Our journey to zero: Reducing serious safety events by over 70% through high‐reliability techniques and workforce engagement

The techniques and best practices used to achieve a successful safety culture transformation and drive down the incidence of serious safety events are described. The Safety Transformation Initiative at Children's National resulted in national and local recognition, a financial savings of an imputed $35 million, and a greater than 70% decrease in the serious safety event rate over a 3‐year period (July 1, 2008–June 30, 2011). The results were achieved during a time of significant financial constraints and with limited resources. A blueprint detailing specifics of the implementation is presented to assist others in achieving similar results. Our safety transformation was initiated in our fiscal year 2009 as part of a 3‐year corporate goal. The work is continuing and we aspire to virtually eliminate serious safety events by 2016.     

ASHRM member benefits and programs enhance patient safety

ASHRM's 2013 ongoing theme—“Everyone is a Risk Manager” (ERM)—emphasizes the vital role that all healthcare workers hold as guardians of patient safety, every single day. Each and every employee must take ownership of risk and recognize their part in the patient safety process.     

Maintaining the privacy of a minor's sexual orientation and gender identity in the medical environment

Dealing with self‐identity, sexual orientation, and gender identity is often a struggle for minors. The potential negative outcomes minors face when their sexual orientation or gender identity is disclosed to others before they have an opportunity to address it in their own time has become more evident in the media. Because of the intimate nature of the provider–patient relationship, the healthcare provider may be the first person in whom they confide. If a minor receives a positive, nonjudgmental experience from his or her provider, it will often lead to a more positive self‐image, whereas a negative, judgmental experience will often result in the opposite. Critical components of their experience are a sense of trust that the provider will keep the information confidential and the healthcare setting being organized in a manner that promotes privacy. Healthcare providers play a key role in developing and projecting a safe, comfortable environment where the minor can discretely discuss issues of sexual orientation and gender identity. Establishing this environment will usually facilitate a positive therapeutic relationship between the minor and the provider. Steps healthcare providers can take to achieve trust from minor patients and ensure confidentiality of sensitive information are understanding privacy laws, making privacy a priority, getting consent, training staff, and demonstrating privacy in the environment.     

The journey and Journal get better every year

As I enter into my presidency, I have been reflecting on the past and when I first learned of ASHRM and everything the society offered. I think of all the past presidents and how much I admired their knowledge and dedication to the profession of healthcare risk management.