She has done the same for fire preparedness. "The fire department comes by for education and we put out an actual fire every October, which is National Fire Prevention Month. We even did an exercise where staff were challenged to close their eyes and try to find their way around the center. This helps simulate the experience of a smoky environment."
Yoder says ASCs eager to improve their safety culture will be best served by taking steps to remove barriers that might stand in the way of staff participation. "Leaders must make sure not to tolerate any bullying and harassing behaviors. Make sure your ASC has an open environment where staff feel free to voice concerns. If a staff member speaks up, hear them out and research their concern. Let them understand that you want them to be honest and come forward when there are questions or concerns."
Yoder recommends ASCs consider using the Agency for Healthcare Research and Quality's Ambulatory Surgery Center Survey on Patient Safety Culture to assess staff opinion about the culture of patient safety.
"That tool helps staff think about and answer questions concerning where they work, how they feel when they are at work and how they perceive patients are being treated," she says. "Try to get all of your staff and physician partners to fill it out. Valuable information can come from the survey."
Do not overlook the importance of physician involvement in safety efforts, Merrill says. "I have pushed our physicians to become even more involved and engaged. Everyone looks to them for leadership. We have a picture of one our doctors putting out a fire during an exercise. He was shocked about the weight of a fire extinguisher. Doctors need be fully trained and ready to go, just like staff."
Reaping the Rewards
A commitment to improving safety culture can deliver significant benefits, Yoder says. "When you create a safe environment, staff flourish and grow. Happy employees typically translate to happy surgeons and happy patients. When you embrace the importance of a safety culture, I think much of the work required comes naturally."
Merrill believes the efforts undertaken at Endoscopy Center of Niagara are having a positive impact that extends beyond the walls of the ASC. "Through our exercises, we are providing staff with a better appreciation of awareness and knowing your surroundings. Safety culture should be a way of living and not just contained to the center."
The improvement efforts undertaken at Andrews Institute ASC have paid off, Holder says. In August 2017, the ASC conducted its annual safety culture survey. The employee rating was more than 95 percent—an A+ to Holder.
"That was my personal goal," she says. "We have seen improvements in team building, morale and effectiveness of identifying and handling safety issues and a decrease in incidents. The employees feel they have a voice and they use it. That helps everyone."