They’re devoting themselves to safety.

Dr. Susan Shaw and Petrina McGrath are the co-leads of the new 90-Day Safety cycle that will begin this fall.

Shaw is a critical care physician and anesthesiologist who was a department head with Saskatoon Health Region for a long time before stepping away to chair the Saskatchewan Health Quality Council. McGrath has been the Vice-President of the People, Practice and Quality portfolio for the Region for the past four years.

Petrina McGrath and Dr. Susan Shaw

Petrina McGrath (left) and Dr. Susan Shaw are leading the Safety cycle of breakthrough improvements this fall.

Safety has been a part of what they do for quite some time; now, they are focused on it.

“We are boots on the ground,” Shaw said. “Before, we had to work on safety on the side of our desks. That’s changed. Petrina is full time into this, and I’ve stepped away from 80 per cent of my clinical work.”

Why is safety so important?

“The simple truth is that, while most experiences go well, we do harm people – our staff, our patients, our physicians – every day, though we don’t mean to. We make mistakes,” Shaw stated. “We need to find a systemic way to stop those mistakes, to prevent that harm. That’s our goal in the next cycle.”

“We don’t want to give the impression that our facilities are dangerous places to be. However, neither do we have a mistake-free environment,” said Dan Florizone, president and CEO of Saskatoon Health Region and sponsor of the initiative dedicated to safety. “We know there have been situations where a small error has led to devastating consequences. That’s why we’re focusing on Safety across the Region for the next few months. Because one mistake is one too many. We need to make our care safer for our patients, clients and residents every single day.”

Why did Florizone ask McGrath and Shaw to  take the lead on Safety?

“I work at the bedside, and I see almost every day a situation where we harm people, and we often tolerate it,” Shaw said, “even though all of our staff want to be safe, stay safe and provide safe care. I want to figure out how to make all of our workplaces safer, how to stop that stress and worry for staff and patients. It might not be possible to fix all our safety issues right away, but I’ve been in systems where conditions were created that made a big difference. And I think I know some of the conditions needed for success at a larger level.”

For McGrath, it’s about one family whose story she heard nearly four years ago.

“After I heard their story, I couldn’t tell her that it wouldn’t happen again to anyone else. I couldn’t say that. I didn’t have the confidence it wouldn’t. When this work gets too hard, I think of that family, and I see their faces,” she said.

No one comes into health care to harm – when it does happen, staff, family, clients, and physicians all suffer.

“To me, that’s why this is such important work,” said McGrath. “I feel like we’ve got to get to the next level as an organization, so we can be fully confident about safety.”

There’s also a personal investment for both Shaw and McGrath. This is their health region.

“I want this to be the safest region in the country, because it’s my Region,” said McGrath. “It’s where my family gets care.”

Though the Safety cycle won’t launch until mid-September, Shaw and McGrath have had safety on their minds all summer as they prepare for the 90-day action period.

“Right now, we’re in the exploratory phase,” McGrath explained. “We’re trying to understand the system and the perceptions of our staff and our patients around safety. We’re hearing about patient experiences, and trying to understand our processes.”

“We’re just trying to make sense of all the information that’s out there,” Shaw noted. “There has been so much effort and energy spent on safety over a long period of time. It’s always been a priority, but we’re looking for those break-through measures to take harm prevention to the next level, and across the Region.”

Many safety improvements have been made in the past, but they haven’t yet translated to breakthroughs at a Region-wide level.

“We’ve had pockets of improvement,” said McGrath, “but we haven’t seen a system-wide improvement.”

“We’re trying to understand what is happening right now, and why we haven’t had system-wide success as a region, why we haven’t been able to harness those improvements on a larger scale, when it’s been a top priority for our system, our providers, and our patients,” Shaw said. “We need to figure out why these smaller groups have been successful, and translate the core elements across the whole.”

Shaw and McGrath see their roles in the safety cycle as connectors – ensuring that communication is happening back and forth and across the organization – and as drivers of improvement.

They hope this focused approach will provide an example for the Region.

“Our job is more of hands-on doing, and we’re going to try to model a lot of the leadership behaviours and expectations that are necessary to make breakthrough improvements,” said McGrath. “That includes showing leaders how to capture and tell stories, and not only how to do the work, but report it back to the rest of the Region. That’s something that’s been a challenge for many.”

They also see part of their job as putting the right people in place on their team.

“We need to harness the talents of people who have an interest in and a passion for safety,” said McGrath. “It’s up to us to help align resources for those people and help them lead.”

Sometimes, people have a passion for safety because they’ve been part of something in the system that’s let them down in the past and caused harm. It’s made them passionate about making improvements, about making the system better, but they don’t know how to go about it, or how to get involved.

“These people are out there with either expertise or energy, and what they need is support and alignment. That’s a big part of what we’re going to try to do,” said Shaw.

Having both of them focus their attention on safety for the next several months will hopefully mean an acceleration of breakthrough initiatives. McGrath likened it to a rocket that takes off. A large push of energy is needed to get the rocket out of the atmosphere, and after that point, it just soars.

“It’s the big boost that we need to send us to the next level,” said McGrath.

“We’re not going to solve all of our safety issues in 90 days of activity,” Shaw noted. “Our focus needs to be on what we can do in 90 days that will set us up in a culture of safety. And our role in that is to help figure out what those major areas of focus should be, and accelerate improvements to those areas.”

Narrowing the focus of the safety cycle is something that McGrath and Shaw are currently working on. They are looking at data, hearing patient stories, and reading reviews of past situations to look for themes, and common processes with risks and therefore potential impacts. They’re also consulting high performance organizations outside of health care, those known for a focus on safety, such as the mining industry, to learn from them

“We really need to find those key drivers,” said McGrath. “Those must-dos, the things that without being implemented, we won’t create real change.”

If you’d like to join the safety team, or if you’ve done some work in your area to improve safety, and have seen good results, the Safety team wants to hear from you. Email Petrina or Dr. Shaw with your information.

“We can learn from areas that have made improvements as much as we can from areas that are struggling,” said McGrath.