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James Hoffman, PharmD, St. Jude chief patient safety officer, chats with Elizabeth Day and her son, Stone. Parent advisers offer crucial feedback to enhance patient safety.

When It Comes to Quality, Safety Matters

St. Jude sets the standard for quality, patient care and clinical improvement science for children with life-threatening diseases.

By Mike O'Kelly; Photo by Peter Barta

When Elizabeth Day arrived at St. Jude Children’s Research Hospital three years ago with her son, Stone, she never dreamed she would help shape the hospital’s patient safety program.

As a parent adviser for the hospital’s Quality/Patient Safety efforts, she helped launch a program that allows parents and staff to monitor for signs of sepsis. This dangerous condition occurs when the body abnormally responds to an infection. Day also took part in a video used to educate staff and caregivers about sepsis.

“When I joined the St. Jude Patient Family Advisory Council, I was amazed to see the level of detail we were involved in — from clinical processes to safety procedures,” Day says. “It means everything to see the extra steps St. Jude takes to protect our children.”

Safe and Sound logo

St. Jude patients often have weak immune systems due to their diseases and treatments. That’s why patient safety policies and infection prevention are always top of mind. Parent advisers offer crucial feedback to enhance patient safety. The hospital created a program called “Safe and Sound” to shine a light on these efforts.

Leading the way

“We provide outstanding care,” says Pat Flynn, MD, St. Jude deputy clinical director, “but there are always ways to improve. We want to partner with everyone who can help every child be safe and sound at St. Jude. We’re strengthening our quality and patient safety efforts through an organized approach.”

The plan seeks to get patients and families more involved in safety efforts. Not only does this improve patient safety overall, but it also helps St. Jude guide other hospitals in creating positive change.

Safety-focused research led by St. Jude is already making an impact.

James Hoffman, PharmD, St. Jude chief patient safety officer, recently published two studies in the journal Pediatrics. He figured out a way to reduce alert fatigue in medical records systems.

He also identified the patient safety research topics most important to hospital leaders and parents.

Alert accuracy

When a user of the electronic health records system inputs medicines that may not work well together, an alert appears. If incorrect alerts appear often, users tend to override them. The stream of warnings can cause staff to pay less attention to the alerts. This is called alert fatigue.

Hoffman and his colleagues looked at alerts and found ways to reduce the overrides by 40%. The research provides a guide that other hospitals can use. Hoffman stresses the importance of vigilance.

Hoffman and his colleagues found ways to reduce medication-alert overrides by 40%. The research provides a guide other hospitals can use.


“Persistence and monitoring are so important,” he says. “You can’t implement something and walk away. You must monitor and sustain, and then evaluate.

St. Jude has always had a strong commitment to patient safety,” Hoffman continues, “but we want a higher level of rigor, accountability and structure.”

Parent partners

In the other study, St. Jude researchers teamed with other children’s hospitals to outline the top 24 research topics that could improve patient care and safety. The team collected data from parents, clinicians and hospital leaders. Hospitals around the world can use these results to decide the best ways to improve patient safety and clinical outcomes.

Parents played an important part in the research process in that study. This kind of parent involvement is a growing trend in patient safety. It had early roots at St. Jude. The hospital has had at least one parent adviser on its patient safety committee for more than a decade.

“Including parents and families in the discussion makes a difference,” Day says. “The hospital truly cares about constantly improving processes to benefit the patients. That makes St. Jude even more special than it already is.”

From Promise, Summer 2019

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