In search of safety: an interview with Gina Pugliese. Interview by Alison P. Smith

Gina Pugliese, MS, RN, is currently a vice-president for Premier, Inc. In addition to faculty and editorial positions, she directs international training courses in hospital epidemiology. She has made innumerable contributions to the field of safety over the past 25 years through her work with regulatory and federal agencies. Changing organizational culture from a "blame culture" to a "safety culture" is one notable challenge facing organizations. The airline industry has achieved significant changes in its safety culture by virtually eliminating a power hierarchy in the cockpit, a worthy example for operating rooms. Redesigning care delivery processes will minimize the opportunity for error if efforts are made to avoid reliance on memory, automate repetitive functions, reduce the number of steps involved, or use protocols when appropriate. The sophistication of consumers and the emergence of organizations like the Leap Frog Group will continue to challenge health care providers and potentially accelerate safety improvements.     

The effect of workforce issues on patient safety

The workforce of any health care organization is vital to its continued survival, but a highly competent and committed workforce is vital to its success. The evidence is clear: employees influence not only the financial performance of the organization, but also the safety and quality of the clinical care provided to patients. Health care organizations must understand these important linkages and have in place corporate strategies to manage workforce issues with a systems focus that ensures excellent leadership and operational processes, a healthy culture, and optimum patient outcomes. New levels of knowledge, resources, and implementation are needed to move health care in the United States to the next level of quality performance. Staff satisfaction and retention should be at the heart of the clinical improvement strategies. Such an approach will allow organizations to cope and thrive in an environment of workforce shortages and increasing consumer demand for quality. To quote Robert Waller, MD, of the Mayo Clinic, "The goal is the best care for every patient, every day. Our patients deserve nothing less.     

An interview with Rhonda Anderson. Interview by Connie R. Curran

Nurse executives working in a hospital system experience varied and challenging opportunities to enhance the quality of patient care as well as the success of their professional careers. In this interview, Rhonda Anderson, MPA, RN, CNAA, discusses the hospital system, the managed care environment, and the importance of developing nurse managers.