How does your organization celebrate retirement? It's not a typical interview question, but perhaps it should be: How we treat the people who have given years of their lives to the organization speaks volumes about how we value everyone else. Today's episode is half-podcast, half-tribute to Sostenes the lab director -- because listening to people speak about his life at retirement made me want to live mine better. Key Points: -Just another party? -Getting rid of the "old guard" -Building a legac...
Jun 26, 2025•8 min•Season 3Ep. 9
How can we care for strangers if we do not care for each other? This episode looks at some of the best and worst charitable policies in the workplace and examines how safety culture can be elevated and restored during difficult times. Key Points: -Mandatory charity -Acceptable charity lists -Service awards and fundraisers Support the show For more information, visit PorterQI.com , or email Q4Us@porterqi.com....
Jun 12, 2025•7 min•Season 3Ep. 8
How much do you trust your coworkers to watch your patients during lunch? This question is an often overlooked key indicator of safety culture. Nurses are possessive of "their" patients and this episode explores reasons and symptoms of lunch breaks that are not covered. Key Points: -Critical debriefing -Trusting your team -What makes a "good" team? Support the show For more information, visit PorterQI.com , or email Q4Us@porterqi.com....
May 29, 2025•7 min•Season 3Ep. 7
Do you ever hear coworkers say, "Someone should fix that"? Have you ever wished Marie Kondo would come to your healthcare facility and tidy up? This episode looks at the physical environment as a sign of safety culture. Key Points: -The Van Halen Effect -The Psychology of your workspace -Someone should fix that References: -Ozden, E. (Sept. 28, 2021). The Reason Behind David Lee Roth’s Brown M&Ms Request for Live Shows. Rock Celebrities. https://rockcelebrities.net/the-reason-behind-david-le...
May 15, 2025•8 min•Season 3Ep. 6
What is the intersection between safety and security? This episode shares some of my adventures at the bedside and explores opportunities to strengthen safety culture with best practices in security. Key Points: -Violence is prevalent -TJC on violence in healthcare -Safety and Security References: -The Joint Commission (May 15, 2024). 2023 Sentinel Event Data Annual Report. https://www.jointcommission.org/resources/news-and-multimedia/newsletters/newsletters/joint-commission-online/may-15-2024/n...
May 01, 2025•9 min•Season 3Ep. 5
Everyone wants to believe that we treat our patients like family. But is it possible to prove it? Today's episode provides a quick auditing method to identify whether you have a family-friendly organization. Key Points: -Family Support Systems -Humanizing Healthcare -Family Furnishings References: -Goldfarb, MJ; Bibas, L; Bartlett, V; Jones, H; Khan, N (Oct. 2017). Outcomes of Patient- and Family-Centered Care Interventions in the ICU: A Systematic Review and Meta-Analysis. Critical Care Medicin...
Apr 18, 2025•9 min•Season 3Ep. 4
Efficient throughput and end of life care work at opposite ends of the spectrum. How does your end of life care reflect your safety culture? Today's episode explores ways to track the quality of end of life care and assess your facility's safety culture in the process. Key Points: -End of life care and the culture of safety -When it takes too long to die -Assessing quality and procedures Support the show For more information, visit PorterQI.com , or email Q4Us@porterqi.com....
Apr 04, 2025•7 min•Season 3Ep. 3
How should we respond to voluntary reporting? What can we do when our scientific approach to the study of errors becomes as dehumanizing as the culture that caused the error? This episode discusses non-mandatory reporting by turning the lens of safety culture onto the safety department itself. Key Points: -Why reporting happens -Troublemakers and safety culture -The best weapon against never-events Support the show For more information, visit PorterQI.com , or email Q4Us@porterqi.com....
Mar 21, 2025•8 min•Season 3Ep. 2
Have you ever questioned the credibility of your safety culture survey? So many safety culture assessments describe vague things to avoid, but how can you tell if you have it? This season, we're sharing the Top 10 Signs that your healthcare organization has a solid safety culture. Key Points: -What is "good" healthcare? -Virtue and ethics in safety culture -Introducing the Top 10 Signs References: Norwood, Arlisha (2017). "Dorothea Dix." National Women's History Museum. Accessed October 2, 2024 ...
Mar 07, 2025•10 min•Season 3Ep. 1
As the holidays approach, I'm revisiting the subject of what matters most to patients. This episode discusses the discharge process, length of stay, and outcome metrics that can serve as a compass for other quality measures. Key Points: -Universal needs -Critical questions -What if? Support the show For more information, visit PorterQI.com , or email Q4Us@porterqi.com....
Nov 21, 2024•23 min•Season 2Ep. 18
Did you hear about the redesign of the nurse manager role at Advocate Health? This episode discusses the six insights gleaned from three simple questions that just might save the nurse manager role. Key Points: -Ask the frontline -Mutual goals -Critical mentorship References: -Twenter, P (Oct. 21, 2024). Advocate redesigns the nurse manager role. Becker’s Clinical Leadership. https://www.beckerhospitalreview.com/nursing/advocate-redesigns-the-nurse-manager-role.html . -American Association of Co...
