On June 22, 2023, the Health Care Improvement Foundation’s (HCIF) Partnership for Patient Care (PPC) hosted an in-person Safety Forum workshop, “Gun Violence Prevention in the Hospital Setting”. PPC Safety Forums bring together health professionals to collaborate and share knowledge on enhancing safety in healthcare environments. Past forums have covered diverse topics, such as workplace violence, suicide prevention, root cause analysis, and best practices. This year’s focus was gun violence in hospitals, an issue that has escalated, with a rise in violence against healthcare workers since the pandemic. Between 2010 and 2020, 400 healthcare professionals lost their lives due to firearms in the workplace. This statistic emphasizes the urgency of collaboration between health systems to protect their staff and prevent such incidents.
Dr. Stanton B. Miller, Executive Director of the Jefferson Center for Injury Research & Prevention at Jefferson Health, led the keynote talk on the 23rd floor of Independence Blue Cross, overlooking the light rain that fell upon Central Philadelphia. Using a framework from the World Health Organization, he discussed the problem-solving methodology for addressing workplace violence in healthcare. Dr. Miller defined healthcare violence as any form of aggression involving staff, licensed practitioners, patients, or visitors, underscoring its pervasive nature. The magnitude of the problem became evident as he presented statistics, with 75% of 25,000 workplace assaults occurring in healthcare and social service settings. Many incidents remain underreported due to historic attitudes accepting violence as part of the job. Dr. Miller highlighted gun violence as a critical determinant, comparing it to a societal disease that affects American society deeply. “Just as individuals can suffer from PTSD… American society is suffering from PTSD” related to social issues, especially gun violence, claimed Dr. Miller. He dispelled misconceptions about the differences in violence between rural, urban, and suburban areas, urging against discriminatory assumptions.
Leadership emerged as a crucial intervention. “Leadership sets the tone, sets the culture, and needs to clearly define workplace violence,” Dr. Miller said, emphasizing the need for leadership “to be clearly dedicated to placement of systems across an organization that enables staff to report violent instances”. He emphasized the importance of fostering a culture that encourages staff to report violent instances and takes responsibility for addressing workplace violence. Developing screening tools and reporting protocols, along with coordination between databases, were also identified as effective measures. The Haddon Matrix, a tool from Injury Science and Public Health, was introduced as a key element in the implementation process. It helps measure adverse effects and identify effective interventions for specific situations. Dr. Miller highlighted the role, or lack thereof, of legislation in protecting health care workers from violence against them, highlighting the need for such interventions as incidents rise. He ended his keynote by touching on measurements, focusing on the importance of using data informing and evidence based practices.
The roundtable discussion that followed exemplified the need for interdisciplinary conversations between health systems and departments. The audience represented a diverse group of professionals from all parts of the healthcare ecosystem. Representatives from Emergency Services, Patient Quality, Public Safety, Ambulatory Services and Senior Leadership from various Health Systems across Greater Philadelphia shared their expertise, fostering a natural and impactful exchange of ideas. The event concluded with a networking session, where participants continued their discussions. One group decided to get lunch to continue the conversation, embodying the success of this in-person event and demonstrating the power of face-to-face interactions in fostering meaningful connections and promoting positive change. HCIF and PPC remain committed to initiating these essential conversations between health professionals, leading the region in enhancing safety within the health care ecosystem.
In the middle of Philadelphia sits an oasis of nature and beauty, rivaling some of the more exotic and scenic national parks in the United States. HCIF had the unique opportunity to spend the day at the Discovery Center for our staff retreat in July. In addition to being able to utilize a beautiful public space to promote creative thinking and inspiration, we were heartened by the giggling campers who were in the room next door to us. We even had the chance to enjoy a nature walk after a long day of exercising different parts of our brains than we usually do in our day-to-day work. We left the retreat exhausted, but inspired and ready to put our ideas and thinking into action.
