Cultivating a Culture of Safety: How VA Fayetteville Coastal Strengthens Its Safety Framework
By Corey Howard, Program Applications Specialist
At VA Fayetteville Coastal Health Care System, safety is not just a priority—it’s a commitment to creating an environment where every action has clear meaning and contributes to the well-being of Veterans and staff.
In our journey toward becoming a High Reliability Organization (HRO), we focus on collaborative practices and continuous improvement to enhance care and instill a sense of purpose in our work.
Foundations: Core Principles Guiding Safety
Our approach is anchored in three essential principles:
- Leadership Commitment: Leaders allocate resources, ensure proper training, and maintain accountability at every level.
- Psychological Safety: We foster an environment where every employee feels secure speaking up, confident their insights will drive positive change.
- Continuous Process Improvement: Systematic evaluation and refinement of processes through initiatives like Systems Redesign ensure every experience, good or bad, guides our progress.
These principles form a robust framework that underscores the importance of each person’s contribution.
Leadership: Setting a Clear Direction
Leaders at VA Fayetteville Coastal Health Care System provide clear guidance by actively supporting employees and recognizing their efforts. Programs like the HeRO Awards honor those who exceed safety expectations. By utilizing tools such as SAIL (Strategic Analytics for Improvement and Learning) to track performance against national benchmarks, leadership ensures every initiative is measurable and every improvement advances our collective mission.
Employee Engagement: Every Voice Matters
Dr. Beau Nelson, Chief of Engagement and Experience, emphasizes organizational buy-in, stating: “Employee Engagement is a system-wide enterprise that starts and ends with leadership. It is facilitated through relationships built on transparency, integrity, and mutual trust. We move—or not—as one.”
Our strength lies in collective effort, with each team member contributing significantly, whether in clinical, non-clinical, frontline, or leadership roles. Sharing “Safety Stories” demonstrates how policies apply to real-life scenarios, reinforcing that every individual’s actions create a safer, more efficient care environment.
Active Implementation: From Data to Action
Wayne Martin, High Reliability Organization Coordinator, explains: “VA Fayetteville Coastal Health Care System values learning from close calls and safety events. Identifying risks and developing actions to reduce harm improves the quality of care we provide. Our HRO/Patient Safety Champions maintain safety at all levels through messaging and peer collaboration with day-to-day subject matter experts.”
This engagement is reflected in our initiatives. The HRO/Patient Safety Champion Workgroup analyzes trends from the Joint Patient Safety Reporting (JPSR) system to drive tangible actions. Guided by two Lean Black Belt-certified experts, workflow improvements have streamlined over 112 processes this year alone, demonstrating our commitment to reducing inefficiencies.
Dr. Mark Wallace, Systems Redesign Coordinator, states: “The Systems Redesign team delivers results, and the Return on Investment for Flavaville shows just that. The national Continuous Process Improvement Dashboard shows a cost savings/avoidance of $49,679,059.00 to date.”
Addressing Challenges: Proactive Risk Management
We view challenges as opportunities for growth. Open communication and robust near-miss reporting via Employee Occupational Health (EOH) channels enable proactive issue resolution. A 13% reduction in near-miss reports this year reflects growing confidence in our systems and strategic problem-solving.
Measurable Success: Data-Driven Outcomes
Amanda Lowrance, Acting Chief of Quality and Safety, notes: “Without a measurable starting point, we cannot gauge progress. These metrics help us decide whether to sustain current practices or explore new ways to improve Veterans’ care.”
Our progress is evident in key outcomes:
- Improved Patient Safety: SAIL metrics show advancements in medication safety and fall prevention.
- Enhanced Transparency: A 120% increase in reported injuries highlights our culture of openness.
- Recognition of Excellence: Rising HeRO Award nominations reflect active reinforcement of safety practices.
“Measuring outcomes drives continued improvement,” adds Ms. Lowrance.
Unified Efforts for Meaningful Progress
At VA Fayetteville Coastal Health Care System, every improvement and shared experience strengthens our commitment to safety. Executive Director Marri Fryar affirms: “Together, we prove the power of teamwork in delivering exceptional Veteran care. Through communication, data-driven decisions, and mutual recognition, we build a future where every employee finds purpose in their work.”
Closing with a final emphasis, Fryar states: “Every individual—healthcare provider, administrative staff, or volunteer—plays a vital role in fostering safety and excellence. Our Veterans deserve care upheld not by one, but by the commitment of many.”