Nov 01, 2024•17 min•Season 2Ep. 17
Important notices are common in healthcare, but opportunities for feedback can be hard to find. Yet, communication about problems is essential to a robust patient safety program. This episode looks at changes in technology that could improve safety communication across the healthcare industry. Key Points: -Safety communication in space -Healthcare feedback loops -Overwhelming public comment References: Sull, D; Sull, C (Oct. 18, 2023). How Do Nurses Rate Their Employers? MIT Sloan Management Rev...
Oct 10, 2024•15 min•Season 2Ep. 16
Big Pharma spends billions of dollars on advertising that teaches the public how to say the names of their products. While millions of people live with hypertension, many of them cannot remember the name of their diagnosis or what it means. This episode discusses healthcare communication and shares helpful models for improvement. Key Points: -Big Pharma ads get it right -Idiopathic Explanations -Louis Braille and medical coding References: -Institute of Medicine (2001). Crossing the quality chas...
Sep 20, 2024•13 min•Season 2Ep. 15
Have you ever noticed how admission orders can be corrected, but a faulty discharge is nearly impossible to correct? Today's episode explores fake deaths, inaccurate discharges, and how to begin solving for resurrection errors in healthcare. Key Points: -Fake deaths are common -Computers do not believe in resurrection -Discharges are surprisingly inflexible References: -Wikipedia (2024). “Safety Coffin.” https://en.wikipedia.org/wiki/Safety_coffin . -Stechyson, N. (June 19, 2024). “Noam Chomsky ...
Aug 27, 2024•12 min•Season 2Ep. 14
What can a con-man teach us about patient safety? Sometimes normal human reactions are just what is needed to breach protocol and result in harm. Today's episode explores the relationship between the perfect heist and safety culture. Key Points: -Reaction Videos -Dual Auditing -Decoys and False Alarms References: Diaz, Naomi (Nov. 17th, 2022). Why healthcare mergers and acquisitions are a cybersecurity risk. Becker’s Health IT. https://www.beckershospitalreview.com/cybersecurity/why-healthcare-m...
Aug 08, 2024•15 min•Season 2Ep. 13
Infectious disease fascinates me. When the State of Texas offers a free certification program in pandemic preparedness, including courses in epidemiology and infectious disease, I'm eager to sign up. Tune in to hear some of what I loved, what I didn't love, and why access to this type of knowledge is a great opportunity overall. Key Points: -Public Health History in Texas -Research Hesitancy -Neglected Tropical Diseases References: -Texas Epidemic Public Health Institute (2024). Certificate Prog...
Jul 29, 2024•15 min•Season 2Ep. 12
Have you noticed how busy the clinic waiting rooms are becoming? As the largest living generation retires from providing care and seeks to receive it, our primary care models are experiencing new challenges. This episode seeks to focus our efforts on an improvement mindset as we manage the surge of patients. Key Points: -Blocking the Door -Black Friday in Healthcare -Primary Care Triage References: -Shen, Fan (2004). The Barefoot Doctor. Gang of One . University of Nebraska Press. Support the sh...
Jul 12, 2024•14 min•Season 2Ep. 11
Have you ever been asked to sign that you'll pay whatever is "leftover" from your bill -- without knowing the total? This episode uses a risk approach to discuss the expectation that patients must promise to pay to an infinite and undefinable cost, and shares solutions that fit a patient safety model using clear communication and patient-empowered decision-making. Key Points: -The Blank Check -Transparency Laws in Practice -Patient-Driven Billing Support the show For more information, visit Port...
Jun 25, 2024•16 min•Season 2Ep. 10
Is it possible that one of our top safety interventions could increase the risk of patient harm? Why do some huddles seem so fruitful while others fall short? This episode shares 5 pitfalls of the typical staff huddle with tips on how to improve their productivity without increasing the risk for clinical errors. Key Points: -Reality is not like the research -The unforgiving med pass -Opportunities for engagement References: -Pimentel, CB; Snow, AL; Carnes, SL; Shah, NR; Loup, JR, Vallejo-Luces, ...
Jun 02, 2024•11 min•Season 2Ep. 9
Does healthcare improvement sometimes feel like an impossible task? This episode looks at ways to refresh more than the data, but also our outlook and understanding, through an analytical approach. Key Points: -Time to give up? -Human rights applications -Breaking it down References: -World Vision International. (Feb. 9th, 2018). A Stolen Trombone, Barrier Analysis and Isaiah 65 – A chat with Tom Davis – World Vision’s New Global Lead for Sustainable Health. Retrieved September 8th, 2022, from h...
