Tag: maternal

Maternal Health Awareness Day 2024

Today is, National Maternal Health Awareness Day 2024. This year the focus is on Access to Care. Access in Crisis.

Elizabeth Rochin, PhD, RN, NE-BC | January 23, 2024

Posted under: Maternal Health, Quality of Care

The definition of “maternal health awareness” might depend on who you ask. And where.

This year the focus is on Access to Care. Access in Crisis.

And that is true. For many rural communities, closures of obstetric units and hospitals have created tremendous burdens in obstetric availability. Medicaid reimbursement has created significant voids in hospital budgets that are no longer sustainable. Insurance costs have created chasms in care, leading to a lack of obstetric specialists and delivery options in states least likely to afford lapses in care.

But there is more to accessing high-quality maternal care than we realize. Or recognize. Or care to admit. I will give you a few examples that create challenges to accessing even the most well-supported maternal care sites.

1. Racial disparities and racism: In April 2023, the Centers for Disease Control published Maternity Care Experiences that revealed troubling facts (survey methodology available within the CDC document):
  • 30% of Black, Hispanic, and multiracial mothers reported mistreatment (e.g., violations of physical privacy or verbal abuse) during maternity care.

  • 40% of Black, Hispanic, and multiracial mothers reported discrimination during maternity care.

  • 45% of all mothers reported holding back from asking questions or discussing concerns with their provider.
It is very easy to state, “That’s someone else,” or “That doesn’t happen here.” Are you listening to your patients? Are you able to hold space for the possibility that their experience is different from your own? Do ALL patients feel safe in accessing care in your facilities?

Researchers from the University of California at San Francisco found that “racialized pregnancy stigma may result in reduced access to quality health care; barriers to services, resources, and social support; and poorer psychological health”.
The experiences of Black women at the intersection of race, gender, and pregnancy | Bixby Center for Global Reproductive Health (ucsf.edu)

2. Obesity stigma: The stigma associated with obesity continues to impact a woman’s or birthing person’s choice of providers, or their willingness to seek out care. Obesity stigma is fueled by misconceptions and assumptions about people with obesity and continues to exist today. Have you ever seen a colleague or co-worker roll their eyes upon receiving the report of a pregnant patient with severe obesity? Have your own eyes rolled? What assumptions do you make about weight? And how are these assumptions keeping women and birthing people from accessing care due to obesity stigma from healthcare providers?

3. Mental health stigma: The stigma that continues to permeate healthcare is that of mental health disorders. “The bipolar patient in room 3…” Have you heard that recently? Ever? In 2019, researchers in California reviewed 300 records of women who died within one year of giving birth. The second leading cause of death was substance use disorder. Two-thirds of these women had at least one (1) interaction with the healthcare system. Are we seeing despair? Are we making assumptions about maternal mental health? Check out the Maternal Mental Health Leadership Alliance for more information.

4. Homelessness: Back in 2022, I wrote a blog entitled Homelessness is Not Neglect. There is incredible stigma that is associated with homelessness, and more particularly pregnant women who are homeless. Between assumptions, misconceptions, and other issues that can taint perception, homelessness can be a significant deterrent to seeking maternal health care. Here is a quote from the blog I wrote, and it is just as important now as it was then:

 “Members of our team immediately called CPS on a Black mother for being homeless. She left AMA during labor, and we do not know where she delivered. I was so distraught. Our policy directs us to contact CPS for homeless parents. Like they have not been traumatized enough already. We must change our policies to protect these mothers and families and make every effort to keep these newborns with their mothers.”

5. Incarceration: According to Knittel et al (2022), “We Don’t Wanna Birth It Here”: A Qualitative Study of Southern Jail Personnel Approaches to Pregnancy: Women & Criminal Justice: Vol 33, No 5, approximately 55,000 pregnant people are incarcerated in jails each year. As many of these people are of childbearing age, it would stand that some of these people would deliver while incarcerated. In 2018, Black women were incarcerated at twice the rate of white women (Equitable Care for Pregnant Incarcerated Women: Infant Contact After Birth - A Human Right (umich.edu)). This commentary by Franco et al provides a bleak picture of maternal health in our carceral systems. I would strongly encourage the review of this paper and learn more about how to advocate for maternal health patients who experience incarceration. Not only is there stigma of patients during their period of incarceration, but also upon release and their re-entry into their community.

