• Article
  • March 8, 2018

What Happens When a Nurse and a Doctor Co-lead a Hospital Safety Team

The RN and M.D. quality and safety leadership duo has rapidly decreased preventable patient harm by combining the expertise of physicians and nurses.

When Kristin Cummins and Michele Saysana described during the 2018 Quality and Safety in Children's Health Conference how they work together at Riley Hospital for Children at Indiana University Health to decrease patient harm, they explain their relationship is like a marriage. "This is a partnership," says Cummins, DNP, M.S.N., R.N., NE-BC; director, quality. "It's like a marriage. It's not about Michelle being a great physician and me being a great nurse, it's about the chemistry because we're talking to each other all the time."

This RN/M.D. quality and safety leadership partnership has rapidly decreased preventable patient harm at Riley Children's by blending the expertise of physicians and nurses. The team is structured to align nursing and physician quality goals and priorities. The partnership focuses on clear communication, consistent messaging and fosters interdisciplinary collaboration to drive improvements. Leaders accomplish this through integrated quality and safety councils and hospital-acquired condition teams, as well as unit and department quality and safety councils.

"This has really changed how we do things, and it gives us the opportunity to manage quality at the local level within the hospital, says Saysana, M.D., FAAP, executive director and chief quality and safety officer. "It also gives us the opportunity to manage quality at the leadership level and help leadership at the facility and system level to think different about quality."

Saysana says there is not a day that goes by where the two are not checking in with each other, even if it's just for 15 minutes. "We have to be sure we're both on the same page so we can be consistent in our messages, not only to front-line staff members, but up the chain as well," she says. "We are always helping each other understand the other's world so we can emphasize the same message."

Reducing pressure injuries

The first big project the leadership team took on was to decrease pressure injuries. The hospital's goal was to decrease them by 30 percent.

"In our first calendar year, we saw a 55 percent decrease in pressure injuries and a decrease in severity," Saysana says. "We did this through the physician-nurse partnership. We had amazing physician engagement, identified root causes and leveraged each other's relationships with physicians and nurses.  This work instilled deeper appreciation for each profession. By the end, we were cheering for each other."

In the end, a successful nurse/physician partnership to improve patient safety comes down to trust, transparency and communication. With a shared vision and consistent messaging, this partnership can have big effects on safety initiatives. "We're often were asked what do we attribute our success to," Cummins says. "I attribute it to the physician engagement and Melissa attributes it to nursing engagement."

Send questions or comments to magazine@childrenshospitals.org.