May 16, 2024•13 min•Season 2Ep. 8
Have you noticed there are a lot of companies diving into primary care and then quickly exiting--or how many of these ventures carry the term "health" in their title rather than "healthcare"? This episode explores the dichotomy of healthcare that treats the sick and health companies that provide primary care for the healthy, including recommendations for how these companies could recover and thrive. Key Points: -Healthcare for the Healthy -Holistic Care -Unmet Needs and Opportunities References:...
May 06, 2024•11 min•Season 2Ep. 7
Have you ever experienced unintended consequences in your efforts to improve healthcare quality? Is there a better way to find solutions to persistent problems? This episode applies the principles of Precision Medicine -- with its individualized, scientific approach -- to the field of healthcare improvement. Key Points: -Viper Reimbursement -Magic and distraction -The garden quality indicator References: -Bragg, Alistair (2022). Great Moments in Unintended Consequences: Transcontinental Railroad...
Apr 19, 2024•14 min•Season 2Ep. 6
Patient Decision-Making is supposed to be the goal, but just defining it can cause a heated argument. What prevents it from happening, and how can we overcome those barriers? This episode uncovers a missing piece in patient decision-making, and offers recommendations for a solid patient-centered framework. Key Points: -Speak Up campaigns -Obscure language -Precision Risk References: -The Joint Commission (2024). Facts About Speak Up. https://www.jointcommission.org/resources/for-consumers/speak-...
Mar 29, 2024•12 min•Season 2Ep. 5
This Patient Safety Week, I had the honor of sitting down with healthcare tech and e-iatrogenesis expert Benjamin Cooperman to discuss my toughest questions about digital harm, healthcare cybersecurity, and high reliability organizing (HRO) in the healthcare tech space. He has an extensive background in information technology and HRO consulting in the healthcare industry. This feature-length episode covers the human side of digital patient safety, discusses hospital closures related to healthcar...
Mar 11, 2024•39 min•Season 2Ep. 4
The topic of Artificial Intelligence and healthcare tech often prompts polarized responses across the industry. Will AI replace doctors? Will technology alleviate burnout, or worsen it? What do we need most in the development of healthcare innovation? Today's episode shares some cautionary tales as well as tips for success. Key Points: -Decision support -AI Gatekeepers -Smart Development References: -Jennings, Katie. (February 19, 2024). “An AI Doctor In A Box Coming To A Mall Near You.” Forbes....
Feb 23, 2024•13 min•Season 2Ep. 3
Nearly 10 years ago, the goal of mandatory electronic documentation was to improve patient engagement, care coordination, research, disparity, and healthcare quality. As we look toward the next wave of requirements for interoperability, this episode reviews our progress toward these goals and shares recommendations for the future. Key Points: -Is digital better? -Vulnerable data -Patient ownership References: -Office of the National Coordinator for Health Information Technology (ONC) (May 2, 202...
Feb 09, 2024•15 min•Season 2Ep. 2
Why do some patients prefer to spend $100 on imported frankincense oil than spend the same amount on a clinic visit? What can alternative medicine tell us about measuring patient satisfaction? Today's episode discusses these novel trends. Key Points: -Why essential oils? -Limits of patient satisfaction metrics -The patient's voice References: -“Vapor rub relieves cold symptoms for children, researchers find (2010). Penn State Medicine. https://www.psu.edu/news/medicine/story/vapor-rub-relieves-c...
Jan 27, 2024•12 min•Season 2Ep. 1
Why do healthcare professionals shy away from working in scenic rural areas, even when they are offered the comfort of broadband internet and affordable housing? Today's episode addresses the two reasons why doctors and nurses avoid rural health and how innovators around the world are solving those problems. Key Points: -The new Netropolis -Rwanda's blood bank program -Specialty café References: -Ingraham, Christopher (2019). If you lived here you’d be home by now: Why we traded the commuting li...
Dec 29, 2023•14 min•Season 1Ep. 40
What is the greatest risk to your organization and how can you tell? What does a "good" solution look like? Today's episode shares how to use a risk assessment to identify hot spots in your organization and innovate for the best solutions. Key Points: -Relative risk? -Scoring Risks -Discussing solutions References: -Fox, Andrea (May 31, 2023). Florida bans offshore health record storage. HealthcareITNews . https://www.healthcareitnews.com/news/florida-bans-offshore-health-record-storage-0 . -McK...
Dec 14, 2023•16 min•Season 1Ep. 39
Are there trails blazed outside the system’s parameters that frustrate planners? This episode discusses “desire paths” in sidewalk design as an example for surgical staffing, and looks at how AI could help us get a better understanding of employee behavior and trends. What will we find if we stop to listen to the footfalls of our healthcare community? Key Points: -What are "desire paths"? -Is AI able to eliminate reactive staffing? -The Operating Suite References: -Bramley, E. V. (Oct 5, 2022). ...
Dec 01, 2023•16 min•Season 1Ep. 38