Access to care can mean many things. But one thing is certain. Access to high-quality, affordable, and available care in the community can be life-sustaining and life-changing. Let’s improve maternal health everywhere. Every patient, every time, everywhere.

National Maternal Health Awareness Day 2024
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Creating Quality Improvement New Year Resolutions: Maternal and Newborn Care

Are you among the hospitals who are seeking to improve quality? Have you explored the Psychology of Quality Improvement?

Elizabeth Rochin, PhD, RN, NE-BC | December 13, 2023

Posted under: Maternal Health, Quality of Care

Hospitals across the country are looking forward to 2024 and sharing the vision of their strategic plans. If you are among the hospitals who are seeking to improve quality, have you explored the Psychology of Quality Improvement?

Last week, I joined others from across the United States at the National Institute for Children’s Health Quality (NICHQ) National Network of Perinatal Quality Collaboratives Annual Meeting. Rhode Island is fortunate to be one of many states funded to support its perinatal quality collaborative.

Many topics were consistently mentioned and I wanted to bring awareness to one of those topics here. Postpartum readmissions were one of the issues being addressed, and how we can continue to bring awareness to the key drivers of readmission.

According to the National Perinatal Information Center, between 2018 – 2022, the most frequently reported diagnosis related to postpartum readmission is preeclampsia. Severe hypertension and preeclampsia have continued to rise over the past five years, and that trend does not seem to be changing. Fortunately, there have been great strides in reductions in readmission due to infection, and postpartum hemorrhage has been relatively stable over the past five years.



Preeclampsia is not only the driver for postpartum readmission, but it has been a driver for cesarean birth as well. During the years 2018 – 2022, the NPIC Perinatal Database follows coded reasons for cesarean birth, and preeclampsia has had the highest increase over this same five year period.



Many hospitals are seeking resources to impact the rate of preeclampsia and hypertension that are being seen in obstetric units. Maternal morbidity and mortality discussions and review committees (MMRCs) continue to review maternal deaths associated with preeclampsia/severe hypertension/stroke and have finally begun to explore the impact that racism may have had in diagnosing/addressing/treating/responding to hypertension in Black women.

One of the most critical areas addressed during the NNPQC meeting was the Psychology of Quality Improvement. Yes, there is a foundational approach to QI projects that cannot be overstated. Dr. Veronica Gillespie-Bell (Louisiana) provided an outstanding primer on Creating Change and Managing Resistance (yes, managing the resistance to change). There are those who will embrace change. And there are those who will resist change. But there is a way ahead. And here are the secrets:

  • Define the change through an effective vision

  • Communicating the change

  • Building an improvement team(MUST include frontline staff)

  • Develop reinforcement strategies

  • Assess the climate for change—cultural, commitment, capacity readiness

  • Creating culture for change

  • Select the model for change

  • Understanding and managing resistance

  • Celebrate small wins


**normalization of deviance can completely derail change management**

It is very important to address normalization of deviance (NoD) within change management. NoD has been mentioned several times in these blogs over the past year. If you need a refresher, check out our previous discussions. Become familiar with the term. There are reasons that, on average, it takes 17 years to translate research to practice. This is one of them.

Are your frontline teams drivers or mere passengers in the quality improvement process? How can you leverage the bench strength of your teams to effectively create changes in patient care? If your frontline teams do not have an active role in your quality improvement initiatives, you are missing a critical voice in successful (and sustainable!!) change.

  • Are they ready to engage in QI work?

  • Did the team have any input in creating the QI project?

  • Are there identified champions and informal leaders who can contribute a diverse lens to the process?

  • Is there bandwidth available?

  • How many other projects and initiatives are underway?

  • Is this considered a priority among many others? Who is communicating that priority? (“This is something we have been told to do” versus “We have an opportunity to improve patient care and maternal outcomes”)

  • Is the team multidisciplinary and includes all facets of care?


It is important to include your patients and families in your quality improvement initiatives, particularly if the target population is patients. Let’s use maternal severe hypertension for a moment.

  • Do you have patients with lived experience on your Quality Improvement projects? How are you ensuring that diverse voices are a part of your work?

  • Have your patients reviewed your preeclampsia/hypertension discharge materials? Do they understand them? Are they in a language they understand?

  • Are you disaggregating your outcomes data by race and ethnicity? Are your time to treatment outcomes similar, or do you have glaring differences in treatment outcomes?


