How do you become a patient safety leader? In a recent interview with IHI, Wanda Kaye Hambrick, Vice President of Quality and Patient Safety for Baptist Healthcare (Pensacola, Florida), shared her experience and advice. Hambrick participated in the IHI Patient Safety Executive Development Program in 2017.
What was your path from clinician to patient safety leader?
It was a little by accident. I was working in an operations role as a nurse running a Level I trauma center. But I knew I had a passion for leadership so I went to school to get an MBA.
I had a mentor named Steve Mayfield who was an engineer I met through the Georgia Hospital Association. He opened my eyes to the engineering side of safety. He explained that safety is about a process not a person, and that my fallacies and mistakes as a clinician can be intercepted by good human factors techniques. Once I realized I could help keep lots of people safe by leading patient safety work, doors began to open.
What are some of the major challenges in patient safety right now?
The main challenge is distraction. Every clinician arrives to work planning to do the right thing, wanting to do the right thing, seeking to do the right thing, and assuming that will happen. But processes get in our way. Administrative burdens get in our way. Other priorities take our eyes off the ball. The challenge is to take the clearest path to keeping us safe and our patients safe despite the distractions.
What are some of the keys to successful safety leadership?
Involvement, passion, and leading the charge through example are all very important. You can’t lead from an office. You have to show people that you‘re passionate about it. I think a clinical background is helpful because you can relate to people who are delivering the care.
I enjoy talking with small groups of clinicians and talking with them about their safety concerns and what matters to them. I enjoy partnering with them. “Going to the gemba” — which means going to where the work occurs — is a very rich way of partnering together and talking through the issues and possible solutions. It’s enlightening and very rewarding when you can see that and work together to make processes stronger.
Because of my training as a nurse, I remember that delivering care was so different from planning it. When you marry those two together, and plan the work while participating in it or shadow someone who is doing it, it becomes a very rich process. Going to the gemba allows you to immerse yourself in the work, and from this you can let the real experts — the people doing the work — help to create a better process.
At the same time, as a leader, you’re developing empathy for what the people who care for patients go through every day. There’s nothing easy about health care. It’s very challenging. Developing relationships and seeing the challenges up close keep you from making judgements that are harmful.
As leaders, we tend to categorize things as staffing, physician, or administrative issues, but what does “staffing” really mean? At the end of the day, it means that you can care for your patient in a way that’s not rushed, and involves partnerships to get rid of some of those distractions that I talked about. It definitely takes all of us.
As you developed your skills as a safety leader, was there anything that surprised you?
When I first became a leader, I didn’t understand the value of relationships. Those relationships manifest in all kinds of ways until they become so much bigger than patient safety. They benefit the bottom line and allow an institution to not just survive but thrive. Relationships make the whole patient experience richer.
What advice do you give those who appear to have safety leadership potential?
You can never go wrong developing relationship building skills. I didn’t know that as a new leader and so I had to learn that the hard way through the knocks and bumps of not having good relationships. Strong relationships always help you no matter what kind of leader you’re going to be. Professional maturity means trusting others and having them trust you, and you can’t do that without having a relationship.
