IHI Open School Video Short: How does a zoo promote safety?

Kathy Duncan, RN, IHI Faculty

Duncan: We go outside of health care to see our see our system in a new way and get fresh ideas for improvement. Today, we’re going to learn about a safety system to handle a totally different hazard, one we rarely face in health care. We’re going to look at dangerous snakes.

Hi, I’m Kathy Duncan and today we’re going outside of health care to the Central Florida Zoo. The Central Florida Zoo has a lot to teach us about safety. Specifically, we’re going to learn three valuable lessons about reliability. In order to create reliable systems, we need to 1) prevent failure, 2) identify failures and mitigate their effects, and 3) learn from failure to better design our systems.

How does the zoo apply those concepts when handling venomous snakes?

Hoffman: My name is Michele Hoffman. I’m a reptile keeper at the Central Florida Zoo. I’ve been here for four years, and work with one of the largest selection of venomous reptiles in the southeast.

Duncan: Michele took us behind the scenes to show us how they stay safe when handling snakes, to clean their enclosures and to move them.

Hoffman: The red and the green cage cards will actually tell us at a quick glance if the snake in the enclosure is venomous or non-venomous. So the red obviously is the venomous and the green is the non-venomous; red is stop and green is go.

The numbers above the enclosures tell the keepers how many animals are in the enclosure. So for example, there is only one rattlesnake in here and there are three pythons in that enclosure. So we know if we open the door and only see two animals, there might be one hiding somewhere, to keep your eyes open, and actually find all of those animals before you reach in or before you do any work in the enclosure.

Duncan: All of this helps prevent snake bites. But what is a failure does occur? When keepers handle snakes they work in pairs, so if something goes wrong, there’s a trained person there to help them.

Hoffman: We’re expected to work really closely with our co-workers and our managers. We have a very open relationship when it comes to trust and being able to speak up.

Duncan: They also use a belt clip with key information about the snake, such as the anti-venom.

Hoffman: That way if something goes wrong, somebody can come in from the outside and know exactly how to handle the situation and know what anti-venom to bring with you to the hospital.

Duncan: This helps to reduce harm if a failure does occur. The next principle of reliability is that you may redesign your systems based on what you’ve learned from failures.

Hoffman: It’s been over twenty years since we’ve had a venomous snake bite here at the Central Florida Zoo, and the reason for that great track record is that we’re always adapting, adjusting, and learning how to improve our systems prevent any failures in the future.

Duncan: For example, they used to use a lanyard, instead of the belt clip, with all the snake information.

Hoffman: We actually switched it to the belt clip in order for it to be completely out of our way, and not in any sort of position where it could get attached to anything or snake’s tail could get hooked around it.

Duncan: They also modified their trash barrel to have a plexiglass window on the top, so that they could see where the snake is.

Every time I visit the zoo, I see opportunities to standardize, mitigate failure, and even redesign the work. They’ve taken the opportunities to really look at how they can keep not only their keepers safe, but how they can keep their animals safe as well.

So as you go about your daily work and daily life, look at other opportunities to really see how you might be able to bring things back to health care.