When you go to a hospital, you expect to be helped, not harmed. Providing the safest and best care possible to all our patients is our #1 goal. I’m proud to say that thanks to the hard work of our kid experts at Children’s Minnesota, we exceeded our patient safety goals in 2024.This kind of progress doesn’t just happen. Patient safety requires a concerted effort. It means following some important principles. Natalie Lu is a certified professional in patient safety, registered nurse, and quality and patient safety coach at Children’s Minnesota. She’s also a mom. I’ve invited her to share more about our patient safety work and how it’s paying off.
Natalie Lu in her own words
As much as we don’t want it to be, risk is all around us. Sometimes it’s risk you expect. I’m the mom of a child with an appetite for activities that far surpasses my own threshold for adventure. So, it’s no surprise that I sign quite a few waivers associated with their rock-climbing, rope courses and snowboarding feats. When signing these waivers, I’m always struck with the gravity of how much risk can come with recreation.
Medical procedures also carry risk. Even in places of healing, like children’s hospitals, there is the risk of harm. Keeping central lines free of infection, keeping skin free of breakdown, avoiding adverse drug events, and stopping unplanned extubations, these are some of the most common preventable harm events we see in pediatrics.
At Children’s Minnesota, our patient families entrust us to deliver safe care, so we’ve put ourselves on a “Journey to Zero,” devoting enormous time and effort to eliminating preventable harm. Our hard work is paying off! In 2024 we aimed to reduce preventable harm by 10% over 2023, and we achieved a 40% reduction!
These results are thanks to the comprehensive approach we take, combining cause analysis, safety coaching, safety learning reporting and peer support programming. There’s a lot I could say about each one of these tools, but there are two things in particular I’d like to highlight here: collaboration and culture change.
Collaboration
The most important work being done to drive down adverse events in our health system is collaborating with our patient families. Pediatrics is heralded as a leader in delivering family-centered health care, which means “working ‘with’ patients and families, rather than just doing ‘to’ or ‘for’ them.” At Children’s Minnesota we strive to place families as the constant in the care team; we are the visitors in their experience. One example of how we are collaborating in real-time during hospitalization is by holding proactive safety huddles, where members of the care team trade ideas with patient families about what might make care delivery safer. We also have a Quality and Safety Experience Team of family advocates who serve as a patient safety advisory group in a reflective space beyond hospitalization.
Pediatric hospitals are also working together to improve patient safety. Children’s Minnesota is part of Solutions for Patient Safety (SPS), a collaboration of more than 140 pediatric hospitals across the U.S. and Canada that share successes and fresh ideas. We are flipping the script on patient safety events from reactive to proactive approaches. Since its inception in 2009, SPS reports that we have collectively spared more than 30,000 children from preventable harm, saving more than $600 million at children’s hospitals across the country.
Culture change
Safely caring for patients means building a culture where we have safe systems in place and where we’re also taking care of the people who provide our care. Well-intentioned medical professionals never want to cause harm. After an adverse event, it’s important that we focus on “what” went wrong versus “who” did something wrong. To not approach an incident with shame and finger pointing, but with the goal of understanding the root causes of what happened so we can improve the systems in which the incident occurred, so it won’t happen again. This is called creating a “just culture.”
We’re creating a just culture by weaving proactive safety tools into our daily practice. An example of this is we often ask each other where we might see the next error happening. When we proactively identify potential risks, we start to see patient care from angles we wouldn’t otherwise see. Whether it is walking around a unit in the hospital or small group conversations to discuss what makes our work safer, we are finding ways to prevent errors before they occur.
We are also creating a just culture by caring for our Children’s Minnesota caregivers. An example: We are proud to have a nationally recognized peer support program, a framework that optimizes how we care for each other as we deliver care to patient families in the vulnerable moments of hospitalization. In his May 2022 Advisory on Building a Healthy Workforce, former Surgeon General Dr. Vivek Murthy urges health care organizations to invest in peer support models as a best practice to mitigate burnout and feelings of loneliness and isolation that can be associated with care delivery.
Thank you
An essential part of improving patient safety is having supportive leaders. As our Children’s Minnesota community prepares to wish our president and CEO well in retirement, I want to thank you, Dr. Gorelick, for your leadership in building a culture of safety. You have made an indelible mark on our “Journey to Zero” by rounding with and recognizing unit-based safety coaches, hosting a Peer Support Salon experience in the boardroom, and delivering countless (or maybe you’ve counted?) notes of gratitude to our colleagues who have written “Good Catch” submissions for our Safety Learning Report platform. You have leaned into this work with curiosity, never hesitating to express enthusiasm and gratitude. Thank you for leading by example and modeling a safer pursuit of progressive pediatrics.
We aim to do even better in 2025.
Guest blog written by Natalie Lu.
