Medical Center Uses Innovative Methods to Improve Patient Safety

By Navy Lt. Jennifer Cragg
Special to American Forces Press Service

March 11, 2009 - Health care providers at the largest Air Force medical center on the West Coast are using state-of-the-art, interactive human patient simulators as just one of many safety initiatives to improve medical care, the medical center's commander said yesterday. "Actually, you would be very surprised. [The simulators] respond just like real patients," Air Force Col. (Dr.) Lee Payne, commander of the 60th Medical Group at David Grant U.S. Air Force Medical Center, Travis Air Force Base, Calif., told "Dot Mil Docs" listeners on Pentagon Web Radio.

"They breathe, they blink, and they talk back to our staff, depending on the scenario," Payne continued. "They have a pulse, and they react when you treat it right or don't treat it properly. It makes the scenario extremely real."

The use of human patient simulators is just one of the many ways the medical center is implementing the Team Strategies and Tools to Enhance Performance and Patient Safety, or TeamSTEPPS, program at one of the largest inpatient military treatment facilities in the Air Force.

"[TeamSTEPPS] really builds their confidence," Payne said. "Our doctors, nurses and medical technicians have expressed a greater sense of confidence in their abilities to perform as teams when these concepts are used.

"Applying these concepts is actually like speaking one common language," he continued. "This is due to each team member understanding what their roles and responsibilities are."

Payne said training is built into the work day at the center. "We are consistently implementing TeamSTEPPS training into our practices for our doctors, nurses and medical technicians, and we have seen an increase of incident reporting as a result," Payne noted.

TeamSTEPPS is the cornerstone of the Military Health System patient safety program, Payne said. "Our next goal is to be able prove that [by] improving TeamSTEPPS scores in training scenarios, [we] directly improve patient outcomes and reduce medical errors."

Another positive outcome from TeamSTEPPS is the number of process improvements at the center. "Last year, we used our TeamSTEPPS training in incident reports to generate 46 process improvements," Payne said.

One example is the introduction of debriefing after each procedure and operation.

"That really improved communication, resulting in a 66 percent decrease in incidents where needed equipment wasn't readily available at the time of the procedure," Payne said.

"It's really critical that we encourage reporting of incidences and near-misses," he said. "The identification of these potential problems allows us to intervene before someone is actually harmed, and so increasing incident reporting is one of our key strategic objectives."

Payne said medical center officials continue to set their sights on offering world-class health care. "One of our three stated objectives is to become the nation's safest health care organization," he said. "We submitted our application to [the Occupational Safety and Heath Administration] to be evaluated in June for [Voluntary Protection Program] Star status."

OSHA's Star program is designed for worksites with exemplary health management systems, according to the OSHA Web site.

If they are successful, the center will be one of eight hospitals with that status nationwide, and the first in the Defense Department to receive that recognition.

The medical center provides a full spectrum of care to more than 95,000 eligible beneficiaries, and 400,000 people eligible through the Veterans Affairs Department's Northern California Health Care System.

(Navy Lt. Jennifer Cragg is assigned to the Defense Media Activity's Emerging Media directorate.)