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3 Words for a Safety Culture – Proceed Until Apprehended

CHNOLA leaders Lisa Labat and Jenn Schwehm at the Children’s Hospital Association Quality & Safety Conference

“If we don’t put the major emphasis on how the doctors and nurses and pharmacists and managers feel about their work and their relationships with each other, we haven’t a prayer at plugging the holes that have been sinking the [patient safety] ship.”

John Nance: Why Hospitals Should Fly: The Ultimate Flight Plan for Patient Safety and Quality Care

The most important three words in my book The Florence Prescription: From Accountability to Ownership (TheFlorenceChallenge) are Proceed Until Apprehended because that is the mindset that is essential to foster a more positive Culture of Ownership.

Among other things, this means that if you see something that needs to be done, you do it. You get help if you need it. But you never ignore the problem because “it’s not my job” or because “no one empowered me” to take care of it.

This “Proceed Until Apprehended” mindset is an essential element of any quality and safety commitment. You cannot hold people accountable for how they “feel about their work and their relationships with each other,” as John Nance admonishes us to do. Those things are inspired by a personal sense of ownership for the mission of the organization.

Lisa Labat and Jenn Schwehm (pictured above) presented at the recent Children’s Hospital Association conference in Atlanta about the incredible advances that have been made at Children’s Hospital of New Orleans. The chart at the lower right side of their poster illustrates the dramatic reduction in serious safety events over the past two years.

They titled their presentation “Proceed Until Apprehended: A Cultural Journey” because an important element of their success in reducing safety issues and enhancing quality outcomes has been their commitment to a Culture of Ownership.

As just one example of that commitment, every daily Safety Huddle begins with the group repeating The Pickle Pledge, which they all know by heart (did you notice the Pickle Guy wearing a surgeon’s mask in Lisa and Jenn’s poster?). Almost everyone at the huddle is wearing their wristband for that day’s promise from The Self Empowerment Pledge. Because every associate has been given The Florence Prescription there is almost universal familiarity with these personal commitments throughout Children’s Hospital.

The Culture of Ownership work at Children’s Hospital has been recognized in other ways as well. Just this past month CNO Jamie Wiggins was honored by LSU Health School of Nursing with the Nightingale Award for Nursing Administrator of the Year and Children’s Hospital of New Orleans was recognized for being a Best Place to Work by New Orleans City Business magazine.


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