FORT DRUM, N.Y. (May 28, 2015) -- A "high reliability organization" is defined as one that has succeeded in avoiding a catastrophic event in a setting where normal accidents can be expected due to complexity and risk factors. In line with HRO principles, the U.S. Army Medical Command has set a goal of becoming the world's leader in high reliability health care and creating an effective culture of safety.
The Fort Drum MEDDAC is doing its part in helping MEDCOM reach these goals.
According to the Centers for Disease Control and Prevention, the national average for surgical site infections is 2-5 percent; the Fort Drum MEDDAC is below the national average. Of the 6,000 invasive procedures performed by Fort Drum MEDDAC staff throughout its on-post clinics and in hospitals in surrounding communities from 2012 to 2014, the infection rate was less than 1 percent.
Since the beginning of 2015, MEDDAC providers have performed nearly 700 procedures, with only one potential infection noted.
MEDDAC providers perform procedures at Carthage Area Hospital, Carthage; Samaritan Medical Center, Watertown; and River Hospital, Alexandria Bay. The philosophy for a health care HRO focuses on the concept that every member of an organization has an equal say in ensuring the safety of patients.
Within the MEDDAC, the staff is empowered to report and communicate potential events that may have resulted in patient harm. These events are reported through the Patient Safety Reporting system.
According to Barry Eyestone, MEDDAC patient safety officer, "people are reporting because they understand the program and because command is involved with recognizing the errors and trying to put an immediate fix to certain things."
Eyestone went on to say that the command team emphasizes Patient Safety Reporting through the "Good Catch" award program.
The "Good Catch" is a monthly monetary award given to a staff member who identifies that month's top Patient Safety Report. Two to three good catch reports are generated and voted on by Patient Safety Committee members.
Col. Fernando Guerena, Fort Drum MEDDAC deputy commander for clinical services, reiterated that speaking up and reporting potential issues "isn't about finding a guilty party, it isn't about accusations, it is a circular way of discussions."
Discussions are taking place not only within MEDDAC and among staff members. Because providers perform a number of procedures in off-post hospitals, they also need to have a voice and feel empowered to speak up in that setting. According to Col. John Groves, deputy commander for nursing, the MEDDAC has "continuing quality assurance meetings with Samaritan (Medical Center).
So if there are issues that come up, we have the right people in the room to make the necessary adjustments."
He went on to say that the MEDDACs partnerships and relationships with community hospitals help the staff to better serve patients.
"We had a concern at Samaritan, but we were able to get all the key players together, so the respect we have (among us) is notable," Groves said. "As soon as we raise a concern, the top-ranking leader of that organization calls a meeting and figures out how to fix it."
"It was very collegial. It wasn't uncomfortable; it wasn't a pointing-fingers thing. It was just raising awareness that there was a concern," he added.
The idea of encouraging employees to speak up when they see something wrong stems from a training program called TeamSTEPPS.
According to the U.S. Department of Health and Human Services website, "TeamSTEPPS is a teamwork system designed for health care professionals that is a powerful solution to improve patient safety within your organization, an evidence-based teamwork system to improve communication and teamwork skills among health care professionals."
The premise behind TeamSTEPPS is that every person on the team -- from the top-ranking surgeon in the operating room to the person sweeping the floors -- does a part in keeping the patient safe. It also teaches that no matter the rank, if an employee sees that something is wrong, he or she should speak up.
Currently, the Fort Drum MEDDAC has trained about 90 percent of its employees in TeamSTEPPS, with a goal of reaching 95 percent. The MEDDACs clinical guidelines, staff following procedures and the command team promoting a culture of safety have all attributed to the success of the organization.
But there is still room to grow, according to Guerena.
"We still need to sustain (this success) and maintain it," Guerena said. "We must keep our minds open to new issues, new bugs, and there are always new technologies. We are a learning organization."
Social Sharing