How You Can Reduce Patient Safety Risk

Each day in a hospital, staff members undertake complicated daily tasks caring for the critically ill, which can include ensuring nearly 200 steps for each patient. At Johns Hopkins Medicine, our quality and safety efforts aim to ensure that all of these steps work together to provide safer care for our patients.

The Johns Hopkins Armstrong Institute for Patient Safety and Quality works to eliminate preventable harm to patients and to achieve the best patient outcomes at the lowest cost possible. The institute also oversees, coordinates and supports patient safety and quality efforts across Johns Hopkins’ integrated health care system.

Lori Paine, director of patient safety at The Johns Hopkins Hospital and at the Armstrong Institute, is responsible for the strategic and tactical oversight of the patient safety program across Johns Hopkins Medicine. Lori’s role is designed to meet the Armstrong Institute’s values and work collaboratively and respectfully with all Johns Hopkins Health System entities to eliminate harm, improve outcomes the patient experience and value. Renee Demski is vice president of quality for The Johns Hopkins Hospital and Health System and the Armstrong Institute. Her main focus is the effective integration of quality services across the health care continuum for the Johns Hopkins Health System, with the goal of maximizing organizational improvement, efficiencies and the value of clinical services.

In today’s Ask the Expert, Paine and Demski will answer some important and meaningful questions about patient safety risk and how you can reduce it as an employee of Johns Hopkins Medicine.


What are the patient safety and quality goals of Johns Hopkins Medicine?

Johns Hopkins Medicine’s goals for patient safety and quality are to:

  • Reduce preventable harm.
  • Eliminate waste.
  • Improve clinical outcomes and patient experiences.

Who oversees and manages patient safety and quality for Johns Hopkins Medicine?

The Johns Hopkins Medicine Patient Safety and Quality board of trustees provides oversight for the patient safety and quality efforts across the organization. This committee meets quarterly and provides guidance and accountability over the progress and improvement efforts that are targeted to provide safe, high-quality care.

While the board of trustees provides the highest level of oversight, affiliates across the health system have quality and safety departments, improvement committees, and individual board committees that ensure we are also working toward our goals at the local level. Monthly systemwide quality and safety meetings bring together stakeholders at each of our affiliates. During these meetings, we discuss priorities, areas of concern and ways to continuously improve care.

The Armstrong Institute also supports the coordination of safety and quality improvement efforts across the health system by managing programs to reduce preventable complications and infections. Specifically, the Armstrong Institute:

  • Develops and delivers training programs and other educational resources that increase the ability of Johns Hopkins Medicine faculty and staff to carry out work that prevents errors and complications, improves patient outcomes, and enhances value.
  • Supports the scholarly activity of faculty in improving safety and quality and provides consultative services and technical support to our hospitals and departments.
  • Measures, tracks and broadly reports performance on safety and quality measures within Johns Hopkins Medicine.
  • Supports improvement programs across Johns Hopkins Medicine. Examples of these programs include adverse event reporting, the Safety Culture Assessment and the Comprehensive Unit-based Safety Program (CUSP).

The Armstrong Institute works closely with each affiliate to coordinate care through the entity’s designated quality and patient safety committees. These committees oversee the local improvement efforts.

How is patient safety and quality work structured?

To ensure we’re reaching our goals, Johns Hopkins Medicine approaches patient safety and quality through four domains:

  • Reducing patient safety risk
  • Improving patients clinical outcomes
  • Enhancing patient-centered care initiatives and improving the patient experience
  • Enhancing value

Safety and quality meetings across the health system build agendas and discussions around these four domains to keep us focused on our goals. While these areas govern our quality and safety work, they also fall under Johns Hopkins Medicine’s patient- and family-centered care strategic priority.

How does Johns Hopkins Medicine define patient safety?

Patient safety is the creation of safe systems and processes that lead to the elimination of preventable harm. Harm can be prevented by a series of steps, such as washing hands before entering a patient’s room or revising institutional policies to be more in line with best safety practices.

To prevent harm from occurring, Johns Hopkins Medicine designs and implements systems and protocols to help our care providers identify hazards, defend against errors, anticipate where our safety procedures could fail to prevent harms and ultimately keep errors from occurring.

How does patient safety affect me in my daily work?

Every staff and faculty member across Johns Hopkins Medicine is responsible for ensuring patients receive safe care.

To provide the safest care possible, you should practice these steps in your daily work:

  • Know your unit’s quality and safety performance data. You can check your unit’s progress on the internal Johns Hopkins Medicine Dashboard at
  • Speak up if you see a real or potential problem. We need a culture in which every employee feels comfortable raising concerns—whether you are a nurse, patient transporter, physician or an environmental services worker. We each play an important role in creating a strong safety culture that fosters open communication and supports a learning environment.
  • Use your chain of command and/or adverse event reporting system to report near misses and defects in care that could lead to a potential patient harm.
  • Participate in your unit’s safety activities through the CUSP teams.

What is my role in patient safety?

As employees of Johns Hopkins Medicine, we all have the ability and responsibility to ensure our patients receive the safest and highest quality of care possible. We know the most powerful and effective way to ensure quality of care is to hold our peers accountable for performing best safety practices, every day, in every interaction.

This can mean reminding individuals to wash their hands before entering a patient’s room or speaking up if we see a potential harm. This can be challenging and even uncomfortable for us to do. But these acts of leadership and courage help us prevent harm. It only takes one individual to inspire an entire group to actively participate in patient safety.

How can I become more involved in patient safety and quality improvement initiatives?

Connect with your institution’s quality and safety departments to learn more about efforts most relevant to you.

You can also use the Armstrong Institute’s website to learn about the numerous opportunities available to the Johns Hopkins community to deepen their involvement in patient safety and quality improvement initiatives. These include:

  • Training and education opportunities, including workshops, team training programs, e-learning, Grand Rounds presentations, fellowships and certificate programs.
  • Support for patient safety and quality work through such efforts as a small grants program.

Learn more about your organization’s CUSP program and get involved.

You can also join or start a clinical community. These are peer-driven groups that collaborate across Johns Hopkins Medicine to improve care in focused areas.


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