Safety in Numbers

From the clinical staff to those in facilities management, everyone at Massachusetts’s Signature Healthcare collaborates on safety

John Duraes, Director of Facilities Management & Engineering, Signature Healthcare

Early in John Duraes’s tenure as director of facilities management and engineering at Signature Healthcare, a vendor needed access to the healthcare system’s roof to repair a piece of equipment. But, when a patient looking out a skylight spotted the man wandering around with a bag of tools and wires, an alarm was raised. “He called the nurse and said there was a man on the roof with a bomb,” Duraes recalls. “Since then, we’ve installed a roof-access program where workers sign in and need to wear designated red vests. It’s a funny little thing, but at the same time it helps us ensure safety.”

Though he might not be treating patients directly, Duraes has found ways to make an impact on the health and safety of patients, practitioners, and the community—something every Signature Healthcare employee is trained and encouraged to do.

From doctors to custodians, all Signature Healthcare employees go through a “Culture of Safety” program, which is far more than lip service. These individuals are expected to eat, sleep, and breathe safety. The system names safety coaches— individuals trained to coach others in best practices—for each shift in each department. “Management isn’t always around to coach, so we enable peers to help everyone be more conscious of safety,” Duraes says.

But even within facilities management and engineering, Duraes notes, everyone works together to find new solutions for patient safety. Across the main campus and Signature Healthcare’s additional 17 off-site properties, Duraes and his team keep close documentation of myriad details to ensure compliance and consistency. “We have five three-inch-thick volumes of documentation we have to maintain every year to ensure that we’re doing our due diligence,” he says. “But, my secret is my awesome team.”

The lobby in the Cancer Center at Signature Healthcare features comfortable seating and natural light. The facility offers high-caliber care to those who might not be able to get to the Boston area quickly.

In fact, this push for safety is so ingrained in the inner workings of Signature Healthcare that it even differentiates the organization from other healthcare organizations. The lean, strategic leadership team has an open-door policy and encourages any employee with an idea that could improve processes to share it. The CEO and the rest of leadership also start every day with a 15-minute huddle in which they discuss any safety issues or concerns and any “catches”—moments when team members prevent potential issues before they occur. “We want our neighbors and our family members to come here because of our quality of care and our focus on safety,” Duraes says. “Our mission is to find things that we’re going to make mistakes at and then try to prevent them before they happen.”

That focus extends to both patients and Signature Healthcare’s own employees. The organization has been regularly and routinely recognized by the likes of US News and World Report and the Joint Commission as a top hospital for both quality and safety and a key performer on quality measures. Those accolades come, Duraes explains, from being equally passionate about the safety of employees. In addition to spotting catches for the well-being of patients, safety coaches are tasked with, for example, checking whether a nurse is wearing the proper personal protective equipment when attending to a contagious patient, or whether the ice in front of the entryway could cause a worker to slip and fall.

The organization has rolled out wellness programs to ensure employees are safe and healthy away from the workplace as well. “We are an organization that not only cares for our patients and the community but genuinely cares about the staff that work here—as well as their family and their health concerns,” Duraes says. “Through weekly and monthly programs like walking challenges and diet challenges, we’re trying to entice our staff to be healthier. As part of that program, they earn points and can save up to $100 for certain goals.” In addition, the healthier the staff becomes, the more the organization saves on insurance costs—but even this is then reinvested into infrastructure, continuously providing employees with a safer workplace that provides better care to the community.

One such investment was the recent development of the Cancer Center at Signature Healthcare, a project Duraes worked closely on. The 37,000-square-foot building broke ground in August 2016 and admitted its first patients a year later. The facility offers both radiation oncology and medical oncology in affiliation with Beth Israel Deaconess Medical Center. The Cancer Center offers top-tier care to those that might not be able to get as easily or quickly into the Boston area. “We’re only 20 miles out of Boston, but it’s not unusual to take an hour to get there,” Duraes says. “When patients are going through chemotherapy and radiation therapy, those trips can be very difficult for these individuals and their families. We wanted to build the best-quality healthcare possible to serve our community.”

From updating bathroom fixtures to relamping the entire hospital, every seemingly minor decision that Duraes and his team make needs to be carefully considered, well documented, and made with safety in mind. Luckily, the entire organization is working together to make those decisions the right way. “We’re stewards of our community and stewards of our environment,” Duraes says. “It’s all a team effort. You really have the opportunity to be successful in this organization because we empower and encourage each other. We’re committed to the health and well-being of everyone in our community.”

Photos: Courtesy of Signature Healthcare