(AHRQ), in the recently-published
article “Create Positive Change —
Lead From the Middle.” The AHRQ
article points out that nurses are the
link between upper management and
the support staff, meaning they are
ideally positioned to influence positive
change that makes care both better
and safer: “When frontline nurses are
empowered and take on a leadership
role, patient care improves and job
To help hospitals improve upon
the safety of nurses, physicians, and
support staff, the AHRQ created a
Comprehensive Unit-based Safety
Program (CUSP) toolkit. CUSP
includes the Safety Program for
Surgery, which aims to improve safety
culture and reduce surgical site in-
fections and other complications. The
goal is for everyone to be aware of
any potential safety issues or medical
conditions that might affect surgery.
When reviewing planned procedures,
team members can verify completion
of safety checks; that the right equip-
ment, instruments, medications, or
special requirements are ready; and
have opportunities to ask questions
and clarify misunderstandings in an
atmosphere actively promoting com-
munication and team cohesion.
In addressing operating room
safety, hospitals must adapt their
workplace culture to eliminate rigid
hierarchies. Leaders at all levels of
healthcare need to be involved and
engaged. Everyone in the OR must
be made to feel comfortable and
should feel free to ask questions of
other team members regardless of
status or position.
Other initiatives to reduce safety
risks to nurses and healthcare staff
include the Harvard University-based
group Safe Surgery 2015, which is
actively working to have all operating
rooms in the world use the World
Health Organization's Surgical Safety
Checklist. Numerous versions of the
checklist now exist, and the group offers a template on its website to help
hospitals tailor it to meet their needs.
Additionally, the Partnership for
patient advocacy groups, and federal
and state government health agencies
to make hospitals safer, more reliable,
and less costly.
Dr. Cipriano is president of the American Nurses Association (ANA), the
premier organization representing the
interests of the nation’s 3. 6 million
Patients is a public-private partnership
managed by the Centers for Medicare
& Medicaid Services that includes
17 organizations working with over
3,200 hospitals across the country
to improve the quality, safety, and
affordability of healthcare for Americans. One of the key elements of the
initiative is to bring together leaders of
major hospitals, healthcare providers,
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