Building a Culture of Safety

Learning the Landscape

Crothall had to build a culture of safety from the ground up. “Most safety issues were briefly discussed and dismissed before we made it a focus,” said James Burke, Crothall Resident Regional Director of Operations at Children’s Hospital Colorado. “The bedrock of our operations is safety, so we had to make safety a priority for the whole staff.” Crothall established its presence by discussing safety risks and opportunities with the clinical and support personnel.

The approach took patience and determination. “There was an initial rise in safety incident reporting when we came in, but that was a good sign for the long term,” said Burke. “This meant that people were putting a hyper-focus on safety, and the increased reporting helped us learn the challenges we had to address to make real change.”

Crothall’s approach fit in perfectly with the hospital’s new vision. Children’s Hospital Colorado introduces “Target Zero,” an institutional focus on zero safety incidents for patients and workers. Various committees throughout the hospital formed to investigate specific safety risks, such as slip-and-fall causes and lifting techniques. Crothall EVS and Patient Transport managers serve on the committees to maximize their effects.

“Talking about it was the beginning of big changes,” said Brian Varner, Director of Risk Management for Compass One Healthcare. “Now, everyone in the hospital would say that safety is the number one priority. Then the Crothall team followed up with passion and smart decisions.”

Focus from Day One

The focus on safety starts right away for new employees. Crothall overhauled the recruitment and screening process for EVS full-time employees to be sure professional skills and abilities fit in with the new culture of safety. “We keep safety top-of-mind at all times as part of our duties as managers,” said Burke. “When I call to confirm an interview, I mention safety. During the interview and the orientation, we drill safety priorities and procedures. No one forgets because we won’t let them.”

EVS teams celebrate their safety wins to focus on what goes right. “We’re always focusing on our key performance indicators, especially time without safety incidents,” said Burke. “When we make it a month, a quarter or a year without a class of safety incidents, the team knows it with positive staff meetings and good feedback from our safety champion.” Information and milestones are shared with the Crothall Patient Transport unit, especially when findings can help smooth their operations.

Quality safety inspections keep teams on their toes at all times. Safety professionals from outside the department help conduct objective inspections of rooms, hallways and other EVS zones to share positive and negative results with the safety champion. The shared results help managers understand how EVS employees have improved and can improve safety in the hospital.

The next step was action planning to make iterative changes. Managers align future plans for their departments and staffs with action planning derived from the trends and changes in safety inspections. Corporate safety officers work with managers and staff so reports of any incidents or risks are more detailed than before and geared more towards change management.

Heroes and Zeroes

The hospital set Target Zero, and Crothall helped hit it. Children’s Hospital Colorado ranked low in the Crothall family regarding safety, with an average of 22 safety claims per year. Three years later, the unit led the pack with zero safety claims. “It was one of the most extraordinary transformations I’d seen in environmental services,” said Varner.

Workers get more than celebrations to commemorate their victories. The tradition of Safety Day helps keep safety at the top of people’s minds with some fun and rewards. Associates who work for a year with fewer than three safety tickets are awarded an extra personal day. Winners in the corporate “Safety Bingo” games are also recognized for their accomplishments. Ad-hoc parties and catered meetings help EVS workers feel gratitude from managers.

Patient experiences improved as turnaround times edged lower. Cleanliness scores in regular patient experience reports rose 7 percent in the first year. During the same time, EVS teams increased productivity to 27,633 total room cleans with a 58-minute average turnaround time.

Good news of Crothall’s accomplishments spreads quickly. Crothall’s EVS services will be expanding to University of Colorado Hospital in 2019 to target their safety issues with new environmental services.