According to its website, the Discovery Center provides education and adventure programs that “inspire self-discovery, foster personal achievement, and build community across Philadelphia”. It struck me that this is very similar to what we hope to achieve through our programming to improve health care. Ultimately, our work promotes opportunities for individuals and communities to achieve optimal health and well-being through collaboration and shared learning. It was just fortuitous that our mission found a kindred spirit in the Discovery Center.
During the retreat, the first in many years, we had the opportunity to connect in person and reflect on our accomplishments over the past several years, including our anti-racism work, a new strategic roadmap, and organizational work to improve our exposure and social media presence. Related to this, we had a chance to think about our identity as we begin designing a new website (coming soon). We celebrated the launch of several successful programs, including the Health Equity Data Strategy Collaborative; the 2022 Regional Community Health Needs Assessment; PENNJ-SOS, an opioid stewardship program engaging clinicians and patients; and hosted multiple summits addressing gun violence in the hospital setting, health literacy, and health equity. We also enjoyed a fun Team Bingo game – if you haven’t done this before, it’s a great ice breaker for teams or new partners.
We also had the opportunity to think about our current healthcare environment and how HCIF can support recent shifts, such as addressing social needs and risks to achieve optimal health. Our retreat highlighted how HCIF is poised to meet the needs of both our community and health care partners to facilitate achievements in health equity. We left the day with a number of to-dos, takeaways, and next steps to move towards our long-term vision as the go-to source for supporting work to improve health.
We started the day with an overcast sky overlooking the lovely Discovery Center lake and left with a bright shining sun, much akin to the brightness and energy with which we left the retreat.
Cities Changing Diabetes – Philadelphia (CCD) is an HCIF-led project that integrates community-driven and place-based approaches across multiple sectors to address obesity, diabetes, and their social drivers in the city’s historically vulnerable and underserved communities. Funded by Novo Nordisk, CCD – Philadelphia promotes chronic disease awareness and addresses key social drivers of health through partnerships with more than two dozen organizations, including community-based organizations and houses of faith. This summer, HCIF advanced these objectives through the engagement andonboarding of four new partners, and by convening new & existing partners for a collaborative meeting and site visit.
On August 9, Health Care Improvement Foundation (HCIF) held our Annual Site Visit and Collaborative Meeting. The gathering was hosted by two CCD partners; Greener Partners and Calvary St. Augustine Episcopal Church. Featured sessions included a tour of the Belmont School Community Garden, new partner introductions, and reorientation through a collaborative mapping activity for partners to identify where they provide services like food access, health education and peer support across the city. The event utilized graphic recording services by Illustrating Progress across various sessions of the agenda. Other facilitated sessions encouraged partners to explore complementary activities and opportunities to increase impact through collaboration. You can find photos from the day below.
Cities Changing Diabetes – Philadelphia will continue to foster cross-sector collaboration to address social drivers of health for historically vulnerable and underserved communities, improve access to resources for healthy living, and ensure the sustainability of programs through 2025 with ongoing grant funding from Novo Nordisk.
The Health Care Improvement Foundation’s (HCIF) Partner Profiles highlight the efforts of valued and innovative health leaders. Our partners’ work supports HCIF’s vision of healthier communities through equitable, accessible, and quality health care.
We are pleased to feature Shannon Davila of ECRI to share more about her reflections on patient safety and quality improvement. Shannon currently serves as the Director of Total Systems Approach to Safety at ECRI and has a clinical background in adult critical care nursing and specializes in infection prevention and healthcare quality improvement. She is certified in infection control, healthcare quality, is a TeamSTEPPS Master Trainer and a High Reliability coach. Shannon is a current member of HCIF’s Clinical Advisory Committee as well as serving as our partner and facilitator for HCIF’s Safe Table program.
How did you first get involved or interested in Patient Safety?
Shortly after completing my enlistment in the United States Air Force, I went to nursing school. As a new graduate nurse, I worked in the ICU and immediately became aware of the safety risks that our patients face. As I have grown professionally, I have been drawn to focusing on how I can help reduce the risk of harm to patients.
