When a healthcare organization's workplace culture is toxic — when people don't feel psychologically safe enough to speak up, to share ideas or to challenge the status quo — patient safety is at risk. That's the idea behind decades of research Vizient executive principals Allan Frankel and Michael Leonard have devoted their lives to.
"It's abundantly clear that the care patients receive is determined by the care the caregivers get from the organizations that employ them," Frankel said. "If healthcare organizations have a positive working culture and are effective in doing what they need to do, then the people on the frontlines find joy in their work and go home at the end of the day saying, ‘I feel good about myself because of what I did today.' In turn, the patients get better care."
Frankel and Leonard created Safe and Reliable Healthcare, a company dedicated to helping healthcare organizations improve the consistency and quality of their care and reduce incidences of harm. In 2022, the company joined Vizient to create a comprehensive solution that partners with organizations on their high reliability journeys. The Vizient Safe and Reliable Healthcare offering provides high reliability consulting; safety, resiliency and burnout data collected from SCORE culture and engagement survey; professional development programs; and other insights to transform and empower hospital leaders and frontline teams one work setting at a time.
But it's through the Learning & ENgagement System (LENS), a web-based dashboard with real-time communication, feedback and updates, that they've found the power to bring the concepts of high reliability to life and shape organizational culture. The dashboard enables hospital leaders, managers and frontline teams to increase transparency and simplify communication to grow community, manage work and consistently deliver high reliability healthcare by eliminating barriers and closing the loop on day-to-day ideas, tasks and concerns.
"Dr. Frankel and Dr. Leonard set out to not just reach managers but find a way to filter information down to the frontline teams to create a cohesive culture and an environment that focuses on psychological safety as well as clinical safety," said Kaitlyn Drew, director of product delivery. "Through the culmination of their research, they realized that the whiteboards and corkboards traditionally used for daily management systems weren't an effective means of communication or method for creating a safe environment. By shifting to a data-driven digital platform like what would become LENS, the information would be more easily accessible and could help shape the culture of the unit, too."
Empowering teams through consistent communication
LENS gives frontline teams a central and accessible place to voice concerns and track leadership progress as issues are resolved, ensuring that teams not only see the concerns being addressed, but are able to get those concerns resolved faster, allowing them to focus more of their time, energy and attention on their day-to-day responsibilities. Using LENS for regular morning huddles around the dashboard, hospital teams are able to touch base on pressing concerns and agenda items in person and post huddle notes for later review by team members who are not on the schedule. The mobile functionality also allows leaders and teams to text thoughts, questions or concerns in real-time as they arise, reducing the likelihood of forgetting that thought during rounds, walk-abouts, on break or between tasks. LENS also allows for immediate response time, regardless if the concern is as simple as replacing a trash can in a room or more complex, like re-ordering supply that's low or reporting a critical piece of equipment missing or broken. The enhanced communication also helps combat burnout in a time when expectations and demands are increasing daily on healthcare teams.
"When people are burned out, emotionally exhausted or by themselves and don't feel like they're part of a team, we see a rise in the ‘somebody else will do that in the next hour, that next shift' mentality," Leonard said. "Suddenly we're at ‘never,' and that's why we see avoidable infections and rates of harm. But, when people feel psychologically safe, feel like they can raise their hand and see that somebody listens and does something about it, we see less incidences of harm and increased patient safety and care."
Pairing best practice with customization fosters healthier healthcare workplaces
The first LENS dashboard launched in 2017 and currently is used in 13 healthcare organizations. It is customizable for each healthcare unit, coupling local organizational control with Vizient Safe and Reliable Healthcare best practices to help work settings create and foster a healthy workplace environment.
"Every provider has their own initiatives they want to focus on, so we work to keep the LENS dashboard as locally controlled as possible," said Jared Goodey, product director. "What makes LENS so successful is the provider feeling like the dashboard is their space — a forum for their team to communicate, share experiences and promote their culture together."
Clare Hicks, senior product manager, said that an organization's culture can vary within a system or individual facility.
"The pharmacy unit has a different culture than the lab, which is totally different than the ICU or nutrition services or environmental services, so when we talk about maintaining local control, that's the piece we want to protect and foster," Hicks said. "A positive culture makes people feel safe and empowered to speak up and keeps them wanting to come to work, so we don't want to homogenize it, but rather protect it."
As part of the cultural shift LENS brings to a healthcare organization, leaders, managers and teams also are encouraged to share good news, positive experiences and wins to the dashboard.
"We want LENS to change the world of healthcare," Goodey said, "And we feel joining Vizient is going to help us grow and evolve to reach the scale we need to be at to do so."