Latest / Becker’s Healthcare - Clinical Leadership Podcast / Building a Culture of Safety Across Healthcare Teams with Dr. William Scharf
Transcript
- 0:00Hi, everyone. You are listening to the Becker's
- 0:02Healthcare Podcast.
- 0:04I'm Erica Carbajal, and thank you so much
- 0:06for tuning into this episode where we're joined
- 0:09by doctor William Scharf, executive clinical director of
- 0:13quality and safety
- 0:14for AdventHealth.
- 0:16Doctor Scharf, thanks in advance for taking the
- 0:17time.
- 0:18Thanks so much, Erica.
- 0:20Glad to be
- 0:21joining today. Yeah. We're excited to have you.
- 0:23Welcome. Welcome.
- 0:25Well, doctor Scharf, to start us off, do
- 0:27you mind sharing a little bit about your
- 0:29background in health care and your current role
- 0:32at AdventHealth with our audience?
- 0:35Sure. I'm a a surgeon by training.
- 0:38I, went to the University of Illinois,
- 0:41and for medical school and started there for
- 0:43residency and completed surgical studies at the Ohio
- 0:46State University
- 0:47before being in practice,
- 0:50in,
- 0:51Downstate Illinois for a number of years.
- 0:54My life, significantly changed. In 1999,
- 0:57to Air was Human, came out.
- 1:00The imagery at that time was just that
- 1:02there were roughly forty five thousand to one
- 1:04hundred thousand
- 1:05lives being lost each year from a medical
- 1:08error.
- 1:09But the real thing that impacted me is
- 1:11just that there were a couple of visionaries
- 1:13at the organization that I was at that
- 1:14started a patient safety collaborative.
- 1:17And the thing that resonated with me was
- 1:19just that most air is not caused by
- 1:22bad people. It's caused by bad systems.
- 1:25And so, I immersed myself in just almost
- 1:27everything that I could with patient safety
- 1:30and,
- 1:31you know, that sometimes,
- 1:33life throws you curveballs and, I'm here at
- 1:35AdventHealth,
- 1:36with,
- 1:37just an absolutely wonderful organization with a sense
- 1:40of purpose.
- 1:41Yeah. Absolutely. And I know AdventHealth is doing
- 1:44a ton in terms of just creating those
- 1:46systems that you mentioned and those processes that
- 1:50really focus on prevention and and fostering that
- 1:52culture of safety. So excited to hear about
- 1:54that.
- 1:56Doctor Scharf, what is one major patient safety
- 1:59goal that your team at AdventHealth is focused
- 2:01on for 2026?
- 2:03And maybe what operational changes
- 2:05are you working toward to achieve some real
- 2:08progress?
- 2:09Well, I can just say is is that
- 2:11historically when I came, I inherited a newly
- 2:14found patient safety academy.
- 2:16I don't really think that many healthcare organizations
- 2:19have their own patient safety academy or something
- 2:21therein.
- 2:23And, since that time, well, let me just,
- 2:26unpack this a little bit. This is that
- 2:27our Patient Safety Academy, we bring in our
- 2:30clinical and operational leaders,
- 2:32across all of, Annette Health for a three
- 2:35day course, because you really need to understand
- 2:38what are the fundamental
- 2:40parts of patient safety science.
- 2:43We cannot have, our good leaders
- 2:45just finessing and doing what they think is
- 2:47best. They need to have a good foundation
- 2:50in science.
- 2:51And what's happened over the course of years
- 2:54is is is that, there was so much
- 2:56success out of the Patient Safety Academy is
- 2:58is that others have said, this is that
- 3:01doctor Scharf and, some of my other members
- 3:03of my team, what can we do to
- 3:06bring you to our places so that perhaps
- 3:09we could have a condensed version so that
- 3:11you could talk to our managers
- 3:13and, unit, leaders?
- 3:16And to that end, we have created what
- 3:18we call the signature safety seminar.
- 3:20And,
- 3:21what we will do is,
- 3:22our team will jump on a plane or
- 3:24drive to one of our hospitals,
- 3:27and we'll have a condensed version
- 3:30that teaches learning, knowledge,
- 3:32leadership,
- 3:34and, data
- 3:35management.
- 3:36So, it's a great experience.