ECRI and the Institute for Safe Medication Practices Patient Safety Organization (PSO) and HCIF have been partnering for the Partnership for Patient Care (PPC) Safe Table program for the past seven years. This program offers a framework for Patient Safety Officers to discuss and exchange best practices and solutions for current patient safety issues. Throughout that time, we’ve discussed over fifty different safety topics of concern. Reflecting on the program’s history, what do you see as some of the biggest accomplishments the Safe Table program has achieved?
First, I would say the longevity of the program is impressive! Additionally, the resilience of the participants to stay engaged over those years and through a pandemic demonstrates the power of those relationships. This program creates a safe space for safety leaders to talk, share and learn, and the value of that is evidenced by their continued commitment to the program.
“The Safe Table program serves as a valuable learning system for this region of Pennsylvania…This helps advance the application of safety principles and strategies across health systems, ultimately contributing to making our region safer.”
Shannon Davila
As an innovative model, how do you see the Safe Table program serving the general discipline of patient safety and overall contributing to making our region safer?
The Safe Table program serves as a valuable learning system for this region of Pennsylvania. Under the federal legal protections offered by the PSO, participants are able to share details of safety issues and learn from each other. This learning helps advance the application of safety principles and strategies across health systems, ultimately contributing to making our region safer.
One of the roles of HCIF’s Clinical Advisory Committee is to identify and address Southeastern Pennsylvania’s quality and patient safety priorities. We also know ECRI releases their annual Top 10 Patient Safety Concerns report. As a well-versed patient safety professional, what do you see as some of the biggest challenges ahead or shifts occurring in the field of Patient Safety? Are there any specific regional priorities that you are focusing on?
Issues related to staffing shortages have been something that ECRI has highlighted since the pandemic, and we still see many problems stemming from this issue. This includes problems with transitions of care, managing complex patient populations, and maintaining an adequate level of competent safety and quality improvement professionals. These professionals are critical for healthcare systems to both identify safety and quality issues and bring about transformative change.
As a longstanding partner of HCIF who has participated in several PPC programs over the years, what do you think makes HCIF unique and what have you found most valuable about working with HCIF?
I would say without a doubt, the HCIF team. I work closely with Pam and Liz and their dedication to their members and the program design is always evident.
Reflecting on your own career, what has been one of the proudest moments or greatest accomplishments of your career thus far?
In 2016 I was awarded the Heroes of Infection Prevention Award from Association for Professionals in Infection Control and Epidemiology (APIC), one of my mentors had nominated me and I was honored to have received it.
If you are interested in connecting with our partner, you can connect with Shannon via email at sdavila@ecri.org.
To get to know Shannon a bit more, she shared the following: A quote that she often returns to and inspires her in her work , “You can’t improve what you don’t measure.” Something most people don’t know about her is that she has a green thumb and loves to garden. To reflect back on her gardening hard work, she likes to document her plants as they grow by taking photos of them!
Lauren Eckel joined HCIF in September 2022 as Project Coordinator for the Population Health team. Lauren provides support to multiple project teams in the management of community and population health projects. Prior to joining HCIF, Lauren worked as a Research Assistant for Pennsylvania State University on the FFC-AC-EIT research study, which strives to optimize function and physical activity and prevent adverse events among hospitalized patients with ADRD. She also interned for the City of Philadelphia’s Office of Children and Families Out-of-School Time program as the Policy & Qualitative Researcher. Get to know Lauren better in this month’s staff profile.
How did you learn about HCIF and what prompted you to start working there?
I learned about HCIF while researching employment options after completing my master’s degree in Public Health from Drexel University in June 2022. I had heard wonderful things about HCIF and their mission to drive superior health care through collaboration and shared learning. HCIF’s mission and vision to create healthier communities through equitable access and quality health care directly aligned with my career goals and personal interests in the public health field which is initially what prompted me to join HCIF.
What has been your most rewarding professional experience thus far? What is your proudest accomplishment during your time at HCIF?
