I was a panelist today at the Ellison Pierce Symposium, a continuing medical education program run by Boston University School of Medicine. I had the pleasure of hearing a presentation by Timothy Babineau, President and CEO of Rhode Island Hospital and Hasbro Children's Hospital in Providence. Tim gave a concise and cogent description of the problems involved in implementing a strong quality and safety program in an academic medical center. There is a facetious expression that, "you've seen one academic center, you've seen one academic medical center," but I saw an awful lot of similarities between Tim's campaign and our own. Nonetheless, I'm always searching for new ideas, and he provided one: Start each meeting with "did we harm or almost harm a patient this week" as a way of emphasizing the priority of this topic in the institution and of keeping the issue in the forefront of people's minds.
About an hour after returning to BIDMC, I happened to have town meeting with a group of our housekeepers and food service workers, and I decided to try out Tim's idea. Now, please recognize that these meetings usually focus on lots of other things that do not include patient quality and safety. You might guess the normal topics -- salaries, benefits, transport to work, and such. Nonetheless, I started by reminding them of our overall goals of trying to treat patients in a safe manner, and pointed out that they have more direct contact with patients than virtually anybody in the hospital. I stated that the best way for us to avoid harm to patients is to call out lapses in our performance as we see them, and I promised that they would never get in trouble for mentioning these kinds of situations or incidents. Then I asked if they had noticed anything recently that raised concerns for them. The ideas and suggestions started to pour out! They demonstrated a remarkable sophistication and depth of understanding of concepts related to infection control and other quality-related protocols.