Enhancing workforce resiliency was front and center on Thursday, March 23, as Duke Health hosted its 12th annual Patient Safety and Quality Conference. More than 600 people turned out, marking the third consecutive year of record attendance.
A record 152 abstracts were submitted this year, with more than 430 individuals contributing to the performance improvements described in the abstracts. The top 87 abstracts – also a record – were on display at the conference.
In addition to safety and quality in patient care, the conference also highlights Duke University Health System's (DUHS') devotion to its value of teamwork, with scores of individuals and groups working together to make the event happen.
The gathering is coordinated through the DUHS Quality Office in conjunction with the Duke Patient Safety Center. Also involved are a Conference Planning Advisory Group and the Patient Advisory Council and its many volunteers. Planning the conference is a year-round job – work already is underway for next year's event.
"Our Duke quality conference is all about learning from each other and is tied to our core value – we are here today to continue to learn how to better care for our patients, and their loved ones, and each other," said Thomas Owens, MD, vice president for medical affairs and chief medical officer for DUHS. "This conference has grown, changed and adapted as healthcare has changed, as our team has grown, and as all of you have brought forward your great ideas and the tremendous work that is going on across Duke Health."
William J. Fulkerson Jr., MD, executive vice president of DUHS, praised the performance improvement work of employees. "Today we celebrate the work you and your colleagues are doing across the organization to continue to build our safe practices and enhance the quality of the care provided," he said.
The conference's keynote address was delivered by Tait Shanafelt, MD, director of the Mayo Clinic Department of Medicine Program on Well-being, a clinical laboratory evaluating personal and organizational factors that contribute to satisfaction.
Shanafelt reviewed troubling statistics about job satisfaction and emotional exhaustion among physicians and nurses. He noted the personal and professional repercussions of emotional distress among providers, and highlighted organizational approaches to promote well-being among healthcare workers.
"We've known [all this] for a decade and yet we have not responded to that system issue the way we would respond to other system issues," he said. "Distress is common among healthcare professionals, and there are multiple types. Burnout is one of the most frequent. Distress has an impact on the nurse, physician and their patients."
A panel of Duke Health leaders discussed the current climate and strategies to build workforce resiliency and promote well-being. The session was moderated by Jonathan Bae, MD, associate chief medical officer for Patient Safety and Clinical Quality, DUHS. Panelists included Catherine Kuhn, MD, Director, Graduate Medical Education; ACGME Designated Institutional Official, Duke University Hospital (DUH) and DUHS; Kevin W. Sowers, RN, MSN, FAAN, President, DUH; Rhonda S. Brandon, Chief Human Resources Officer, DUHS; and Vicky Orto, DNP, RN, NEA-BC, Chief Nursing and Patient Care Services Officer, Duke Regional Hospital.
Orto said she and her team try to keep a laser-like focus on emotional exhaustion and strive every day to make sure that high quality staff in appropriate numbers is working on units and have satisfying work environments. "That is a pretty tall order that takes a lot of time and energy but is worth every hour that we spend on it," she said.
Sowers said patient care is more complicated now than in prior decades – both medically and socially. "A level of social complexity around patients and families adds to the medical complexity we face," he said. "We encounter situations with violent or disruptive patients and families that didn't used to exist." Focused efforts are needed to cope with such stressful situations at the system, team and individual level, Sowers said.
Brandon said that while both individuals and organizations are responsible for managing stress and enhancing resiliency, individuals should not wait for the organization to take the first step in dealing with the challenge. "It's important that you acknowledge your truth and it's important for us as an organization to give you permission to raise your hand and say 'I need help,' " she said.
Marti Wilson, health center administrator at the Duke Eye Center in Winston-Salem, was attending the conference for the second time. "Safety is such a huge concern in the healthcare system and is the foundation for everything that we do," Wilson said. "If we can take away ideas from here and implement them back at the clinic level – even one thing – then that's been worth attending the conference."
Major Duke Health performance improvement accomplishments of the past year
- Duke Health achieving Healthcare Information and Management Systems Society (HIMSS) Stage 7 recognition for both ambulatory and inpatient settings – the highest achievement for shared patient data without paper.
- "A" safety scores from Leapfrog for all three DUHS hospitals for the seventh year in a row.
- American Heart Association "Get with the Guidelines" recognition for excellent stroke care for all three DUHS hospitals.
- In the Baldrige Journey, Duke University Hospital (DUH) receiving a national site visit for the second time and recognition nationally in two categories. Duke Regional Hospital (DRH) receiving N.C. level III recognition. Duke Raleigh Hospital (DRAH) receiving N.C. level I.
- DUH and DRH being recognized by Healthgrades with the Distinguished Hospital Award for Clinical Excellence 2017.
- DUH ranking on the US News Honor Roll for the 17th consecutive year.
- DRAH being recognized with a four-star rating by CMS on Hospital Compare for Overall Hospital Quality – best in Wake County.
- Duke HomeCare and Hospice achieving a CMS four out of five star rating in clinical quality in its Home Health program.
- Private Diagnostic Clinic (PDC) achieving Joint Commission Primary Care Medical Home certification, as well as Joint Commission recognition as a Best Practice for Ambulatory Falls Prevention. PDC also developed an ambulatory hand-hygiene program that the Joint Commission noted as the first of its kind in ambulatory care.
- Duke Lifepoint Hospitals extending Safe Choices training to leadership, and implementing just Culture and Second Victim training.
Awards for winning abstracts
The Rebecca Kirkland Award. "Achieving high reliability pediatric medication safety through multidisciplinary adverse drug event review." Authors: Bill Harris, RPh; Rene Tyre, RN; Nicole Panosh, Pharm D; Travis Heath, Pharm D; Chi Dang Hornik, Pharm D; Austin Cutler, Pharm D; Paul L. Martin, MD; Heather S. McLean, MD. Entities: Department of Pharmacy, DUH; Women's and Children's Clinical Services Unit, DUH Department of Pediatrics, Duke University.
The Learner Award. "Multimodal intervention improves patient discharge process." Primary author, John Paul Shoup, MD. Program: Internal medicine-pediatrics residency program.
The Karcher Patient Safety Award. "Ambulatory falls prevention program." Authors: Heidi Campbell, COT; Bridgett Cherry, RN; Yeu-Li Yeung, OT/L. Entity: PDC.
This article was written by William Stagg, Jr., Duke Health Marketing & Communications