Do your staff regularly report safety issues and concerns? Do they then take a lead role in solving those issues? Ticket, Huddle, PDSA, Audit…..and Repeat is part of the Achieving Kaizens Together (AKT) process that is revolutionizing safety culture within the Rosecrest Communities. Rosecrest Communities owns and operates three continuing care facilities in Nova Scotia (the Ivy Meadows, the Sagewood, and the Magnolia) and has implememented AKT as a means to practice and propel continuous change. One such success was the new equipment safety zone. So how did they get here, and could their approach help revolutionize your safety culture? Ticket • A ticket is an improvement opportunity card • Anyone in the building can share any type of concern, but with it, they must indicate why they think it is happening, and provide a potential solution • This becomes a ticket that will be tracked until resolved! • In the new equipment safety zone example, the problem was that it wasn't clear what equipment was safe to borrow from the wellness center • The potential solution identified? Mark equipment that is safe to borrow, and implement sign out sheet. Huddle Board • Is the ticket in action? This step is how it moves from identification, solving, completing, and then to the audit process. • Employees and managers alike gather and ideas to address the concern raised are made from the people on the floor. • Sometimes, the solution isn't the right fit, creates a different concern, or doesn't actually solve the initial concern. If that occurs, the huddle board process is started again! PDSA (Plan Do Study Act) • This is the process of coming up with the solutions. • Breaking down the problem, reviewing the background, problem statement, goal, root cause analysis, and implementation plan are all discussed. • A new process may be supported by policies or procedures, and plans are made to communicate and train on these new processes. To supplement the ticket generation process, there is a Daily Status Check , every day, twice a day (to incorporate both day and afternoon shifts). The status check involves asking safety centered questions, and are directed to staff to set up their day to be successful. Questions may include: • What are any known or anticipated resident or staff safety risks that worry you most today? • Tell us about any equipment or process that would make care safer or more efficient for residents and staff? • Tell me about any incident reports in the last 24 hours or the past weekend? What did you learn from these incidents? • Tell me about how you have collaborated on a care plan? • How are you feeling today? How can we support you? What is our plan to implement this support? What are you expectations for the day? • Can you tell me about any modified duties that we need to accommodate today? • Provide any learning needs that you can identify? • Describe any staffing issues affecting us today. Want to hear more about AKT? Keep checking back to the Safety Matters blog for our next piece on adapting AKT to address challenging behaviours.