A New Vision for University Hospitals St. John Medical Center

Jonathan Sague’s calling as a health care professional came early in life.

Sague was 13 and an Explorer Scout when he got his first real taste of public service with a trip to a fire station.

He realized that he was not only the type of person who wanted to run to the fire, he wanted to run to the person who was ill or injured.

That experience motivated him to train as an ICU registered nurse, paramedic and, more than anything, an acute care nurse practitioner with a sub-specialty inflight nursing.

With that focus on health care came vision.

And now, Sague (MSN, ACNP-BC, EMT-P) is bringing vision to University Hospitals St. John Medical Center as Chief Operating Officer.

Vision Zero: Zero Harm, Zero Suffering and Zero Defects is the standard he brings since joining the UH St. John team last November.

Vision Zero

“My vision for this year is called Vision Zero: Zero Harm, Zero Suffering, Zero Defects,” he explains.

Zero Harm: “Harm is preventable when we care for our patients. We should have a vision of zero in achieving the goal of no harm for our hospital. The way we do that is by supporting a culture where people can raise their hands and say, ‘I see something that is unsafe,’ ‘I see something that is not right’ and ‘I’m going to stand up and speak out and take action and prevent the harm from happening.’”

Zero Suffering: “Not all suffering is preventable, but a big portion of it is. Sometimes suffering is waiting for things like an exam or imaging or a diagnosis. I always use the example of waiting too long for a mammogram. A woman has a lump on her breast and she’s waiting for a diagnosis. You can’t wait two weeks for a mammogram. That’s suffering and it’s unnecessary. So, how do we focus this year on increasing access to health care and decreasing wait times? That is the goal.”

Zero Defects: “Zero defects means zero mistakes, zero shortcomings in my own work expectations and having the tools I need to do my job the way it should be done and do it properly. And, also, to make sure that when we are visited by a regulatory body we pass with flying colors. We do all the things they say we should be doing to give the best care to our patients in the community.”

“Vision Zero is a huge campaign we are launching this year across the hospital,” adds Sague. “Every chance I get to speak to employees about this, I do.”

“Zero is attainable,” he emphasizes. “I got this vision from my days in the helicopter. For us, the number zero was very important – because 99.9% safe meant that we crashed once every thousand times we took off. That was not an acceptable number. Each of us as a crew member, as a team, we all strapped ourselves in a seatbelt into that airframe everyday. We all wanted to go home that night. Vision Zero had to happen. That was the only way. I flew in that helicopter for 6 years without a safety incident. We were crew members and that’s the culture of zero defects.”

Meet Jonathan Sague

A Cleveland-area native (Chardon High ‘99) and a devout Catholic, it was natural for Jonathan Sague to have a heart for his hometown.

From his beginnings as an Explorer Scout motivated to enter the health care profession, he knew early on that he wanted to devote his life to helping and healing others.

He had an adventurous side, too, and wanted to follow his vocation to become a flight nurse.

Along that path, he became a surgical ICU nurse. He found that his calling was a true fit. “I really enjoyed taking care of patients,” he said.

But he really wanted to be a flight nurse and kept training toward that goal, only to learn that, 15 years ago, there were no jobs yet for nurse practitioners in helicopters.

So, he continued to follow his second love: Cardio-thoracic surgery. “I really loved taking care of heart patients,” he said. He earned the privilege of managing a 10-bed ICU unit locally at the age of 25.

Then, when nurse practitioners were approved for helicopter service, he was the first they hired.

In 2014, he was recruited to the Dallas area where he helped build a revolutionary mobile integrated health care practice network: a collaborative effort of caregiver teams that triaged patients through telemedicine, saving both time and resources for patients and providers alike through a simple phone call. Care was then delivered quickly in the patient’s home. This prevented unnecessary 9-1-1 calls, emergency department visits, and hospital admissions. Patients loved it because they wanted to stay home.

Returning to Cleveland in 2017, Sague rejoined UH as Vice President of Clinical Operations managing its care transitions team, mobile advanced practice providers, and post-acute quality network.

And now, at UH St. John, he is excited to bring vision and focus to his role as a leader in patient safety and care. It’s all about Vision Zero: Zero Harm, Zero Suffering, Zero Defects.

“If we can do those things, we’ll be the best hospital in the United States,” he reports.

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