Latest / Becker’s Healthcare Podcast / Kevin Webb on Making Hospitals Safer Through Culture and Error Prevention

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Kevin Webb on Making Hospitals Safer Through Culture and Error Prevention · Becker’s Healthcare Podcast

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  - So join us November second through the fifth
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  - at the Hyatt Regency in Chicago,
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  - Register on our events page at beckershospitalreview.com
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  - by clicking on the events tab in the
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  - upper right.
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  - This is Scott Becker with the Beckers Healthcare
• 1:00
  - Podcast. I'm thrilled today to be with a
• 1:03
  - long term leader of health systems and hospitals
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  - with Kevin Webb. Kevin's got a fascinating career.
• 1:08
  - He began as an audiologist, ended as president
• 1:11
  - of of part of health systems, just an
• 1:13
  - amazing career. And he's written a new book,
• 1:15
  - Is Your Hospital Safe? We'll talk about that
• 1:17
  - a little bit later today. Kevin, can you
• 1:19
  - take a moment and introduce yourself?
• 1:21
  - Sure. My name is Kevin Webb.
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  - I'm currently retired.
• 1:26
  - When I was working,
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  - I was an audiologist who early in his
• 1:30
  - career
• 1:31
  - got into hospital administration
• 1:33
  - kind of by accident.
• 1:35
  - And,
• 1:36
  - the last twenty years of my career,
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  - I worked for ProMedica, a health system based
• 1:41
  - in Toledo, Ohio.
• 1:43
  - And at the time I retired,
• 1:46
  - I was responsible for ProMedica's 11 hospitals
• 1:50
  - and
• 1:51
  - our employed
• 1:53
  - provider group, which had about a little over
• 1:56
  - a thousand providers at the time.
• 1:59
  - And how does a person move from being
• 2:00
  - an audiologist to being in charge of that
• 2:03
  - large of a health system or or or
• 2:05
  - a part of a large part of the
• 2:06
  - health system?
• 2:07
  - Yeah. Well, at the time, I was working
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  - for a, medium sized hospital in Lima, Ohio,
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  - about 90 miles south of Toledo.
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  - And I was the director of the speech
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  - and hearing clinic. So, you know, I had
• 2:22
  - a couple of audiologists and I think I
• 2:24
  - had five speech pathologists that reported to me.
• 2:27
  - And I reported to a vice president at
• 2:30
  - the hospital
• 2:31
  - and our hospital
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  - was going through
• 2:34
  - a really difficult time.
• 2:36
  - Our nurses,
• 2:38
  - went through a
• 2:39
  - three month strike
• 2:42
  - and,
• 2:43
  - CEO of the hospital
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  - brought in...
• 2:47
  - CEO of the hospital got fired
• 2:50
  - because of the nurses strike.
• 2:52
  - And new guy came in and he brought
• 2:54
  - in... You may remember the name Clay Sherman.
• 2:58
  - He wrote the book Uncommon Leader and the
• 3:00
  - New American... The other one was a New
• 3:03
  - American Hospital.
• 3:05
  - And he was brought in to,
• 3:07
  - consult
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  - for a year,
• 3:10
  - with our new administration
• 3:12
  - to change the culture of the hospital.
• 3:14
  - And I got very involved in that process
• 3:16
  - and as a result got promoted to vice
• 3:19
  - president of the hospital.
• 3:21
  - And over the next
• 3:23
  - next few years,
• 3:24
  - the CEO gave me more and more responsibility.
• 3:28
  - Even though I had no background in, hospital
• 3:30
  - administration,
• 3:31
  - didn't have an MBA,
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  - he sent me off to
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  - Harvard for
• 3:37
  - a week long class. He sent me to
• 3:39
  - Yale.
• 3:40
  - He,
• 3:41
  - forced me to join the American College of
• 3:43
  - Healthcare Executives, which was a great move,
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  - became a fellow,
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  - learned a lot along the way. And then,
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  - our hospital was partially purchased by ProMedica
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  - in 1999.
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  - And then ProMedica
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  - asked me to become to Toledo to run
• 4:02
  - of their... One of their hospitals in the
• 4:04
  - suburbs of Toledo
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  - in,
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  - 2000.
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  - And then,
• 4:11
  - my,
• 4:12
  - responsibilities
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  - with ProMedica
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  - gradually grew from a medium sized hospital called
• 4:18
  - Flower Hospital on the outskirts of Toledo
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  - to,
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  - being,
• 4:24
  - the president of the largest hospital in the
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  - system,
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  - Toledo Hospital
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  - and Toledo Children's Hospital. And then from that,
• 4:33
  - my responsibility grew to,
• 4:35
  - being responsible for all the hospitals in the
• 4:37
  - health system. So the presidents of all the
• 4:39
  - hospitals reported to me and I also got
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  - responsibility
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  - for our employed
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  - physician group. It was a fun ride and
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  - I learned a heck of a lot.
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  - I I always say that in my first
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  - role
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  - as an audiologist, as a
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  - director of the speech and hearing clinic
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  - in Lima, I learned how not to run
• 5:00
  - a hospital.
• 5:02
  - And then
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  - when,
• 5:04
  - John White, the CEO of Lima Memorial brought
• 5:07
  - in, Clay Sherman, I learned how how to
• 5:10
  - run a hospital and got really excited about
• 5:12
  - that and very passionate about
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  - trying to get
• 5:16
  - trying to get good at running hospitals.
• 5:19
  - When you talk about how not to run
• 5:21
  - a hospital, what are some of the things
• 5:23
  - you mean there? Just just tell us a
• 5:24
  - bit there what your thoughts are.
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  - Sure. Well, when I was
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  - director of the speech and hearing center, the
• 5:31
  - CEO at the time,
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  - he was he was a jerk,
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  - quite frankly.
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  - He treated everybody with disrespect. And for some
• 5:40
  - reason, he had a great disrespect for nurses.
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  - And,
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  - as a result of that, the nurses formed
• 5:47
  - a union.
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  - And
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  - six... Well, like, seven or eight months later
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  - because he refused to
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  - sit down at the negotiating table to even
• 5:59
  - form the first
• 6:01
  - contract with the union,
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  - over over
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  - seven or eight months, they decided to heck
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  - with you, buddy. We're gonna go on strike.
• 6:09
  - So they went on strike the day after
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  - Memorial Day
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  - and,
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  - stayed out on strike until,
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  - a little after Labor Day.
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  - And, I remember
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  - the present... The chair of the board
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  - called a meeting of all the management staff
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  - in the hospital
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  - a little... About a week after Labor Day
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  - and, we thought, oh, we're gonna hear more
• 6:34
  - about what... What's gonna happen with the new
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  - contract with the nurses.
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  - And,
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  - the president of... The CEO of the hospital
• 6:42
  - wasn't there.
• 6:43
  - And, the guy announced that, well, we fired
• 6:46
  - him.
• 6:46
  - And, everybody in the room erupted in cheers
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  - because we all blamed him on the nurses
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  - strike and the sit... And the the culture
• 6:55
  - in the hospital,
• 6:57
  - which was just sick,
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  - because of the way he treated people and
• 7:00
  - that that slowed down from him to his
• 7:02
  - vice president.
• 7:04
  - Thank you. And talk a little bit about...
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  - What are you doing now? What are you
• 7:08
  - most focused on and excited about currently?
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  - Well,
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  - I,
• 7:14
  - just,
• 7:15
  - published a book called Is Your Hospital Safe?
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  - Advice from someone who managed hospitals for thirty
• 7:21
  - five years.
• 7:23
  - And, just that... Just did that in
• 7:26
  - August.
• 7:27
  - It's available on Amazon.
• 7:30
  - And it it talks about medical errors
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  - and the size of that problem,
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  - the causes,
• 7:37
  - some of the ways to fix the situation
• 7:39
  - with medical errors in hospitals.
• 7:42
  - And then I give some advice to
• 7:45
  - people who use health care
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  - on how to how to pick a hospital.
• 7:50
  - So it's
• 7:51
  - really geared towards
• 7:53
  - people with non medical backgrounds who
• 7:56
  - are exposed to hospitals and to
• 7:59
  - help them understand more about what's happening in
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  - hospitals and what what needs to happen to
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  - make them better.
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  - And and talk about a couple few things
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  - that you learned from it, that we should
• 8:10
  - learn from it, that people should be doing
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  - to make their hospitals better. What are a
• 8:13
  - couple of your thoughts?
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  - Well, the primary cause of medical errors is
• 8:18
  - human is human error. And,
• 8:23
  - hospitals for so long have had blaming cultures
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  - where
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  - when there... When there's an error that causes
• 8:30
  - harm to a patient, we'll blame an individual
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  - and,
• 8:34
  - you know, maybe fire them or
• 8:36
  - do something else to them rather than trying
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  - to learn from that error. And and it's
• 8:41
  - just easier to blame somebody than it is
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  - to learn from the error.
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  - And it's usually caused by, you know, poorly
• 8:48
  - designed processes,
• 8:50
  - a lack of standardization,
• 8:52
  - a bad culture, poor communication.
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  - Those are the main causes.
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  - And and you could fix those things if,
• 9:00
  - as a hospital,
• 9:02
  - you you get into things like lean and
• 9:04
  - six sigma
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  - and try to improve your processes,
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  - to error proof them. Use those technique... Techniques
• 9:12
  - to help error proof your processes
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  - and, change your culture. So you're not blaming
• 9:17
  - people. You're trying to figure out, well, why
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  - did they make that error? And let's educate
• 9:22
  - them so that they don't make the error
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  - again.
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  - You you can also help fix
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  - or try to increase your chances of not
• 9:31
  - having an error by being more transparent
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  - about the errors that you make as a
• 9:35
  - hospital. You know, sharing those errors with all
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  - of your staff.
• 9:40
  - And if you're,
• 9:42
  - really good at it, then you wanna share
• 9:44
  - those errors with other hospitals so that you
• 9:46
  - can learn from their errors and they can
• 9:48
  - learn from yours.
• 9:50
  - And so you wanna make error recording
• 9:53
  - very easy,
• 9:54
  - for employees in the hospital
• 9:57
  - and doctors.
• 9:59
  - You wanna teach people how to escalate
• 10:02
  - problems. If they see something that they, in
• 10:05
  - their gut, feel is wrong, it's probably wrong
• 10:08
  - and
• 10:09
  - they need to report it to somebody. They
• 10:12
  - need to escalate that up the chain of
• 10:13
  - command.
• 10:15
  - And because
• 10:16
  - I know from experience
• 10:18
  - and and implementing a number of error prevention
• 10:21
  - tools in the hospitals that I worked at,
• 10:25
  - Most of our worst
• 10:27
  - errors that caused harm to patients,
• 10:29
  - including death,
• 10:31
  - involved a failure to escalate the problem
• 10:35
  - because people were afraid to or they didn't
• 10:37
  - know that they could
• 10:38
  - or they just didn't trust their own instincts.
• 10:42
  - So you need to make it safe for
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  - people to do that.
• 10:45
  - And and
• 10:46
  - another thing that would be helpful
• 10:48
  - if more hospitals did,
• 10:51
  - it would be if they,
• 10:53
  - would educate their staff about human error.
• 10:57
  - It's it's humbling when you learn about human
• 11:00
  - error and,
• 11:01
  - the psychology
• 11:02
  - behind human error. We all make errors since
• 11:05
  - we're all human, and it doesn't matter how
• 11:07
  - many degrees you have or how much experience
• 11:09
  - you have doing whatever you do. You're gonna
• 11:12
  - make errors for a number of reasons.
• 11:14
  - And,
• 11:15
  - I think
• 11:17
  - maybe that's one of the first things you
• 11:18
  - need to do, to make them a little
• 11:20
  - more humble
• 11:21
  - and to realize, you know, we could we
• 11:23
  - could do better, if we instituted a a
• 11:26
  - variety of different,
• 11:29
  - tools
• 11:30
  - to,
• 11:31
  - try to error proof our systems.
