More than 50 senior leaders and board members who are not in direct patient care roles have been certified in patient safety by a national body because 'patient safety is everyone's duty.'
Rusty Holman is a physician and chief medical officer at LifePoint Health, so it makes sense that he should be certified in patient safety. He holds a Certified Professional in Patient Safety credential from the National Patient Safety Foundation, which merged with the Institute for Healthcare Improvement in May, 2017.
For the past few years, Holman has headed up an internal executive patient safety conference in the Nashville area for leaders at LifePoint.
The 72-hospital chain considers it mandatory for patient safety officers and quality directors at its hospitals to achieve the certification, and supports other clinical positions in achieving the designation as well.
But as it became increasingly clear that quality and patient safety could be measured and quantified, and as more of its clinicians became certified, a few LifePoint executives began to see the value in getting certified themselves.
The logic: Their effectiveness and empathy for clinicians could be greatly improved by learning more about quality and patient safety themselves. They went to Holman with a request: Could they also get certified?
"Much in same way we've always exercised financial and operational discipline and strong community partnership, we've pivoted our culture toward patient safety in such a way that recognizes the improvements we need to make and that there's a science to patient safety," he says.
"It's not just a series of common-knowledge principles you follow through on."
About 105 individuals throughout chain have been certified, roughly half of whom are part of individual hospital C-suite teams, including CEOs and even a CFO.
Culture change can be tricky to implement and slow to build, Holman concedes, and the organization's journey toward making quality and patient safety a priority represented a culture change of sorts as people outside of traditional patient care roles were encouraged informally to get certified, if they desired.
There was no organizational mandate toward leaders on achieving the designation, but a few early adopters recognized that imperatives to improve patient safety metrics might be easier to achieve if the offer of patient safety certification was extended to more than just patient safety officers or quality directors.
The organization needed broader involvement, a guiding coalition, and strength in numbers, as Holman puts it.
"The cultural piece is something we all recognize is slow to build," he says.
"Fundamentally, we did not necessarily want to change our culture, but we wanted to evolve what was already strong about it and deliver outstanding results in quality and safety."
Many of the newest certified C-suite members have done so because they were challenged by their colleagues, says Holman.
Senior leaders went through a training process and an exam "that's not by any stretch easy" to achieve certification, says Holman. That sent a signal to everyone that patient safety is worthwhile, important, and not just good for patients, but for their careers.
"It makes them better leaders, informed executives, and it helps achieve our mission of making communities healthier," Holman says.
Thanks to the testimony of those few early adopters, momentum followed.
"Early it was just a handful. But the number has grown significantly over the past three years," he says.
And it's unusual.
"I'm simply not aware of other large health systems are encouraging anyone outside patient safety or quality to undertake this certification," says Holman.
Vicki Parks, chief financial officer at Jackson Purchase Medical Center, a 227-bed community hospital in Mayfield, KY, received her certification in early 2016.
She accepted a challenge from her group president to become the first CFO in the company to be certified in patient safety. In her training and background as a CPA, things are very clear-cut.
That's not so in patient care. "Accounting rules standards to tell us how to do everything. There's not a lot of gray involved in the CFO world," she says.
"But what I learned is that most of what they do every day is based on judgment. I learned to listen to [clinicians] more, instead of judging so much. There are so many extenuating circumstances to why they act in a certain way and I don't think I had any idea what they went through on a daily basis."
Mark Holyoak, CEO of 49-bed Castleview Hospital in Price, Utah, and a 17-year LifePoint employee, achieved his certification in late 2016.
Though Holyoak is a nurse by training, he sees benefits to having non-clinicians achieve patient safety certification because it helps them better understand why decisions are made in patient care, and helps them make better decisions involving budgets.
"We're looking at process improvements, but as CEO it's helped me make the decisions through the lens of being as safe as we can be," he says.
Philip Betbeze is the senior leadership editor at HealthLeaders.