My most rewarding professional experience thus far is being able to work with so many partners whose missions align with creating healthier communities. Getting to know our partners on a deeper level and being able to connect with like-minded souls has truly been a rewarding experience. As for my proudest accomplishment during my time at HCIF, I am most proud of receiving my Certified Health Education Specialist (CHES) Certificate. I couldn’t have done it without HCIF’s support.
What excites you most about your position at HCIF?
I am most excited to be able to provide support to many of our population health projects and bring about positive health changes to the communities to which HCIF serves.
What are your long-term career goals?
My long-term career goals are to one day work for the CDC as a Public Health Advisor and eventually go back to school to receive a DrPH in Leadership, Advocacy, and Equity.
What is a quote that inspires you in your work?
“It’s not about ideas. It’s about making ideas happen.” By: Scott Belsky
The Health Care Improvement Foundation (HCIF) is featuring our partners on our website and in our monthly newsletter. We would like to take this opportunity to highlight your work and contributions to improving the health of people in Philadelphia and beyond. We hope these profiles will give our readers a better understanding of the breadth of work that HCIF is involved in, as well as an introduction to our innovative and valuable partners that we are fortunate enough to work with.
Phil Landis, DNP, RN, CEN, NPD-BC
For over a decade, HCIF has supported regional and statewide health literacy initiatives through a grant from the Pennsylvania Department of Health. Pennsylvania Hospital has been a clinical partner in this work since its inception. Since 2017, Phil Landis, DNP, RN, CEN, NPD-BC has worked with HCIF as Pennsylvania Hospital’s Health Literacy Project Lead. Dr. Phil, as he’s known to colleagues, serves as Clinical Nurse Education Specialist, Emergency Department and Observation Units and Co-Chair, Patient/Family Education & Health Literacy Committee. We asked Dr. Phil to reflect on his accomplishments as a longtime champion of health literacy.
You have been working to advance health literacy for over a decade. What inspires you in this work?
The pioneers who started this work, and from whom I’ve learned so much. Although it sometimes seems that progress around health literacy is slow, the traction and trajectory concerning the concept continue to grow legs and move forward. At least at Pennsylvania Hospital, the awareness has definitively increased during my 13-year tenure as co-chair of the hospital’s Patient/Family Education & Health Literacy Committee (“make sure you take it to Phil’s committee for input/approval!”).
Penn Medicine has prioritized health literacy across the health system and at individual facilities. What is one of the most impactful changes that Penn has achieved in this space?
Penn Medicine is following the new paradigm and moving from health literacy as an individual imperative toward a “health literate organization”, which broadens the depth, scope and responsibility of health literacy to the larger health system. We are presently working with our health literacy/patient education partners in the other entities in conducting a “health literate organizational assessment”, using some of the established tools developed by Dr. Rima Rudd and her colleagues. This will allow us insight into how to better serve our patients, from campus wayfinding to written materials, to electronic portals and clearer communication.
What is one key thing you would like the public, or someone not in health care, to understand about health literacy?
That it does not correlate to income or education, and that decreased health literacy can directly impact one’s quality of life and health outcomes. My advice to patients is to write down all of your questions ahead of time when you visit your provider, and do not leave the office until you have all of them answered in language you understand!
What have you found most meaningful about working with Health Care Improvement Foundation? What’s something you’ve learned from our partnership?
The importance of collaboration across so many diverse groups, and how critical personal relationships are in working on projects together. It has been an honor to meet and work with so many wonderful professionals from so many different backgrounds.
Reflecting on your long career as a nurse, what is one of your greatest accomplishments within your work so far?
Maintaining compassion and an appropriate sense of humor in dealing with the human condition, and knowing that I made a difference in my patients’ and families’ lives.
Dr. Phil’s advocacy for health literacy and willingness to share tips, tricks, and lesson learned with both clinical and community partners has certainly made a difference in HCIF’s health literacy initiatives. Something you may not know about Dr. Phil is that he grew up on a turkey farm in Lancaster County, and enjoys regularly baking for his Emergency Department colleagues. He will be retiring later this year, and is looking forward to sleeping in until at least 6am, instead of 4:30am!
