If 1 is the loneliest number…

I think we’ve established for the foreseeable future that the regulatory survey of the physical environment—and, by extension, how one prepares for that survey—is very much a question of numbers. And, as it should happen, when it comes to the survey piece, those numbers can be very small, indeed (based on a limited sample size).

So, recognizing that the numbers threshold is basically anything more than none, how many instances of non-compliance do you have to find before you start looking for those conditions throughout the organization?

In my own practice, the truism upon which I rely (and I am rarely disappointed to find the contrary) is that there is at least one instance of non-compliance for just about any performance element/standard combo you might bring to mind. There are probably a handful of elements for which you might be able to avoid a finding (maybe something related to smoking—we’ve got that under control by now, don’t we?), but the lion’s share—how difficult is it to find one instance of noncompliance?

My sense is that there is a lot of focus in the hazard surveillance process on closing the loop on corrective actions (another truism – it’s the easiest thing in the world to fix something, but keeping it “fixed,” not so much), but less so on how are we managing what we find as a function of what hasn’t yet been found (but, just as surely, is waiting for its day in the sun).

We have covered, at some length, the importance of point of care/point of service staff in identifying issues in the environment—I am convinced that the only truly effective/impactful way to manage the physical environment is the participation of the many.

How are you engaging line staff in keeping an eye on things, particularly in light of the exhaustion being experienced and endured by just about everyone in healthcare? Safety scavenger hunts? Prizes or incentives for timely reporting of “stuff?” I would love to get a little conversation going on this area—reach out through my e-mail (stevemacsafetyspace@gmail.com ) and I’d be happy to report back anything that comes up.

I think, by working together, we can make zero be the loneliest survey number…

About the Author: Steve MacArthur is a safety consultant with The Greeley Company in Danvers, Mass. He brings more than 30 years of healthcare management and consulting experience to his work with hospitals, physician offices, and ambulatory care facilities across the country. He is the author of HCPro's Hospital Safety Director's Handbook and is contributing editor for Healthcare Safety Leader. Contact Steve at stevemacsafetyspace@gmail.com.