No matter your priority for this next year, whether it is maternal hypertension, postpartum hemorrhage, safely reducing primary cesarean birth, sepsis, maternal mental health, or other healthcare needs, creating a strategy to implement change in practice or process can take time. But let’s face it…our patients don’t have 17 years to implement change. They are relying on us now to provide the highest quality of evidence-based care.

As part of your New Year resolutions, think about adding sustainable change to your strategy. Change and sustainable change are two different concepts. Quality and patient safety are at or near the top of many hospitals’ strategic plans in 2024 and beyond, with many including high reliability as a metric of success. Achieving these goals are possible, but only with the cumulative efforts of data, knowledge, commitment to equity, and action. And yes, the psychology of quality improvement.

Here's to sustainable change and outstanding quality improvement in 2024. Happy New Year

If your team would like to incorporate sustainable quality improvement in your organization, NPIC can support your strategy. Reach out to us to learn more.
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Creating a Use Case for Maternal Data and Quality Improvement

Every quarter, NPIC provides member hospitals with a plethora of data. Data that can be tremendously helpful in creating and sustaining quality improvement action plans to support optimal outcomes in maternal and newborn inpatient care.

Elizabeth Rochin, PhD, RN, NE-BC | July 20, 2023

Posted under: Data & Analytics, Maternal Health

Every quarter, the National Perinatal Information Center provides member hospitals with a plethora of data…a hospital’s own data and comparisons to their subgroup and the entire NPIC database. This data can be tremendously helpful in creating and sustaining quality improvement action plans to support optimal outcomes in maternal and newborn inpatient care across the United States. While real-time data access is critical for day-to-day patient care, quarter-over-quarter data analysis can be useful to assess interventions and programmatic shifts.

So, I decided to examine a few areas many hospitals focus on, particularly postpartum readmissions and cesarean birth. And I also wanted to look back to 2019 and come forward to 2022, as yearly trends can inform of areas of opportunity. And both postpartum readmission and cesarean birth allow for such reflection and calls to action.

Postpartum Readmission
Many hospitals focus on postpartum readmission and for good reasons. Readmission rates tend to be used as a proxy for quality but can also be bellwethers for population health opportunities.

NPIC Database 2019 – 2023, Delivery Readmissions coded with:


Observations:
  1. Severe maternal hypertension and hemorrhage continue to be areas of focus secondary to AIM patient care bundles and The Joint Commission Patient Care Standards.

  2. Not every readmission is a failure. Education on maternal warning signs and when to seek care may drive some of these readmissions. It is important to identify the drivers of readmission and any education or information that may have led to better recognition of serious maternal complications. Educational tools such as AWHONN’s POST-BIRTH Warning Signs and Save Your Life tools or the Centers for Disease Control Hear Her Campaign should be used with all postpartum discharges.

    AWHONN
    CDC Hear Her Campaign

  3. Major puerperal infections have decreased which is a good sign for postpartum patients. Consistent preventive measures and early identification of infection and sepsis can be lifesaving. Learn more about maternal sepsis at the Sepsis Alliance and the Tara Hansen Foundation.

    Sepsis Alliance
    Tara Hansen Foundation

Cesarean Birth:
Healthy People 2030 has set a cesarean birth target of 23.6% for low-risk women with no prior births. States across the US have participated in the Alliance for Innovation on Maternal Health Safe Reduction of Primary Cesarean Birth patient safety bundle. The original patient safety bundle was launched in 2015. So how are we doing?



Well, as a nation, and as a database, we are not hitting the target. There are some hospitals that are getting it done and doing it well! I hope we can celebrate your work and the work you are doing to promote intended vaginal birth, and to reduce the likelihood of future cesarean birth. We look forward to continuing to engage with our top decile hospitals and supporting their work and supporting other hospitals looking to reduce their primary cesarean birth. Here are a few suggestions from some teams across the country:
  1. Celebrate successes, even small ones. Publicly highlight physicians, providers, nurses, and other team members who consistently finish with a vaginal birth. If you don’t follow Dr. Tiffany Montgomery on LinkedIn, think about it. She is the Lead for Perinatal Quality at Parkland Hospital in Dallas, consistently posting about supporting her teams’ wins in reducing primary cesarean birth. Contacting Dr. Montgomery should be your next step if you are looking for ideas.

