Safety Initiative at Children’s Hospital Engages Workforce, Reduces Serious Events by 70%

Implementation of a safety transformation initiative at a Washington, DC, children’s hospital resulted in a 70% reduction in serious safety events and an estimated savings of $35 million during a three-year period, according to an article published online September 20, 2012, in the Journal of Healthcare Risk Management. The initiative involved taking high-reliability principles and translating them into a work plan that promoted the desired objective of a high-reliability safety culture through five key drivers: safety governance, reporting and cause analysis, error-prevention design and strategy, employee empowerment and accountability, and situational awareness and workforce engagement. To engage the hospital’s leadership, a special, mandatory, peer-review board retreat was held to discuss the rate of serious injury in the hospital, and monthly unit-based executive safety rounds were initiated that included frontline staff and a member of the executive leadership. The facility also completely redesigned and improved its systems for collecting adverse event data, performing root-cause analyses, and responding to the findings.