Gary Kaplan, MD, is CEO of Seattle-based Virginia Mason Health System.
When thinking about the quality and patient safety work Dr. Kaplan has overseen to reduce patient harm and save dollars, his leadership of Virginia Mason’s safety culture and Patient Safety Alert (PSA) System stand out.
Virginia Mason’s patient safety performance has sustained itself over a long period. The organization’s more innovative current work is around the “autopause.”
Another good example is Virginia Mason’s respect for people initiative.
One other good example is the Virginia Mason Production System (VMPS), which is directly related to driving down the cost of health care.
Caring for patients safely is the foundation for Virginia Mason’s vision of becoming the Quality Leader.
In 2002, Virginia Mason embarked on an ambitious, system-wide program to change the way it delivers health care and in the process improve patient safety and quality. It did so by adopting the basic tenets of the Toyota Production System, calling it the Virginia Mason Production system or VMPS.
To translate the techniques of zero defects and “stopping the line” in health care, a Patient Safety Alert (PSA) system was established, which empowers any team member who encounters a situation that is likely to harm a patient to make an immediate report and to cease any activity that could cause further harm.
If any Virginia Mason team member’s practice or conduct is deemed capable of causing harm to a patient, a PSA can cause that person to be stopped from working until the problem is resolved. Under Dr. Kaplan’s leadership, a policy statement, senior executive commitment, dedicated resources, a 24-hour hotline, and communication were all key features of implementation.
Implementing the PSA system has significantly increased the number of safety concerns that are resolved at Virginia Mason, while drastically reducing the time it takes to resolve them.
Patient Safety Alert reporting
Under Dr. Kaplan’s leadership, Virginia Mason continues to see increasing volumes of PSAs reported, which positively reflects our safety culture and programmatic efforts such as hospital safety huddles, good catch awards, and activities during Patient Safety Week each year. A comparison of PSA volume from Q2 2016 PSA to Q2 2018 indicates that there has been a 35-percent increase in PSA’s reported. Hospital Safety Huddles are an important driver of PSA reporting as they are frequently highlighted by safety huddle attendees.
Response to unanticipated clinical events
Although the concept is common in other industries, no health care system has implemented policy around this concept to our knowledge. Under Dr. Kaplan’s leadership, a team more clearly defined a policy statement for Virginia Mason where the autopause (a mandatory time for healing, reflection, assessment and support for a provider or providers most impacted) will be applied to an individual when an unanticipated clinical event involves death or serious harm coupled closely with an individual action and will last for a minimum duration of eight hours.
Complex spine program significantly reduced surgical complications
As a result of success driving change, the complex spine surgery team at Virginia Mason reduced surgical complications by 36 percent.
This reduction in complication rates and returns to the OR has decreased infection rates and increased patient satisfaction. These improvements show forward movement around critical areas, particularly on delivering a more reliable outcome, where Virginia Mason has begun warranting some procedures.
Under Dr. Kaplan’s leadership, Virginia Mason was the first health system in Seattle – and among the first in the U.S. – to offer a surgical warranty for hip and knee replacement.
Regular recognition from peers on quality and patient safety efforts
Virginia Mason has received numerous awards for improving patient safety and quality of care.
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