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The results are in. Your voice has been heard. It is now time to put those thoughts, ideas and concerns into action. I want to thank you once again for participating in the 2023 Culture of Safety and Engagement Survey. 79% of our associates and 48% of our medical staff participated in the survey. Hopefully you were able to join one of the Town Halls at the end of November to learn about our results and the plans we are making to take action on the ideas, thoughts, and feedback garnered through your comments. During the Town Halls, I spent about 40 minutes reviewing and summarizing the data. I’ve tried to take that information and further summarize it into this month’s eLert message. As we proceed through the next few months, we will provide updates on the efforts being undertaken to improve the culture of patient safety and further develop a deeper associate engagement to the organization.
To summarize, the overall culture of safety rating increased 11 percentage points from 2021 to the 31st percentile within Press Ganey’s database of healthcare providers. While we celebrate the improvement, we recognize that this is still a failing grade. At the heart of this is a concern about resources and teamwork. Specifically, a more reliable EHR, better staffing in certain areas, and improved communication were the top concerns. Each is valid and something we spend considerable time trying to remedy, and I’ve tried to outline some of those as follows.
- We are working closely with training programs at Wor-Wic Community College, Salisbury University, Wilmington University, Delaware Technical Community College and Chesapeake College to develop a pipeline for future nurses and allied health professionals to join our organization.
- We’ve launched the CNA training program and have summer and college internship positions for student nurses.
- Scholarships and tuition assistance programs are in place for associates seeking to grow in their profession.
- We are working to create career ladders that provide growth and pay advancement opportunities across the organization.
- Nursing leaders continue to explore alternative staffing models through the reintroduction of LPNs to the nursing team.
- Finally, several of our nurse leaders are beginning to map out and pursue Pathways to Excellence designation through the American Nurse Credentialing Center (ANCC). We can do this but it won’t be easy. This is a long game and one that requires patience, resolve, and engagement from within.
Related to the EHR, this is among the highest priorities for AGH administration and the Board. We fully understand the importance of reliable clinical and business applications that support your work and ensure our patients get quality, safe care.
- We have engaged with Altera to develop action plans around those areas that need to be improved or further optimized.
- Our IT department has invested significant resources in building and upgrading the critical infrastructure needed to maintain and operate our software applications.
- We will continue to evaluate whether these investments are enough and if Altera is the right platform. This is a major consideration that requires significant thought, understanding, and evaluation. We have to get this right.
I do want to address the perception that patient safety and quality of care aren’t our highest priority. It is the essence of our work and at the heart of what we do every day. Leadership owns this perception and I assure you our pursuit of high reliability and zero harm is something that guides our work. Despite the many challenges we face, you are making a difference and the results bear that out.
The Board set a goal of seeing a 50% reduction in patient harm events this year. A harm event is any unplanned event that might reach a patient inadvertently. They include things such as falls, pressure injuries or ulcers, a hospital acquired infection, or drug error. These events bring significant added burden to the patient and their family. Through your efforts and a focus on continuous process improvement, I am proud to report that through October, AGH is meeting that goal with 13 harm events compared to 27 events though the same period in 2022. Achieving zero harm is our ultimate aim. When we report errors or events that may cause harm to a patient, it creates an opportunity to evaluate what happened, what could have been done to prevent it, and how we can ensure a future event doesn’t happen. Each of us has a part to play in that. Speak up, share concerns, and ask for clarity if something doesn’t seem right. If you see something, say something.
An offshoot of strong patient safety results is patient satisfaction. When we communicate effectively, adhere to protocols and standards that promote patient safety, and conduct ourselves with the values that define our culture (C.A.R.E.), patients will routinely feel well satisfied with their care. Our goal is to be a hospital performing in the top quartile nationally as measured by Press Ganey and through the 1st quarter of fiscal year 2024, AGH is at the 72nd percentile so we are very close. AGHS, our affiliated medical practices, has achieved a national ranking of the 75th percentile. This is testament to the excellent care you provide. Having our patients give us ratings of 9 and 10 by answering “always” rather than “usually” is really hard. It requires consistency in our work. By putting our patients first, each of us can have an impact in contributing to a patient’s experience. By living our values, each patient can experience the compassion, respect and support they need to restore their health. It’s an incredible privilege to work in health care and to contribute to the dignity and restoration of one’s health, whether you are on the front line or supporting those on the front line. Every role matters.
Finally, the survey was an opportunity to assess the level of engagement with our associates. The overall engagement score increased slightly from the 2021 survey. This is not true of most hospitals. Candidly, this is a win for AGH, given the tremendous effect Covid-19 has had on hospitals and health care workers across the country. Resiliency and good self-care programs are important measures that AGH will continue to try to nurture as we create a culture where associates can thrive and patients benefit.
We hoped to achieve a rating of 4.0 on a scale of 5.0, which would place AGH at about the midpoint for hospitals nationally. We achieved a rating of 3.96, up from 3.91 in 2021. While there were many positive and affirming themes that emerged – strong sense of community, good patient care, quality nurses and medical staff, and friendly environment, there were also a number of opportunities identified – communication barriers, respect, technology and EMR challenges, need for increased staffing, and continued improvement in associate pay and benefits.
Your department leaders have the results for your specific departments and should be sharing that information with you. If they haven’t, please ask them to. Specific action plans are being developed in response to the organization-wide themes that emerged. Those include increased transparency with operating results and performance, better communication across departments and throughout the organization, respect, and continued development of pay and benefit programs for associates. Some things you will begin to notice quickly, others will take more time to evaluate and implement. Nonetheless, we are committed to nurturing workforce strategies that position AGH as a sought after health care employer.
As we close out 2023 and celebrate Hanukkah, Christmas, Kwanzaa and the beginning of another New Year, on behalf of the Board of Trustees and the Senior Leadership Team, we extend our very best wishes to you and your family for a happy, healthy and magical holiday season and an ever more prosperous new year. It is my most sincere hope that the wonder of the season renews your spirit, excites you for what lies ahead, and allows you to pause and take inventory of the many blessings we have.
Thank you for all you do each and every day. Your work matters and our patients depend on it.
Onward and upward, together!
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