- 3:38It's actually been an overwhelming success. And, just
- 3:41as a side note is that later today,
- 3:44I'm gonna hop on a plane and and,
- 3:45go to, some of our hospitals in North
- 3:47Georgia
- 3:48to speak, tomorrow
- 3:50at our signature safety seminar.
- 3:52Wow. Yeah. No. Talk about getting on the
- 3:54ground and really and really teaching this and
- 3:56driving this forward. That's great. What a great
- 3:58initiative.
- 3:59Doctor Sharp, one of the things that comes
- 4:02through often, a theme, if you will, that
- 4:04we hear a lot from quality and safety
- 4:06leaders
- 4:07is that a lot of teams
- 4:09can and are good at initiatives. They can
- 4:12follow initiative, make progress
- 4:14in terms of quality and safety, but what
- 4:17really the differentiator is really
- 4:20the organizations
- 4:21that
- 4:22can drive continuous quality improvement. That differentiator comes
- 4:25down to culture.
- 4:27So from your perspective,
- 4:29what leadership behaviors or operational practices
- 4:33actually do build that kind of safety culture
- 4:36daily that's needed across frontline teams?
- 4:39Excellent question. And, Erica, if you don't mind,
- 4:42I'd like to unpack this just a little
- 4:44bit. I'd like to first say is is
- 4:47that,
- 4:48AdventHealth, we aspire to be the safest healthcare
- 4:52organization in the country. That's our North Star
- 4:55goal,
- 4:56plain and simple. That's where we wanna be.
- 4:58To that end, we recognize is that culture
- 5:01just outweighs policies, technology, and protocols.
- 5:06And here's where it becomes challenging. First of
- 5:08all, changing culture takes a very long time.
- 5:11And secondly, it is hard, hard, hard.
- 5:15And so leaders really need to be asking
- 5:17themselves some questions.
- 5:19Do your staff feel safe to report errors
- 5:22without fear of punishment?
- 5:24Are leaders responding constructively
- 5:26or defensively?
- 5:28Are your frontline leaders
- 5:30trust that
- 5:31their concerns are being addressed or does it
- 5:34go into some black box? And do your
- 5:37teams collaborate or do they operate in silos?
- 5:40That's where we have invested really heavily in
- 5:43what we call high reliability
- 5:45organization
- 5:46unit culture.
- 5:47It's where,
- 5:49we have a team that goes to each
- 5:51of our hospitals,
- 5:53and addresses,
- 5:55create Actually, let me just step back. They'll
- 5:58go to our hospitals, create a They have
- 6:00a 55 inches
- 6:02plasma
- 6:04monitor
- 6:05that connects electronically
- 6:07across the hospital, across the system.
- 6:10And what we do is
- 6:12is that
- 6:13that creates a complete data source, but that's
- 6:16not the whole purpose. The whole purpose is
- 6:18creating a sense of community
- 6:22and having frontline,
- 6:24debriefings,
- 6:26every day,
- 6:27for, each of those units because at the
- 6:29end of the day, that's where, like,
- 6:31care is delivered is at the unit.
- 6:35Yeah. That's interesting.
- 6:36And the point you raised too
- 6:38about, you know, when concerns are addressed
- 6:41or brought up, not having them go into
- 6:42a black box, but really important for staff
- 6:45to feel like the loop was closed, if
- 6:47you will. So can you share can you
- 6:49expand on that a little bit and maybe
- 6:51share an example of what those processes
- 6:53look like in terms of being able to
- 6:56follow-up on on concerns that are raised, you
- 6:59know, at scale across such a large organization?
- 7:03Well, yes. First and foremost, it begins with
- 7:05what we call whole person care. It's our
- 7:08brand promise,
- 7:09that we deliver, to our staff and to
- 7:11our our patients.
- 7:13And, it begins with,
- 7:16a faith based culture.
- 7:18It, we have a set of service standards,
- 7:20one of them, which is keep me safe.
- 7:23And,
- 7:24the recognition is is that we have to
- 7:26to drive down the fundamentals
- 7:28of, psychologic safety and creating a just culture.
- 7:33Yeah. Absolutely. Thanks, doctor Sharp.
- 7:35I wanted to ask too just around a
- 7:37recent press gaining report that we covered, and
- 7:40it had found that nearly half of health
- 7:42care workers, I believe it was about 47%,
- 7:45reported low perceptions of safety culture even though
- 7:48overall scores had improved post pandemic. So what's
- 7:52your reaction to those findings, and where do
- 7:54you think perhaps the biggest disconnect still exists
- 7:57between
- 7:58leadership's intentions and then frontline staff's actual experience
- 8:02of safety culture?
