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says Dr. Pickett. "You need to get to the root cause to prevent the problem from happening again." In fact, Duke recently did just that — following a near-miss of a wrong medication administration that occurred when a staff mem- ber confused two similar-looking drugs. As soon as the issue was detected and raised, a pediatric phar- macist went on the offensive. "She's an excellent problem-solver; she got right to the root of the prob- lem within 24 hours," says Dr. Pickett. The pharma- cist understood the flow of medication administra- tion and created a strategy to make sure the looka- like medications were labeled differently, and that every staff member was alerted and educated about the situation. Then, she created an audit mechanism to make sure the medications were stored in desig- nated locations and shared the new process with the entire health system to ensure a near-miss did not happen again. COVID-19's positive impact You're under more pressure than ever to keep patients and staff safe thanks to the COVID-19 pan- demic that brought the healthcare industry to its knees and temporarily sidelined elective surgery. While many focus on the negatives — the expanded safety protocols an already stretched-thin staff is expected to follow, the fear that's causing patients to delay or cancel outpatient procedures — some safety experts see a silver lining that will improve staff and patient safety moving forward. "The pandemic forced us to communicate better and learn to be more agile," says Dr. Pickett. "Proposed changes that used to take months for us to discuss had to be acted on in a day or two." Stressful? Absolutely. However, COVID-19 forced Duke to make decisions and move in a way that was significantly faster than it did in the past, which is improving the safety of the entire organization and allowing staff to share best practices in real time, adds Dr. Pickett. Still, it's crucial for leaders to acknowledge the impact pandemic-based changes and increased pressure have had on their staff. "The psychological impact of a crisis stays with us long after the imme- diate crisis, so we're focused on helping our care- givers seek the care they may need and removing barriers that might discourage them from reaching out or seeking help," says Ms. Pelletreau. To that end, CommonSpirit Health launched a virtual leadership program in mid-June. While the organization has always sought to support the well- being of its staff, this program focused specifically on the effects of COVID-19. "The goal of this pro- gram is to help physician leaders address their col- leagues' stress and anxiety in working through the pandemic," says Ms. Pelletreau. Dr. Kost, who also serves as the director of the Frank J. Tornetta School of Anesthesia at Einstein Medical Center Montgomery, says the pandemic has showcased the true value of simulation training — programs that can be conducted in settings ranging from acute care hospitals to free-standing ambulato- ry surgery centers — to bolster safety. "Simulation programs provided organizations with the opportu- nity to finalize technical procedures specific to COVID-19, and adapt new protocols as they evolved and the pandemic unfolded," he says. This should carry over to other facets of patient safety. Constant care Ultimately, facilities that create and maintain safe spaces for patients and staff have a collaborative, team-based culture where all disciplines and service lines play critical roles. "Embracing a culture of safety includes promoting psychological safety, accountability, teamwork, communication skills and healthcare leadership that advocates for a hier- archical challenge, which encourages the respectful practice of challenging others if patient safety is compromised," says Dr. Kost. Encourage your entire staff to challenge one another to protect their patients — and themselves. OSM O C T O B E R 2 0 2 0 • O U T P A T I E N T S U R G E R Y . N E T • 5 "All safety-first organizations adhere to rigorous protocols and safeguards." — Barbara Pelletreau, RN, MPH