• 11:33
  - I think people in health care...
• 11:36
  - Management in health care
• 11:38
  - ignores what happens in other industries
• 11:41
  - and what other industries have done to get
• 11:43
  - better at
• 11:45
  - reducing human error.
• 11:47
  - And we can learn a lot from other
• 11:48
  - industries,
• 11:50
  - to do that,
• 11:51
  - primarily the airline industry.
• 11:54
  - Thank you. And talk about now. Are you
• 11:56
  - consulting with systems? What do you do currently
• 11:59
  - to help spread the word and spread the
• 12:00
  - message on what your thoughts are and what
• 12:02
  - you're thinking about making hospitals more safe?
• 12:05
  - Well, this book is an attempt to do
• 12:07
  - that
• 12:08
  - because,
• 12:09
  - otherwise, I I I play a lot of
• 12:12
  - tennis and golf. And and so I'm not
• 12:14
  - I'm not doing anything else to,
• 12:17
  - to,
• 12:18
  - consult with, other org... With organizations
• 12:21
  - about,
• 12:23
  - making their,
• 12:24
  - hospitals safer.
• 12:26
  - I'll I'll ask you the important questions. You
• 12:28
  - know, three important questions.
• 12:30
  - Will Ohio State or Michigan win this year
• 12:32
  - in the Ohio State Michigan game?
• 12:34
  - Ohio State. Okay.
• 12:37
  - Michigan's
• 12:38
  - got some problems.
• 12:40
  - No question. And it's really sad to see
• 12:42
  - all those problems that Michigan is having. I
• 12:44
  - know that brings a tear to your eye.
• 12:46
  - The, the next thing is, Toledo Mud Hands
• 12:49
  - fan or not?
• 12:51
  - You know, I like going to Mud Hands
• 12:53
  - game.
• 12:54
  - They're a lot of fun, but I don't
• 12:56
  - really follow how well they're doing.
• 13:00
  - In fact, when you go to a Mud
• 13:01
  - Hands game, it's more of a social event
• 13:03
  - and,
• 13:05
  - you're not necessarily spending that much time watching
• 13:08
  - the game.
• 13:10
  - No. I I I bet that's right. And
• 13:12
  - and then the golf the golf, what is
• 13:14
  - the key to getting my index below 10?
• 13:16
  - Is there a key? Is there a hope?
• 13:19
  - What what is your number one suggestion for
• 13:21
  - getting that game below a 10 index?
• 13:24
  - Oh my gosh. You know, I'm a 16.
• 13:27
  - So,
• 13:28
  - I obviously have no idea.
• 13:31
  - No. No. No. No. I'm like you, you
• 13:33
  - you know, but those that can't do, teach.
• 13:35
  - So I figured between the two of us
• 13:37
  - came up with good ideas and good suggestions
• 13:39
  - on, getting back into single digits. We'll see
• 13:41
  - how it goes.
• 13:44
  - I think, focus is probably,
• 13:46
  - one of my
• 13:49
  - biggest faults when I'm on a golf course.
• 13:52
  - And I lose focus after about, I don't
• 13:54
  - know, 13 or 14 holes.
• 13:58
  - No. A 100%. And and you lose it
• 14:00
  - for a few holes, it pulls up that
• 14:01
  - hole and all of a sudden you've got
• 14:02
  - a score you don't want for the day.
• 14:04
  - It's unbelievable. No. Truly, a challenge and an
• 14:06
  - act of both.
• 14:08
  - Yes. You know? And and and try and
• 14:10
  - drink 10 cups of coffee a day and
• 14:12
  - then play golf. It's a bad combination, but
• 14:14
  - it is what it is. Alright. Well, I
• 14:16
  - would agree with that. Yeah. Kevin, I wanna
• 14:18
  - thank you for joining us today on the
• 14:19
  - Becker's Healthcare podcast. What a pleasure to visit
• 14:21
  - with you. Thank you so much.
• 14:24
  - Thanks for having me.