” Dr. Golbin said. “We want to spread that.”
In 2024, the system’s St. Charles Hospital in Port Jefferson, N.Y., and Catholic Home Care team both received the 2024 Human Experience Achievement for Zero Harm Award from Press Ganey. The award recognizes organizations with member facilities that have gone at least a year without a serious safety event.
Building on its success in quality and safety, Catholic Health has expanded its high-reliability journey to include patient experience and staff engagement. The system is developing a balanced scorecard that will integrate safety and quality metrics alongside annual workforce engagement survey data and HCAHPS scores. This dashboard will be segmented by campus and unit in inpatient settings, by practice in ambulatory settings and by team in home-care settings.
The scorecard is set to go live systemwide by the end of the second quarter, providing leaders with valuable insights to identify areas for improvement and share best practices.
“We want to celebrate the wins and keep our continued foot on the pedal wherever possible,” Dr. Golbin said.
