Creating a Culture of Quality and Safety

James M. AndersonPresident and CEO, 1996-2009

Making Excellence a Way of Life

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Cincinnati Children’s (Fiscal 2013)

Registered beds 598

Operating revenue $1.9 billion

Employees 13,852; 97 nationalities

Research grants $158 million

Locations 16

Patients from 50 states; 53 countries

Department of Pediatrics for the University of Cincinnati College of Medicine

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TresselFragile System

– 15 years of intense work improving quality and safety– 34% decrease in hospital-wide mortality– 43% decrease in ICU mortality

Transparency– With families– With employees– With other institutions– With the outside world

We need to be able to talk about these things

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Requirements to Create a Culture of Quality and Safety

Vision: Take time to develop it thoughtfully

Plans: Focus on what needs to be done, not on trailing results, like financial results

Consistent message: Consistent behavior, even when there is increased risk

Management process that delivers sustainable outcomes

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Our Vision:To be the leader in improving child health

• If we can deliver outstanding results in some areas, why not all?

• What results are we delivering?

• How are we measuring them?

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Creating a Culture

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Business Units: Participants

1. Physician, nursing and business leaders• Shared objectives• Single budget

2. Access to senior leadership team

3. Predictable, recurring meetings

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Business Units: Template Reports

Financial• Activity over time expressed in numbers• Holistic view as a framework for change

Non-financial• How will we be safer, more accessible,

patient-centered, innovative?• Focused attention on transformation

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Other Tools

• Real time data • Strategic planning• Transparency• High-reliability systems• Learning from other high-risk industries

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Final Thoughts• Each part of the organization must perform well

for the whole organization to perform to potential

• Organizational structure reflects priorities

• Mechanisms must be hard-wired, predictable and must foster agility

• Institutionalize boundaryless thinking, risk taking, transparency, small tests of change

• Institution needs a shared, compelling vision and high aspirations

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