The way you do the things you do…

By Steve MacArthur, Hospital Safety Consultant

…and perhaps more importantly, the “why” you do the things you do.

Usually when I come up with a blog post, I don’t have much cause to revisit the topic for at least a little while (for those of you who’ve been following this space for a while, there are clearly revisitations of all types, but there’s usually a little bit of a respite.) But I’ve been thinking about last week’s topic of risk assessments, and I realized that there was one (well, there’s probably more than one) more aspect of this that I think is important. So, if you think about the nature of storytelling through the ages, there is typically some thread of caution or imparted wisdom that works its way into the storyline. I would argue that the best stories are the ones for which that underlying message becomes more succinct and powerful over time—almost to the point of self-perpetuation.

In looking at the telling of any risk assessment “story,,” there comes that underlying imperative in the perpetuation of the story elements to the extent that “future generations” will understand the rationale for how conclusions were drawn; what kind of data was used in the determination, etc. The truth of the matter is that anyone/everyone involved in the initial risk assessment of just about anything will be “gone” at some point, which (I think) speaks to the importance of having a repository for “the whole story” and not just the latest installment.

Don’t take it for granted that what you see very clearly as a completely managed risk is going to translate over the ages to every individual (including surveyors) that darkens the door of your organization. We really have to plan for risk assessments to be able to withstand the increasingly transient nature of the workforce/workplace and to be sure that all the nuance, etc., can still be passed on to the “folks we haven’t met yet.”

I suppose it’s a form of legacy, but one that becomes all the more powerful over time and telling. If every story starts with “once upon a time,” we need to be able to effectively share that “time”.

On a somewhat related note (mostly in that I see a risk assessment on the horizon), our friends the Chicagoans recently released some guidance relative to the management and storage of packaged sterile supplies: My colleagues and I have been identifying a fair number of concerns relating to sterile storage, primarily the use of spaces for sterile storage that might not quite meet the environmental requirements for that purpose.

I euphemistically refer to them as “unauthorized field modifications,” where occupants of a space decide to re-purpose a space without always verifying that the “new” use of the space is something that is supported by the environment.

As the worlds of infection control and the management of the environment become ever more inextricably linked, this is just one more opportunity to make sure that we are doing everything as safely as possible. We know this is a process that will be of great interest during survey, so better to have those “I’s” dotted and those “T’s” crossed (until your eyes are crossed) as effectively as we can.

About the Author: Steve MacArthur is a safety consultant with The Greeley Company in Danvers, Mass. He brings more than 30 years of healthcare management and consulting experience to his work with hospitals, physician offices, and ambulatory care facilities across the country. He is the author of HCPro's Hospital Safety Director's Handbook and is contributing editor for Healthcare Safety Leader. Contact Steve at