Website spotlight: Nursing borrows a trick from manufacturing

Nurse Leader Insider, March 12, 2012

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It can take a lot of courage to do the right thing. To speak up when something's wrong or to challenge a co-worker while on the job. But in the world of nursing, doing so might mean the difference between life and death for a patient. That's why nurses need to have the courage-and encouragement-to stop the line when needed.

In recent years, the phrase "stop the line" has made the jump from assembly lines into hospitals. It comes from the manufacturing world, where Toyota is the famous example of a company with a stop-the-line policy: Every employee is encouraged to stop the production line if they see a problem.

Now, the idea is being applied to healthcare, in an effort to improve patient safety.

Stop-the-line action starts with nursing, says AnnMarie Papa, DNP, RN, CEN, NE-BC, FAEN, clinical director of transition unit and emergency nursing at the Hospital of the University of Pennsylvania and Penn Presbyterian Medical Center in Philadelphia, Pennsylvania. But encouraging nurses to stop the line is about more than getting them to speak up. Leaders should also provide the correct language for them to do it effectively and provide support when it happens.

"Stopping the line is empowering any staff member to literally stop a procedure right in its tracks to prevent a mistake," says Papa. But as soon as she says the word "mistake," she corrects herself with this amendment: "It could be a mistake or to clarify the procedure or process."
That's because when it comes to stopping the line in a hospital, it's all in how you frame it. Using neutral, non-threatening language to question a procedure makes stopping the line less intimidating for everyone involved.

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