Forbes Hospital, part of the Allegheny Health Network, is a 300-bed facility located in Monroeville, Pa. and serves the communities of eastern Allegheny County and Westmoreland County. Starting in 2013, Forbes set out to eliminate staff and patient harm. With coaching support from Value Capture, Forbes leaders redesigned their approach to solving safety problems. Forbes created a daily interdisciplinary huddle attended by leaders, learned to solve problems “in real time” while involving front line staff, and learned to apply tools based on Lean principles to address the root causes of problems. Among the results and capabilities gained by Forbes are the following:
- A reduction of 28% in one year in OSHA recordable injuries to staff, and a 94% reduction in injuries in the highest risk department. An employee health nurse states, “I think differently now. I look at every incident, not just the trends. I have a lot of job satisfaction.”
- A shift from identifying safety problems only after they have reached a patient (10 per day on average at the start) to identifying risks and having a way to solve them before they reach a person and cause harm. A nurse manager reports, “It’s so much better to solve problems when we don’t have to work in silos. Everyone is very willing to help me to solve safety problems.”
- A reduction of more than 80% in the cost of IV drug waste, achieved by moving from 24-hour to 8-hour batches.
- The elimination of stock-outs of isolation caddies, which contain personal protective equipment, through process redesign.
A manager at the hospital reflected on the process of working together. “At first I didn’t want to come [to these meetings]. I take it personally when my department is not able to meet the patient need. Working together allowed me to see that it really was the process that was broken.”