The Keystone Initiative

Engage, Educate, Execute, and Evaluate
Sam R. Watson, Senior Vice President Patient Safety and Quality
Michigan Health & Hospital Association

We haven’t come as far as we think we have in terms of making healthcare improvements. It’s no secret that we are still faced with the human error challenges that contribute to patient safety breaches.

Sam Watson, Senior VP of Patient Safety and Quality at the Michigan Health and Hospital Association asks us, how do we reduce the complexity of healthcare delivery? This mission, tied to increasing reliability of interventions and behaviors, is also a component of an organization’s culture of safety. Since Keystone is a small team, it partners with experts to package interventions and bundles. For the MHA, patients are the keystones. Despite the technical nature of healthcare delivery, the fact that patient safety and quality are not competitive performance indicators currently inhibits the adaption of evidence into practice.

Watson warns us not to get lost in the tools, such as LEAN, Six Sigma, or other evidence-based trends. The fact that healthcare is a human system puts patients at risk every day. MHA initiatives approaches safety as a science in which the organizational culture is evaluated prior and subsequent to implementing educational forums, collaborative relationships, and transparent procedures. An assessment of the teamwork climate across MHA hospitals reveals that RN perception of teamwork climate is significantly lower than the physician perspective, and the RN perception is inversely related to turnover rates.