  2. Don’t bite off more than you can chew. How many quality improvement projects do you have running at the same time? Are the same team members being tapped every time? Creating space for QI is important, but sustainable change is the key. Take the pulse of your team routinely, and don’t forget that frontline team members AND patient voices should always be included in any QI planning and implementation. The Safe Reduction of Primary Cesarean Birth patient care bundle requires a multidisciplinary approach that includes prenatal and intrapartum teams.

  3. Stratify your data by race and ethnicity. Yes, this is important. Stratify your cesarean delivery outcomes by race and ethnicity. The literature for years, including the NPIC database, has shown that Black women historically have higher cesarean birth rates. There are numerous reasons for this, but lack of shared decision-making and continuous labor support, and bias/racism inside and outside hospitals have been found to contribute to higher cesarean birth rates. When you report that cesarean birth rates are “equitable,” your data can support your efforts.

  4. Understand quality improvement. No, really understand it. QI is not a “one-and-done” approach. A true QI project requires planning, data exploration, team readiness assessment, and an authentic approach to including the patient’s voice (as NPIC has termed #AuthenticQI). Quality improvement also requires an investment of time (= money) and inertia. Institute for Healthcare Improvement has an excellent QI framework for reducing primary cesarean birth.
NPIC is proud to provide this brief overview of key maternal outcomes. Our goal is for you to use your data in the best possible way to promote optimal health, well-being, and outcomes for mothers and newborns in your hospitals and communities, and we are proud to be your partner.
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13 to Zero

Preventable maternal morbidity and mortality requires an organizational commitment that is patient-centric.

Elizabeth Rochin, PhD, RN, NE-BC | March 30, 2023

Posted under: Maternal Health, Quality of Care, Social Determinants of Health/Disparities

Inpatient maternal mortality continues to be a significant challenge to healthcare teams in the intrapartum period. Recognition and awareness of inequities in birth outcomes must be a priority for healthcare teams. Preventable maternal morbidity and mortality requires an organizational commitment that is patient-centric.

In many instances, 13% may not sound so high. That is 13 out of 100. You might not think much of it.

But if you were to hear that 13% of maternal deaths occur on the day of delivery, that might change your mind considerably (https://reviewtoaction.org/sites/default/files/2022-10/Pregnancy-Related-Deaths-Data-MMRCs-2017-2019-H.pdf). Of 1,018 deaths reviewed from 36 states, 132 occurred on the day of delivery. That’s approximately 4 patients per month or 1 patient per week. And keeping in mind that this data is not from all states, this number is most likely higher. Building into this model that 84% of these deaths were determined to be preventable creates an even greater sense of urgency.

A study (2020) exploring maternal deaths from 2002 – 2014 during the intrapartum period revealed the following:
  • Black women were three (3) times more likely to die during the intrapartum/in-hospital period than their white counterparts.
  • Three or more severe maternal morbidity indicators were present on admission, including coagulopathy, fluid/electrolyte imbalance, hypertension, and neurological disorders.
  • Acute myocardial infarction, followed by amniotic fluid embolism, and pulmonary edema/acute heart failure were the primary drivers of mortality.
While a study reviewing data from 2002 – 2014 may seem a bit dated, there are still common themes associated with today that must continue to drive the conversation:
  • Cardiovascular disease still contributes to the rate of intrapartum maternal mortality.
  • Black women continue to be 3-4 times more likely to die during or after pregnancy.
To bring more awareness to this issue, the National Perinatal Information Center is embarking on 13 to Zero. This call to action is designed to bring awareness to the continued issues surrounding intrapartum mortality and how to build sustainable quality improvement to reduce and eliminate preventable inpatient maternal mortality.

What does 13 to Zero look like?
  • Using data to inform decisions and quality improvement initiatives, including race and ethnicity data stratification.
  • Recognition of birth outcome disparities and strategic plans in place to address.
  • Measuring and supporting psychological safety within healthcare teams.
  • Foundation of cultural humility and respectful patient care.
The STEEEP acronym (Institute for Healthcare Improvement; National Academy of Sciences, Engineering, and Medicine) focuses obstetric care in a way that can connect teams to purpose:
S: Safe
T: Timely
E: Equitable
E: Efficient
E: Effective
P: Patient-centric

Creating and sustaining high-reliability and equitable inpatient quality improvement programs is critical to eliminating preventable maternal mortality.

