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July 22, 2020

Recognizing Leadership

Last year SCHA launched the Drive to Zero Harm Leadership Award, a new arm of our Zero Harm Awards program. The recognition is designed to celebrate hospital administrators who are often a step or two away from the day-to-day clinical work where so much harm is prevented, but who are so critical to establishing and fostering a culture of safety. Award recipients strive for Zero Harm at every level of their organization and demonstrate a track record of commitment to creating sustainable cultures of safety throughout their healthcare system.

Our inaugural winner, Ralph H. Johnson VA Medical Center Director Scott Isaacks, MBA, FACHE, FAAMA, more than fits that bill. A fervent supporter of highly reliable organization (HRO) principles, Isaacks has taken part in regional and national collaboratives designed to bring these values to bear on the daily operational tasks of the hospital. Thanks to his leadership, his hospital has been recognized as a top performer for quality of care and efficiency both within VA and nationally among both public and private sector hospitals and healthcare systems alike.

SCHA caught up with the VAMC’s Quality Manager Melissa Harrelson, RN, who wrote the application on Isaack’s behalf, to talk about why her CEO was a logical candidate for the Drive to Zero Harm Leadership Award, what the process of applying was like and what the award meant for him and the organization. Here’s what she had to say:

How did you hear about the award and why did you think Mr. Isaacks was going to be a good candidate for it?

MH:  I learned about the award through the South Carolina Hospital Association. [VAMC] has been associated with SCHA for several years now.  We received an email announcing the new award, and it was also located on the website under the Zero Harm Awards page as the first leadership award.

Why did you think Mr. Isaacks would be a good candidate based on what you understood about the award?

MH: Upon reviewing the criteria, and reflecting on Mr. Isaacks as our director, he embodies leadership and HRO principles, and he always strives to give the best care possible to our veterans.

He is visionary, always striving to improve in any area possible. Where some leaders might want to simplify something, we question, question, question to make sure that we actually are doing everything that we can do. I don’t know many leaders that are as passionate, not just Mr. Isaacks, but all of our leaders here, about caring for our veterans.

A lot of your application talks about this sort of cultural shift of employee engagement, improving quality and patient safety. What kind of steps did Mr. Isaacks take to make that happen?

MH: The Association approached our facility and several other facilities to be a part of the high reliability pilot study with the Joint Commission in 2013 [the Safe Care Commitment]—that was the beginning of something no other VA facility had done. We had to overcome several hurdles and get permission to participate. I believe Mr. Isaacks was the Associate Director at the time, and then he became our Director the following year. So, he was engaged at the very onset of our partnership with SCHA. He assisted in leading the way for other VA facilities to [engage in this work]. We initiated [VA participation] in the Zero Harm Awards.  Other facilities have a standard reporting mechanism which is verified through the South Carolina Department of Health & Environmental Control (DHEC), the VA does not.  We developed a process, in conjunction with the South Carolina Hospital Association, to ensure we could still participate and provide the needed information.

Another initiative we started during that time is promotion and training related to Just Culture, and we have carried the concepts through our organization. From the onset, you could see improvement in our patient safety surveys, including improvement in our psychological safety. If you walk through the halls of the Ralph H. Johnson VAMC, you can see the difference.

Several years before working with the South Carolina Hospital Association, our facility leadership began rounding on a regular basis. Rounding has changed since then, but it’s his servant-leadership style that remains steadfast. Not only does he round, and all of our executive leadership rounds, but he engages with the staff and listens to their needs and follows up to ensure staff needs are met. He routinely schedules meetings to attend different staff meetings and he’ll pop in, as well as the regular rounding schedule. He follows through, and he holds staff accountable. It doesn’t matter if it’s an employee or a veteran, if they voice a concern, it’s followed up on.

In relation to the application process itself, do you have any sort of memories about whether it was difficult or whether it was a positive thing in terms of putting it all down on paper, walk me through that.

MH:  It has been a while, but as I recall it was easy to access the award application. The guidelines were straightforward. There was a limited amount of words you had to submit which was easy to adhere to.

Had you told this story before, or did you create something from scratch that captured the full breadth of the work?

MH: As Quality Manager, I always keep track of initiates and new ventures our facility takes part in, especially when it relates to patient safety, quality measures, and taking our facility and moving it forward. I had information at my fingertips. It wasn’t something I had to start from scratch and pull together.

Communicating it is always difficult, but if we had asked just about anyone in our facility to submit the award, I think they probably would have been able to address most of the areas I addressed in the award because we actually do communicate our successes well. And not only do we communicate with them, but the staff are also part of them. And that’s part of performance improvement and the engagement projects we did. Not only do staff know about performance improvement projects they helped make changes to better care for our patients.

What did it feel like to see Mr. Isaacks win the award and be highlighted as among the very best leaders in South Carolina?

MH: It truly was amazing, especially for him to receive the first award that the South Carolina Hospital Association presented to a leader.  It made me think back to our ability to overcome some of the barriers we faced when we first began our journey with SCHA and the opportunities afforded to us when we first were involved with the South Carolina Hospital Association.  This was a testament to how far Mr. Isaacks has led us, and not just our facility, but led other VA facilities to follow the same path of success. It was great.

Is there anything else you’d like to add?

MH: I will tell you one more thing.  I think another reason I thought about him for this award is that in any organization, whether it’s a government organization or private organization, you always have a policy, procedure or rule that sometimes might not be in the best interest of your population, and if this situation is encountered in our facility or organization he will drive evidence-based change.  Whether it’s a Veteran or a patient or another facility, Mr. Isaacks never hesitates to ensure the right thing is done. There have been several occasions we have made changes or been a part of changing a Directive or policy to improve patient care. He’s never one to shy away from ensuring the right thing gets done.


This year’s deadline for Drive to Zero Harm Leadership Award applications has been extended to Monday, August 3. Any staff member of a member organization can submit a nomination here.