Children's Hospital and Clinics in Minnesota

Topics: Patient safety, Medical error, Iatrogenesis Pages: 12 (3247 words) Published: October 29, 2008
Question 1: Evaluate the key elements of Morath’s efforts to transform Children’s Hospital into a learning organization.

Answer: It was Morath’s leadership abilities and initiatives that helped Children’s Hospital (CH) transform from an organization to a learning organization. We elaborate on the following three building blocks of a learning organization that are evident at Children’s Hospital.

Building Block 1: “A supportive learning environment”

Learning in an organization is inhibited by factors such as tradition, outdated procedures, values, structures, and psychological barriers about getting the work done. At a learning organization, the environment encourages people to bring out the problems / errors in the system, to analyze the problems and to seek solutions to them. This enables an organization to constantly learn and grow. In such a learning environment, new ideas are appreciated, people feel safe in discussing failures, disagreeing with others, asking naive questions, owning up to mistakes and presenting minority viewpoints.

The first block of a Learning Organization encompasses the following features: •Psychological Safety
Appreciation of differences
Openness to new ideas
Time for reflection

In a healthcare organization, errors are bound to happen and CH was not an exception. In order to create awareness about patient safety, CEO Nelson hired Julie Morath as COO. At CH she faced following Key Challenges.

Patient Safety – Not an easy subject to broach: The primary challenge for Morath was to even suggest launch of a patient safety initiative at CH. The management at most of the hospitals gets defensive whenever the topic of safety is touched upon. It is believed that the Patient safety should be implicit. Speaking about it means ill repute and exposure to legal risks. Morath also found that many employees were reluctant to believe the Medical Accident Data. They were skeptical with the applicability of this data to CH.

Alleviating fears of damaging careers: Transparency is an important parameter for any learning environment. At CH, when an employee commits an error, the first thing that comes to his mind is “Am I responsible for this near-fatal accident?” or “How it will show on my performance?” So he hopes the error does not come to the surface. It was a challenge for Morath to get people talking more openly about errors without damaging people’s careers.

Accusatory Language: The language used during discussions was accusatory in nature and implied finger pointing. Such language added to the environment, which was averse to psychological safety for anyone who commits a mistake. It was a challenge for Morath to change the old ABC model of medicine: Accuse, Blame and Criticize.

To overcome the above mentioned challenges, Morath carried out the following Key Activities to create a supportive learning environment at CH:

Spread awareness about Patient Safety: Morath created forums where staff members could come together to discuss safety issues and to learn more about current research in the field.

Created Blameless Environment: Morath introduced three ground rules for the focused events analysis. These ground rules included “blameless reporting”, confidentiality and anonymity of event details, and creativity to improve processes and systems.

Presented Statistics and Personal Experiences: Morath presented data from reputed studies such as Harvard Medical Practice Study on the frequency and causes of medical errors. This data showed that fatalities due to medical errors are very common among hospitals across the US and CH would be no exception. To allay the employee skepticism of applicability of the study to Children’s, she asked the employees to discuss personal experiences regarding patient safety. The employees found that all had had such experiences.

Conducted Focus Groups: The focus groups provided the hospital...
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