On a recent site visit to Contra Costa Regional Medical Center and Health Centers in California, the Essential Hospitals Engagement Network (EHEN) team hosted a workshop for clinical leaders that highlighted how to prioritize and predict project successes and how to use team members’ roles and knowledge to accelerate improvement.
My role during the workshop was to coordinate logistics, assist in facilitating group activities, and to soak up as much information as I could from the content experts in the room.
I learned firsthand some of the challenges improvement teams face when they are first forming. I also learned that there are existing tools for developing a team charter, defining team members’ roles, making tough decisions, running rapid tests of change, and implementing new processes.
‘This Project is Personal’
I had a chance to chat with Sonia Sutherland, MD, the physician leader of a team that’s working to decrease incidence of venous thromboembolism (VTE) at Contra Costa. Her team currently is running small tests to determine how best to increase compliance with VTE prophylaxis, or measures to prevent VTE before it occurs. They are also working to educate clinicians, patients, and families about why prophylaxis is critical.
Hearing Sutherland describe the importance of the project was inspiring. “The project is important because it can save lives,” she said, noting that when the team initially formed, the members discovered that each of them had either experienced a VTE or knew someone who had. “We realized that the issue is more widespread than any of us knew.”
For Sutherland, it was personal. Her brother developed a VTE when he was hospitalized recently for a heart attack, which led to a succession of preventable readmissions.
On the morning of my discussion with Sutherland, she had a heart failure patient whose chart was missing orders for VTE prophylaxis. A resident noticed that this person should have had a compression device in place to lower her risk of VTE, even though one hadn’t been ordered. He immediately notified Sutherland, and the issue was resolved.
According to Sutherland, the “experience is evidence that VTE prevention strategies have been hardwired and embedded into the hospital’s culture,” which made her happy.
It made me happy, too—seeing the hard work of Sutherland’s team in person was a great reminder that the work I do in my office in Washington, D.C., has a real impact on clinicians’ behavior and, ultimately, the safety of the patients they treat.