February 08 Issue - Employee Monthly Magazine

Visiting MDs exchange ideas with PhDs

Turning safety difficulties into successes

Last fall, a group of medical professionals from Children's National Medical Center in Washington, D.C., spent two days touring Lab facilities and interacting with researchers. These MDs found Los Alamos science intriguing, but they didn't come to talk science with PhDs. They came to talk safety.

"There is a national conversation on patient error that has amplified our desire to focus on safety culture, both for the benefit of patients and employees," said David Stockwell, a pediatric critical-care doctor and the designated safety liaison physician at Children's.

"We are very interested in how an institution takes safety difficulties and turns them into successes, resulting in a much more safetyfocused organization."

As with the Laboratory, safety is of utmost importance at Children's National Medical Center, where continuous improvement in safety is linked to a basic change in the institution's safety culture. An academic and clinical institution that strives for excellence in all segments of its operation, the 137-year-old medical center admits more than 11,000 children per year and treats about half a million pediatric outpatients during this same timeframe, with the majority coming from the District of Columbia area.

Children's also employs about 430 medical doctors and is the ninth largest research program in the United States.

The doctors and administrators who toured Lab facilities, such as LANSCE, the High Magnetic Field Laboratory, and the Metropolis computing center, admitted that they initially were largely unclear on how their institution related to the Laboratory.

Once they arrived, however, and began talking to employees and safety managers like Dick Watkins, associate director for Environment, Safety, Health, and Quality, and Bill Brady, chief of Occupational Medicine at the Lab, they found striking similarities.

"I was not sure what I was coming here for, but I got it," said Peter Holbrook, Children's chief medical officer and intensive-care physician. "Children's is a multifaceted, complex organization...with a highly educated, independently minded workforce that has a lot of opportunity to make safety mistakes. Los Alamos also is a highly complex place with a highly educated and independent staff that does fairly risky work. So, the two institutions are analogous in many safety-related respects."

"The visit was unquestionably a mutual learning experience with a valuable exchange of ideas," said Watkins. "They saw a great deal of similarity between our issues and theirs. Beyond the breadth of the work at Los Alamos, I believe the Children's team was impressed by our efforts in the Voluntary Protection Program and human performance— people taking care of people is the key to safety improvement."

"The program at Los Alamos showed us that a bottoms-up approach can work," said Holbrook. "By going out to individual units and asking people to do self-assessments, which naturally vary from location to location, you reach out. You ask the people doing the work to identify risks, and you tell them you'll help develop tools to reduce the risks and that you'll monitor the situation to determine if the risks are actually reduced."

The visitors said they will take what they learned at Los Alamos and other institutions and begin a new safety program this year at Children's. Joining Stockwell and Holbrook from the medical center were John Cockerham, president of the medical staff; Brian Jacobs, chief medical information officer; Mary Anne Hilliard, chief risk officer; and Robert Keating, chief of neurosurgery.

‘People taking care of people is the key to safety improvement.'

-Kevin Roark