PI ’til you’re PO’d
One of the more common pushbacks I hear relative to my suggestions for improving policies, procedures, etc., is, “We’ve been doing it like this for (insert time frame here) and it’s never been a problem.”
From a safety professional standpoint, I cannot tell you how disheartening it can be to hear that. I have yet to find an organization that does not change over time, and as the legal disclaimers are wont to say, past experiences do not indicate/ensure future performance.
And all too frequently (with a single instance being far too frequent for me), this ends up coming with a price tag of a regulatory dope slap during survey. Remember this, if nothing else: Compliance is a moving target, and it very rarely moves towards us.
The purpose of our little endeavour is a tiered expectation of the elimination or minimization of risk. I would encourage you all, as you make your way through the remainder of the year, to continuously ask of yourselves, “Are we as low as we can go relative to risk?” The answer should be no — there is always something to improve.
I would also push you to start focusing now on identifying some sweet performance improvement (PI) indicators for next year. Don’t wait until December or January only to decide that what you have is okay.
If I may be so bold as to suggest that there must be at least one thing that needs attending, do some sort of PI project with that. You and I and every regulatory surveyor under the sun know that we do not live in a perfect world, and this less-than-perfect world frequently breeds imperfections. The true test of a safety program is how you identify those incremental imperfections and use them as a basis to manage risk. So get cracking!
About the Author: Steve MacArthur is a consultant for The Greeley Company, a division of HCPro. He brings 30 years of healthcare management and consulting experience to his work with hospitals, physician offices, and ambulatory care facilities across the country. He is the author of HCPro's Hospital Safety Director's Handbook and is contributing editor for Briefings on Hospital Safety. Contact Steve at 
Marge McFarlane, PhD,MS,CHSP | Jun 11, 2009 | Reply
Truer words were never spoken. In these times of “more and more with less and less,” it seems harder and harder to focus on those unlikely but high impact situations when other competing priorities seem more pressing. I like the idea of looking for PI opportunities for next year now. I think that just having discussed this issue may make potential PI opportunities more visible to me as I go through all my other duties as assigned.