IAC and You: A Quality Connection

Sponsored by Intersocietal Accreditation Commission (IAC)

By Nancy Davis

Coaching for Quality & Patient Safety: A Winning Strategy

Do you feel like you are struggling to get your team on board with quality and safety initiatives? Like you are the goalie, and the defensive players have food poisoning? Like the balls are whizzing by you, or worse yet, smacking you in the face? Being on a team of one or of many individuals who are disconnected can be exhausting, but with the correct key players and communication strategies, you can lighten the load.

I like to say that quality and safety is a team sport, because in today’s health care environment when everyone is tasked with doing more with less, it takes a cohesive unit working together to accomplish. In a perfect world, everyone on your team would be quality and safety superstars, but there will only be certain individuals who fall into this category. These will be your quality and safety champions. 

Quality champions are the eyes and ears of the facility. They can assist with QI initiatives, bring potential issues or areas for improvement to your attention, assist with process improvement, record keeping and even accreditation. You may be able to think of a couple of people who fit this bill, but let’s look at what qualities you are looking for. 

Traits that are valuable in these roles are strong organizational skills, detail oriented, interested in compliance, good at record keeping, and confident enough to approach leadership with safety concerns and areas that need improvement. If you have employees that seem interested in professional growth, this role is a great way to add skills to their work experience. I encourage you to ask individuals during their annual performance reviews if they are interested in your compliance team. Assigning tasks to this squad can free up your time to work on projects.

To bridge the gap between those who are passionate and motivated about quality and safety and those who may have another primary focus, you need a variety of communication tools in your toolbelt. Communication is the cornerstone of a winning team. Remember that not everyone learns and engages in the same way. Ways to present this information in a durable form include written communications. Let’s look at a couple.

POLICY AND PROCEDURE BOOK/FILE

Every team needs a playbook. Imagine if a football team didn’t have a book that references all their plays? How would the quarterback know when the center was snapping the ball and where the other key players were headed on the field? How would he know where to look for a wide receiver? Likewise, how is your team supposed to know who is calling 911 and who is getting the drug box in a medical emergency at the facility? If it is a medical emergency in the MRI suite, you have more factors to contend with like criteria for quenching the magnet, assuring that emergency personnel do not enter the MRI suite without being cleared, and how to get the patient out of the room as quickly as possible. Throughout my 30-year career as a technologist and administrator, coupled with my current role as director of CT accreditation at the IAC, I have reviewed countless facility policies. 

Writing effective policies can be tricky. Some can lack any detail or direction, some come from legal departments, that may not understand the complexity of radiology, and some are so lengthy that they mimic the look of the great American novel. When it comes to policies and procedures, less is often more. Imagine yourself in an emergent situation. Say you are in a friend’s boat, and it starts to take on water. If the owner is not right there you would need to figure out how to call for help and where the life jackets are, but if there are 25 pages of instructions without summaries of pertinent steps for these two tasks, you could be underwater before any actions are taken. Similarly, if there is a medical emergency in the facility and your medical emergency policy is 20 pages long, things could go horribly wrong. If you need some assistance with developing concise, effective policies, the IAC offers a searchable repository at tinyurl.com/yc2ma434

WRITTEN PROTOCOLS

Written protocols ensure that the scans performed at the facility are reflective of the exams that the interpreter is expecting. Think of the protocol as a recipe for one of your family’s Thanksgiving dishes. There are several ways to make sweet potatoes, but whoever is going to make them for Thanksgiving needs the exact recipe that you are expecting. If you want the MRI technologist to perform an MRCP and include all the sequences that the physician is expecting, then they need the details written out in a protocol. These details should include the area to be scanned, sequences, contrast, and contrast delay, and angle of the slices through the anatomy. 

These written resources are vital to ensure that all team members have the same understanding when it comes to the facility’s operations. This helps to reduce quality and safety mishaps, but written documents are not enough; you must also create opportunities for connection. Let’s look at a few.

HUDDLE UP

I am curious, do you have morning huddles? I know, the team doesn’t like them and think they are a waste of time, and, depending on what you are discussing, they may be. That said, huddles can be an effective way to connect and focus on what is important. Make it a point to have both a quality and a safety touchpoint each week in the morning huddle. Maybe it is mentioning an article you read about the consequences of a medical error. Or perhaps you call out a compliment that a referring physician gave about imaging from your office. You could also discuss topics that the leadership in the office noticed. These could be positive or critical, although excessive criticism can lead to your team checking out during the huddles.

ROUNDING

Rounding is simply spending time in different environments throughout the office. It is good practice for multiple reasons. First and foremost, it gives you an opportunity to see interactions between staff and patients and observe how staff carry out their assigned tasks within the office. Pitching in to assist staff during busy times and seeing firsthand where challenges exist will help your team feel supported and bring issues to your attention. Additionally, rounding can present opportunities to connect one-on-one to address timely issues.

QI MEETINGS

QI meetings tend to be perfunctory where peer-to-peer results are read, and safety is a line item that can be checked off. But these meetings can create the opportunity to explore concerns the staff may have. I encourage you to provide a means for employees to make known their concerns anonymously. Often members of a team are not comfortable bringing forth issues. They do not want to be labeled as a tattletale or a pot stirrer. This approach may also encourage individuals to reveal a struggle they are having. These issues can often be discussed productively in this environment, especially if the meeting is attended by leadership. 

QI meetings are for all staff. Therefore, I encourage you to vary the day of the week for QI meetings and make them available afterward as recordings, enabling everyone to benefit from the message, despite their work schedule.

By applying these strategies, I predict you’ll see improvements in accountability and continuous learning as you coach your team to a quality and safety win! Most importantly, you’ll cultivate a thriving team that is well equipped to provide the best possible care, resulting in improved patient outcomes.

Nancy Davis, BS, RT(R)(M)(CT), is the director of CT accreditation at the IAC. As a technologist with over 30 years of experience, including management of a private radiology group which grew exponentially both in staff and locations under her oversight, she understands the challenges that practice administrators face.  To connect with Nancy and learn more about IAC’s accreditation services as a CMS-approved quality and safety organization for advanced diagnostic imaging under the Medicare Improvements for Patients and Providers Act (MIPPA), visit intersocietal.org.