The Foundation of Quality Is Safety

"There are hundreds of priorities that sit on my desk. If safety is one of them, it's in with the hundreds of others. But if it's a precondition, that means I begin work at 6:30 a.m. at the point of care asking 'did anything happen last night that could lead to the risk of someone getting a central line infection?’" he says. "That tells the workers that it's a precondition of coming to work."

Nurses need to be on the frontline with patient safety, he emphasizes. "It's fundamental," he says. "Nurses are the guardians of patient safety. They need to be empowered to do this. It's extraordinary what you can achieve when you partner with nurses."

Shannon recommends moving beyond data collected by the Centers for Disease Control and Prevention. This data generally does not deal with "fixing problems in hospitals." Instead, he suggests becoming a "deep observer of the current condition" within the healthcare organization.

For instance, it is important to know how a central line is "placed, maintained, and manipulated." And then, taking that knowledge and learning and "sharing it with everyone," he says. "As a leader, you must commit to fixing things that are there . . . to make sure [an infection] doesn't happen again."

And while comparative effectiveness has its benefits, it's not feasible when dealing with patient safety issues of waiting around five years or so for answers. "Safety is about making little changes at the point of care and then seeing if they worked," he says. This means listening to ideas of those on the frontline of delivering healthcare.