High-Reliability Quality Improvement: Layers of Success
Hospital Leadership/Boards of Directors
  • Is hospital leadership (yes, I mean the Board of Directors and the C-Suite) invested in improving maternal health?
  • Is maternal health and outcome disparities on the agenda of Boards of Directors/Trustee meetings? How often?
  • Do Boards of Directors/Trustees/C-Suite ask about QI projects on a routine basis?
  • Do they routinely ask about outcome disparities?
  • How often do they see the data? And is this data shared with Boards of Directors? Trustees?
  • How engaged is the Board in reviewing and understanding maternal health QI projects?
  • Does the Board of Directors/C-suite have a shared mental model of the social drivers/determinants of health specific to maternal care?
  • Do unit leaders have an opportunity to routinely engage directly with the Board and share best practices and success stories of improved maternal healthcare, particularly through a racial and ethnic lens?
Nursing and Physician Leadership/Unit Level
  • What does nursing leadership look like?
  • What does physician leadership look like?
  • Do they work well together?
  • Are they committed to the same outcomes and priorities?
  • Are they committed to including the voices of those most impacted in perinatal project planning?
  • In other words, are patients of color or others based upon identified social needs invited to participate in QI initiatives within the unit?
  • Is there a Patient Advisory Council that serves to facilitate connections between patients and care teams?
  • Have they assessed the activation and readiness of their teams to engage in QI work?
Frontline Care Teams
Let's explore the teams themselves, the team members who will be closest to the work.
  • Are they ready to engage in QI work?
  • Are Doulas considered part of the frontline care team?
  • Did the team have any input in creating the QI project?
  • Are there identified champions and informal leaders?
  • Is there bandwidth available?
  • How many other projects and initiatives are underway?
  • Is this considered a priority among many others?
  • Is the team multidisciplinary and includes all facets of care?
  • Are there identified naysayers?
What? Naysayers?
Believe it or not, naysayers are not only helpful, but can be very valuable to identifying barriers and real/potential pitfalls of a QI project. The "squeaky wheels," if you will, can be some of your most invested team members who sincerely want positive change. Or they have had enough of “one trick ponies” and QI projects that were not sustainable or implemented without frontline feedback. While it may be tempting to dismiss them, it is much more important to listen and hear their concerns.

The Patients Themselves
Earlier I mentioned the engagement of patients in QI project development. Yes, this is a critical component of successful QI implementation. As important as it is for your organization and team to be engaged and dedicated to QI, what if the project you are considering does not meet the needs of your patients?
  • Were assumptions made based upon conscious/unconscious bias rather than data?
  • When was the last time your healthcare teams participated in respectful care training?
  • Are the measures/objectives/metrics in line with the communities you serve?
  • How will patients react to and participate in a QI initiative? Are they passive or active participants?
How will your team be successful in your journey from 13 to Zero?

NPIC can assist your team in assessing, measuring, and developing action plans to support your journey to Zero. Reach out to Elizabeth Rochin to learn more (Elizabeth.Rochin@npic.org).







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Patient Safety Awareness Week

This week is National Patient Safety Awareness Week. Across the United States, hospitals, healthcare organizations, and patient advocacy groups have one singular focus: identifying, elevating, addressing, and normalizing patient safety in conversations across the care continuum.

Elizabeth Rochin, PhD, RN, NE-BC | March 14, 2023

Posted under: Maternal Health, Other, Quality of Care

Last week on LinkedIn, I posted about a young Black woman who died at a hospital shortly after giving birth. She and her boyfriend had been asking for the nurses to call the doctor about the symptoms she was experiencing. Per the report of her boyfriend, the nurses could not call her doctors because “they would get upset.”

Where do I even begin to address the multiple factors that created this tragedy?

This week is National Patient Safety Awareness Week. Across the United States, hospitals, healthcare organizations, and patient advocacy groups have one singular focus: identifying, elevating, addressing, and normalizing patient safety in conversations across the care continuum.

In 2001, the Institute of Medicine (now known as the National Academies of Sciences, Engineering, and Medicine) published Crossing the Quality Chasm: A New Health System for the 21st Century. This landmark document created a conceptual definition of quality, including a focus on care that is:
  • Safe
  • Effective
  • Patient-centered
  • Timely
  • Efficient and
  • Equitable
Let’s return to the scenario described above, and dissect it:

Patient and Boyfriend Asking for Help with Symptoms
April Valentine was a first-time mother and selected her birth hospital as she would “have a Black doctor and a doula to support her” (https://www.theguardian.com/society/2023/mar/03/california-investigation-centinela-hospital-los-angeles-black-woman-death-childbirth). According to April’s boyfriend and father of the baby, April could not feel her legs for a few hours. She had an emergency cesarean section and died shortly after the birth of her baby.

