Tim Palm, vice president of Cedar Rapids, Iowa-based Mercy Care Management, said it was true, noting that the Mercy Care system has seen a $377,000 decrease in its malpractice insurance costs and has not had one malpractice case in four years. Palm prefaced his remarks by saying “I'll probably jinx us.”
A key to their success, Palm said, was empowering everyone on staff to “stop the line” if they see something wrong.
Palm explained how this is sometimes done with a “safe word,” which can stop activity without alarming a patient. Palm said that Mercy Care's community has a large Amish population in which “Yoder” is a common name. So, if nurses see something that may result in patient harm, they might say “Dr. Fox, don't forget to call Dr. Yoder,” and this stops any activity and signals staff to call a quick huddle, he said.
Palm said it was very easy to tap physicians' pride to get them to buy into a culture of measuring patient safety. He explained how, all their lives, doctors have been at the top of their classes and “they don't want to be compared to the average.”
At Mercy, teams are encouraged to test patient safety ideas with pilot programs of 30 to 60 days or longer, Palm said, and all staff suggestions are given a formal response. Care teams meet regularly to discuss patient safety and meetings lasting longer than an hour are discouraged, he said.
Demonstrating the top-to-bottom team nature of the patient-safety culture, Palm said all care delivery teams get their own receptionists. Palm said these employees gain a “connectivity” to patients and their families that is impossible for a centralized switchboard operator to achieve.