We want to create a system that minimizes the chances of error. Using the techniques of Six Sigma and Lean Manufacturing, we want to anticipate and avoid sources of error by standardizing work and eliminating waste.“One of the biggest obstacles in the pursuit of improved patient safety is variability. The problem with variability (especially when it comes to patient care) is that the quality of care often suffers as a result–the more variability, the more likely that something bad could happen. What we want to strive for at BSI is the opposite of variability, something called “standard work”. Let’s look at this idea with the metaphor of a product assembly line.”The book The Machine That Changed the World is a great example of how the Toyota motor company employed standard work to address the problem of variability. Automotive companies of the time cared little about the concept of variability as their products came off the assembly line. This led to tremendous waste and a wide range of quality found in these products. But industry leaders just assumed this was the cost of doing business. The Toyota company disagreed. They set out to improve the system by cutting out anything which was inefficient and anything which would keep them from tightly controlling the quality of their product. The result: a standard, high quality product which has made Toyota a world leader in both production and quality.”What was so different about their approach? Virtually all of the success Toyota had came from their determination to root out inefficiency, variability, and decreased product quality (though there are many other things which also made them successful). These are the same principles we at BSI want to apply to healthcare. Our goal is to help change the culture of healthcare like Toyota model did for the automotive industry–reducing variability and improving quality through standard work. By controlling the quality of care we provide, we can work to reduce the incidence of preventable medical errors and improve the outcomes for all patients. “Austin Vegas, Campbell University School of Osteopathic Medicine, ’22Gabriel Brotzman, Campbell University School of Osteopathic Medicine, ’22

The goal of checklists is to standardize work so that no crucial steps are missed. This not only improves patient safety, but also builds a better team environment. Checklists can save patients, doctors, and nurses from severe harm.“Would you feel safe having an operation in the hospital where you work? This is an important question that has been raised by medical professionals across America. This question is not intended to start the blame game or point fingers. Rather, it is intended to raise awareness to the need for change in the operating room dynamics all over the world. To provide the best care possible for patients, we must ask this question. Everyone is fallible, and no matter how many years of experience a surgeon, anesthesiologist, nurse, etc. may have, there is always room for improvement. At the Better Samaritan Institute, we want to catalyze a cultural change in operating rooms that recognizes this so the welfare of the patient is always at the forefront.”That is the core tenet of the Better Samaritan Institute, and it is central to the culture change needed in surgery. In one word, the entirety of the Better Samaritan Institute comes down to humility. Countless stories have been recorded where medical harm occurred upon a patient because trained professionals did not address a superior, who they knew to be wrong in one way or another, because they were afraid of the consequences. With the advancement in knowledge and technology, surgery is now more complex than ever. Now more than ever, we need every member of the surgical team to cooperate as a team. That is why it is important that every member of the team feel they can call a time-out with impunity.”One way to do this is by using a checklist. Surgical checklists improve safety, strengthen the team atmosphere, provide peace of mind, and can serve as a foundation to quickly and accurately assess and correct a crisis in the operating room. Crisis is the surgeon’s worst nightmare, but with a checklist, crisis is much less likely to arise. In conjunction with 3Greens, an electronic checklist developed by Dr. Lloyd Hey, and Duke Raleigh Hospital, the Better Samaritan Institute aims to Target Zero. Improvements to the healthcare system must be made until there is zero avoidable harm done to any patient or provider.”Steven Barker, Campbell University School of Osteopathic Medicine, ’22Aman Singh, University of Rochester, ’22Royce Le, University of North Carolina at Chapel Hill, ’20