Could there have been an outcome that had resulted in a healthy mom and baby? I would like to think that this scenario could have and would have played out under the right circumstances and in the right environment.

But what is the “right environment?” What type of environment would view the patient as “the expert” in their own experience? In their symptoms? Doesn’t the patient know themselves best? In the past few weeks, I have offered multiple examples of patients who expressed concerns about symptoms, only to be dismissed (or a thermostat adjusted so a feverish patient wasn’t so chilled) and suffered harm (or death).

Welcome to High Reliability
Healthcare teams hear the term “high reliability” and immediately think of two things: hard work and more work. And in some cases, they would be right. But “high reliability” is more than a term. It is a state of mind and a state of perpetual readiness. And high-reliability organizations do not occur overnight. These are processes that take years to create, and even longer to sustain. They require the perfect blend of leadership, accountability, and teamwork It is a shared and common purpose that has a few core tenets:
  1. Sensitivity to operations: Awareness of risks and how to mitigate them, including the use of patient outcomes data as a driver of improvement.

  2. Reluctance to simplify: Avoiding overly simplistic reasons for why things fail (communication failure, understaffing, inadequate training). Why did these particular issues occur? What are the reasons behind them? Simply stating “we were understaffed” does not answer the underlying reason(s) for staffing issues.

  3. Preoccupation with failure: Organizations that recognize the importance of addressing near-misses and finding solutions to reduce repetition.

  4. Deference to expertise: Recognition of the importance of the voices of those closest to the patient or to the work, and systems that support “hierarchy” may not have all of the answers to make an informed decision.

  5. Resilience: Teams are in a state of readiness, are prepared and ready to respond to system failures or issues “outside the norm” (https://archive.ahrq.gov/professionals/quality-patient-safety/quality-resources/tools/hroadvice/hroadvice.pdf_
Let’s Return to April’s Story
Imagine for a moment that April had been cared for by a healthcare team that had a foundation of quality and safety as its common purpose and utilized the core elements of a high-reliability organization. Perhaps this is what would have resulted:
  1. April’s care team might have recognized that Black women (even young Black women) are 3-4 times more likely to die in or around childbirth. The team might have considered potential bias and potential forms of institutional racism that may create barriers to safe patient care.

  2. The healthcare team might have deferred to April’s own experience and expertise in her symptoms. She couldn’t feel her legs…what could some of the issues have been? Lack of mobility? Laying in one spot for too long? Something physiologic or worse?

  3. April’s care team might have been more comfortable in calling her providers if there had been a strong, underlying current of psychological safety.
Psychological Safety
Perhaps nothing screams more about this story than the perceived lack of psychological safety within the unit.

“Couldn’t call the doctors because “they might get upset”

Psychological safety has been defined in several ways, but one of the best definitions I have found is an environment that creates the experience of an individual “to be enabled to raise concerns, near misses, and potential errors without fear of negative consequences”. Psychological safety has been discussed in the literature and social media over the last few years, in part due to the challenges of the COVID-19 pandemic. Psychological safety requires crucial conversations about hierarchies within organizations and the importance of team communication. When addressing psychological safety within a healthcare team, it is essential to dissect parts of a unit culture that may need to be addressed more fully. That type I have experienced exceptional leadership dyads within perinatal care. Unfortunately, I have also been witness to those that are a true embodiment of the lack of teamwork and synergy required for patient safety.

Call to Action
I hope a lasting legacy of April’s unfortunate death will shed a light on how important a strong patient safety foundation can be. As we recognize opportunities to address and elevate patient safety, let’s commit to the following actions today:
  1. Recognizing patient care quality must be a daily priority.

  2. Recognizing the patient as an expert in their care.

  3. Recognizing high-reliability opportunities that can promote patient care and multidisciplinary teamwork.

  4. Elevate the concept of psychological safety as a national patient safety goal.
Thank you for everything you do for the care of your teams, patients, families, and communities.

Let’s make every day Patient Safety Awareness Day.

NPIC can assist your team in assessing, measuring, and developing action plans to support psychological safety, and tracking its impact on patient outcomes. Reach out to Elizabeth Rochin to learn more (Elizabeth.Rochin@npic.org).


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