- 8:04Well, I would say, first and foremost, when
- 8:06I hear this, it it does make me
- 8:08sad.
- 8:09It does not have to be that way
- 8:11at, most of our places. I say most
- 8:13of our places because,
- 8:15there are some of our AdventHealth hospitals that
- 8:17we have acquired and that are on a
- 8:19pathway, which we call,
- 8:21acquisition to excellence. Nonetheless, is is is that,
- 8:26we have an annual
- 8:28safety culture survey that we look at, really
- 8:31closely
- 8:32and create,
- 8:34strategies and tactics around how to enhance our
- 8:38culture.
- 8:39Now,
- 8:40what I'm getting towards, and that is, is
- 8:42that when we look at each of our
- 8:43hospitals, is that there is always a gap.
- 8:46A gap between leadership and what the frontline
- 8:49staff is
- 8:51perceiving.
- 8:53And, now that's normal. I mean, that's a
- 8:55recognition that there will always be a gap,
- 8:57but what we don't wanna see is a
- 9:00really large gap.
- 9:01And if we have a particular unit or,
- 9:05particular areas that,
- 9:07start to have a gap, then we're gonna
- 9:11intervene or we're gonna try to provide these
- 9:13hospitals,
- 9:14with, tactics that they can,
- 9:16that are actionable,
- 9:17that, they can use, to help,
- 9:20with their teams and so that that gap
- 9:22does not exist.
- 9:24Yeah. Definitely. Sounds like it's really critical to
- 9:27continue to check-in on that annually and and
- 9:29even more often to be able to identify
- 9:32where the gaps are and where they might
- 9:33be growing.
- 9:35Doctor Scharf, I know that you've spoken a
- 9:36lot about the importance of safety as everyone's
- 9:39responsibility
- 9:40as well, not just clinicians, but also ranging
- 9:43from teams like environmental services,
- 9:46HR, spiritual
- 9:47care. So can you share an example
- 9:50where from the bedside maybe, where that cross
- 9:52functional approach has actually made a difference in
- 9:55safety or quality outcomes?
- 9:58Before
- 9:59I dwell into to that answer,
- 10:02Erica, I just wanna say is is that
- 10:04one of the things that we recognized,
- 10:06very early on, and that is is that,
- 10:09HR has to have a seat at the
- 10:11table. And so when we do our signature
- 10:14safety seminar and our Patient Safety Academies, we
- 10:16actually invite HR because they're critical
- 10:19in helping support our work towards a psychologic
- 10:23safety.
- 10:24Now, to answer your question a little bit
- 10:26more fully,
- 10:27and that is, is that it's always been
- 10:29fascinating to me is that when we see
- 10:32comments that patients,
- 10:34have reported about some of the best experiences
- 10:38that they have had, some of the areas,
- 10:40they will call out
- 10:42environmental service individuals who come in and clean
- 10:44their room daily, or the transporters.
- 10:48And there's an old proverb or saying that,
- 10:51is that, you don't have to be Monet
- 10:53to make an impression.
- 10:55And so
- 10:56one of the things that we will do
- 10:57is just that we'll look at the results
- 11:00from our safety culture.
- 11:02And if we see that there's a gap,
- 11:04you know, the transporters do not feel whole
- 11:07or valued,
- 11:08it's just that we're gonna try to,
- 11:11intervene
- 11:12such that they can be part of the
- 11:14daily huddles,
- 11:16that,
- 11:17are, at the high reliability,
- 11:19unit of cultures.
- 11:21Yeah. That's great. And I think that's a
- 11:23really standout example of including,
- 11:25you know, transporters in those daily huddles and
- 11:28also what you mentioned about HR and kind
- 11:30of threading that needle of how they actually
- 11:32do fit in in terms of the psychological
- 11:35safety and cultivating that across the teams.
- 11:38Well, doctor Scharf, thank you so much for
- 11:41joining us on the podcast today, taking time
- 11:43out of away from the high stakes work
- 11:45that I know you're leading to share your
- 11:47insights with our audience.
- 11:49Thank you so much, Erica. It's been a
- 11:50pleasure,
- 11:51and thank you, for all the work that
- 11:53you're doing with Pechers. Have a great day.
- 11:56You too. Take care. We'll stay in touch.