Hospital execs told to walk for safety

Hospital patient-safety advocates are being told to take a walk, literally. Senior hospital officials are being encouraged to make regular visits to different sections of their institution to make personal inspections and engage staff in discussions on how to make their areas safer.

At the University of Michigan Medical Center in Ann Arbor, Chief of Clinical Affairs Darrell Campbell, MD, calls it "management by walking around." At Methodist LeBonheur Healthcare in Memphis, it's called "Executive Walkarounds." The Boston-based Institute for Healthcare Improvement uses the trademarked name "Patient Safety Leadership WalkRounds."

IHI Director of Communications Jonathan Small said they don't mind if other institutions give their program a different name. "That's how we change the world -- by being generous with our ideas," Small said.

The WalkRounds program is part of a "change package" for institutions working with IHI on creating a culture of safety. IHI Patient Safety Director Fran Griffin said at least 200 organizations could be using it.

At Methodist LeBonheur, IHI reports that executive walkarounds led to revising staff assignments, revising medication guidelines and the purchase of new equipment with a focus on safety and sanitation. Dr. Campbell said he makes surprise visits during which he asks three questions: What's the last thing that went wrong on your floor? What happened the last time a patient was harmed? What is your worst nightmare?

Allan Frankel, MD, IHI faculty member and director of patient safety at Boston's Partners Healthcare System, developed the program. He said feedback is its "most essential" component. If someone's comments led to a change, they should be told, "Because you told us this six months ago during WalkRounds, we're doing this project," Frankel said.

He added that WalkRounds could work at any size facility "willing to put in the reasonably meager resources necessary to make it work."