Safety Culture/Infrastructure

Salus will help you understand your organization’s patient safety culture and improve your patient safety infrastructure. Through our comprehensive and hands-on approach, we will work with you to understand your challenges and priorities and customize a patient safety program. This program results in immediate actionable improvements and is preparation for intermediate and long-term achievements. An improved understanding of patient safety and risk vulnerabilities will occur with specific recommendations on how to address these vulnerabilities. Importantly, the demonstration of results will enhance engagement by leadership, physicians, and front-line staff members in improving patient safety, patient care, and the patient experience. Such engagement directly impacts risk management and quality metrics..

High Risk Service Lines

• Perinatal Services
• Emergency Department
• Surgical Services

Certain service lines have magnified challenges regarding patient safety and risk management. These challenges include but are not limited to a rapidly changing work environment, constant interruptions, frequent transitions of care, a high number of inter-professional and interdisciplinary interactions, and clinical team member well-being.

Using our process of intense pre-visit work, combined with case review, on-site interviews and “in-situ” time within the clinical units, the Salus team takes a pro-active approach to patient safety to deliver actionable recommendations. Salus is willing to help you track your progress in implementing these recommendation.

Implementing Clinical Learning Environment Review

ACGME sponsoring institutions undergo a Clinical Learning Environment Review (CLER) approximately every two to three years. These reviews include feedback on patient safety and five additional focus areas, which are very closely linked to patient safety.

In preparing for CLER visits, academic medical centers and health systems invest significant resources. These efforts include the time dedicated by leadership, attending physicians, resident and fellow physicians, and nursing staff during the site visit. Salus encourages organizations to use this valuable information and not just let it sit on the shelf! Salus is uniquely prepared to dissect CLER reports and work with your organization to develop priorities and customize a plan of action to address the feedback provided. In addition to addressing patient safety and the other CLER focus areas (e.g., well-being of the clinical care team), there are substantial benefits to the purposeful implementation of the results from your CLER visit, including improving engagement with your physicians through demonstration of action.

Disruptive Provider

Salus recognizes that the root causes contributing to a physician being labeled as “disruptive” are complex, and often the result of maladaptive behavior from working within challenging patient care environments. Often the contributing system factors that add to the stress-response “disruptive behaviors” are also factors that pose a risk to patient safety. Neither tolerating these behaviors or losing physicians is beneficial or cost-effective for a healthcare organization.

Salus is prepared to assess and positively impact both the contributing factors and the behaviors that lead to “disruption.” This process often includes coaching of individual physicians and advanced practice providers to help your organization retain them and to help them become productive and positive members of your health care team.

Leadership Rounding

Many organizations promote leadership and board member rounding to transform and improve patient safety culture. Rounding preemptively identifies patient safety and risk management concerns, as well as barriers to quality improvement initiatives. The process demonstrates commitment by senior members of the organization to patient safety and mitigates concerns from staff members that items reported end up in a "black hole".

Unfortunately, many of these rounding efforts are short lived. Salus understands that there are several contributing factors to the lack of permanence, such as executives and board members often having non-clinical backgrounds or being several years removed from direct patient care. This leads to a high level of discomfort from the members of leadership and a natural inclination to discontinue these valuable activities.

Salus has completed thousands of these unit-level interviews and has trained individuals from a wide-variety of backgrounds to engage and learn from front-line team members. Salus will train your leaders to round efficiently and effectively, enjoy the rounding process and improve engagement in patient safety efforts.

Consulting

Salus provides consulting services to work with you on additional areas of risk:

• Informed consent
• Policy, procedure and protocol development and review
• Credentialing/privileging
• Documentation
• Disclosure of unanticipated events
• Telemedicine
• Well-being of the clinical care team
• Other service line assessments