MPEGs deliver message in patient safety program

Army medical center program takes award

A distance-learning patient safety improvement program developed at Brooke Army Medical Center in San Antonio by Maj. Danny Jaghab, MS, RD, LD, has won a prestigious John M. Eisenberg Patient Safety and Quality Award.

The award, which is presented by the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) and the National Quality Forum (NQF), was given for "Innovation in Patient Safety and Quality at a National or Regional Level."

When described, the program seems fairly straightforward: It’s a series of two- or three-minute MPEG video clips, each addressing an aspect of patient safety.

But first looks can be deceiving.

"What Danny did was incredibly innovative in its approach, recognizing that one of the ways to capture people’s attention is through video," says Ann Halliday, RN, MSN, CPHQ, chief of the department of quality services at Brooke.

"He made maximum use of the video clips only two or three minutes in length, sent forth a very succinct message, and left people with education that they could immediately implement," she says.

That was particularly important at Brooke, which has a large (2,500) medical center staff, all of whom were expected to embrace safety.

Those staff included housekeeping, lab techs, physicians, nurses, and the dietary department, Halliday explains.

"One of the challenges was how to reach out in an efficient manner to educate our staff on critical principals," she adds.

Using MPEGs to communicate

Jaghab, who currently is nutrition staff officer at the U.S. Army Center for Health Promotion and Preventive Medicine in Maryland, previously had used MPEGs to encourage the consumption of vital minerals by eating colorful fruits and vegetables, and it was very successful.

The impetus for this program came from a meeting at JCAHO headquarters.

"I had heard about the new [2003] patient safety goals coming up and had gone to a JCAHO session," he recalls. "We were also preparing for a survey. I had a real passion for the goals and how we could better educate our staff."

Jaghab’s idea was to put together an MPEG series on patient safety and create a distance-learning program to keep on the intranet and e-mail out to all staff.

There are 34 videos in all; Jaghab wrote the script, which was broken into three parts:

  1. Root causes of sentinel events and their relationship to the various patient safety goals.
  2. Risk factors and risk-reduction strategies pertaining to each goal.
  3. Brooke Army Medical Center guidance (medical command’s guidance) on how the goal should be approached.

Participants simply go to the web site, select a viewer, and scroll down to the topic of their choosing.

Once he had written the first script, Jaghab went to Col. Laura Kostner, RD, and showed it to her. She was enthusiastic and suggested he partner with quality services and patient safety. Then, after getting the go-ahead, he sent out a link to the program by e-mail.

After clicking the link, participants saw a message from Gen. Fox, the commander, asking them to watch the videos.

"We also had endorsements from key leaders, staff, and civilians, such as the Air Force chief of surgery to introduce the video on wrong-site surgery," Jaghab notes.

A similar approach would work with a hospital, he asserts. "You need someone from above to endorse it; that means something."

Individuals who completed the program received a certificate, which in turn went into their credentialing folders.

Success undeniable

When JCAHO surveyors came to survey the facility, "they complimented us on the program, and shared it with the medical command of the Department of Defense (DoD)," Jaghab explains. In fact, it is now on the DoD patient safety web site.

"It served two purposes," Halliday adds. "Its primary purpose was to enhance our patient safety program. And second, not insignificantly, was to help us prepare for the JCAHO survey."

How did they do? "We have a patient safety committee that monitors staff member compliance with patient safety goals," she explains. "And we found that as these clips were released to staff members that compliance with those goals was remarkable. It was new, innovative, and easy."

As for the survey, "We were excellent; we did really well," Halliday says. "Our surveyors were as excited at our innovation as our own staff was."

Need More Information?

For more information, contact:

• Ann Halliday, RN, MSN, CPHQ, Chief, Department of Quality Services, Brooke Army Medical Center, 3851 Roger Brooke Drive, Fort Sam Houston, TX 78234. Phone: (210) 916-3451. E-mail:

• Danny B.N. Jaghab, MAJ (P), SP, M.S., R.D., L.D., Nutrition Staff Officer, Directorate of Health Promotion and Wellness, The United States Center for Health Promotion and Preventive Medicine, ATTN: MCHB-TS-HWR, 5158 Black Hawk Road APG, MD 21010. Phone: (410) 436-8856. Fax: (410) 436-7381. E-mail:

For MPEG Links, go to:

• AMEDD Center and School Knowledge Management web site: E-Learning section

• DoD Patient Safety web site: Click on NPSG MPEGs.

• MEDCOM web site: