HYBRID EVENT: You can participate in person at Baltimore, Maryland, USA or Virtually from your home or work.

8th Edition of Nursing World Conference

October 17-19, 2024 | Baltimore, USA

October 17 -19, 2024 | Baltimore, USA
NWC 2018

Barbara Holder

Speaker at Nursing World Conference 2018 - Barbara Holder
Andrews Institute Ambulaotry Surgery Center LLC, United States
Title : Improving our quality safe culture


Introduction: A baseline Safety Culture Survey administered in our facility in 2014 yielded a rating of B- (82.5) by our staff. The low rating began us on a quest to review and improve our processes.

Purpose of the Study: Explore and implement ways to improve our Quality-Safe environment.

Methods: Annual Safety Culture Survey of employees: utilizing a 5-point tool. Our facility was selected as one of two surgery centers nationwide by IHI (Institute of Health Improvement) to participate in their Sustainability Study (April 2016). Implementation of five-minute meaningful Daily Huddles with an emphasis on safety/prevention which incorporate Lean Quality problem solving techniques.

Results: Discussion: Safety Culture Survey results skyrocketed to 95.02 as of August 2017 a 12.52% increase.

Conclusion: Daily Safety Huddles are conducted daily in every department! Examples of safety initiatives have included infection control (Immediate Use Sterilization): Goal of zero has been reached and maintained for 18 months, Time Out: Peri and Intra-op RN’s are conducting peer reviews of the timeout process for regional blocks and surgery. 100% compliance goal has been achieved and maintained. Patient Education Regional Blocks and Total Joints, for the past year our patients have rated us 9.92/10, thanks to our study and patients guided initiatives. Team up! Solicit outside programs and assistance. Working with IHI has been so enriching to our facility. Please allow us to teach you how to implement this program in your facility!

Implications for perianesthesia nurses and future research: The focus on safety should not remain behind the OR doors. Perianesthesia nurses play a fundamental role during patient screening, pre-op preparations, regional blocks, recovery and ensuring a safe discharge process which includes patient education. The implementation of Daily Huddles has dramatically improved our Safety Culture and departmental team work. Team members have a voice as well as defined Huddle roles. Implementing standard work has provided an avenue for employees to speak up on behalf of our patients and their co-workers. Employees are actively engaged in departmental and facility processes and outcomes! QI studies are more meaningful and yield continuous exceptional results.


Barbara Holder is the Quality Improvement, Safety and Infection Control Officer for Andrews Institute Surgery Center located in Gulf Breeze, Florida. Responsibilities include regulatory compliance and preparation of staff for federal and state inspections. Barbara, has been a Registered Nurse for greater than 38 years, a BSN, is a Licensed Health Risk Manager in the State of Florida and CAPA Certified. In addition, she has been an instructor at University of South Florida’s Risk Management Program. Presentations include: IHI Annual Conference (2016), ASPAN (2016, 2018), OutPatient Surgery: ORX Conference (2017, 2018). Annual ASCA Conference (2018). You may recognize her as a platinum contributor on the ASCA forum site.