Instilling a Culture of Safety

David Mayer, MD, CEO Patient Safety Movement Foundation, Executive Director MedStar Institute for Quality and Safety writes.

As healthcare providers, we are allcommitted to providing high-quality care to our patients. In doing so, we focuson the quality of the services we provide.

We need to embrace and sustain patientsafety by making it a critical component of our culture. Without a culture ofsafety, we can’t truly face and address issues that lead to preventable patientharm and death.

So, How Do We Do This?

First of all, understand that changing yourorganization’s culture is not an easy task. It requires a commitment from thetop levels of your organization, driven by leadership and staff who mustencourage accountability and transparency throughout the organization.Recognize that no one purposefully commits errors and that most errors areshortcomings in complex systems or processes.

Once that commitment is made, you need aplan that ensures hospital leaders are also active in supporting safety andquality for patient care. Leaders must build trust by addressing concernsquickly, communicate openly with staff about improvements and lessons learned,and eliminating any barriers to the reporting of issues. Though the goal is toeliminate preventable incidents, everyone should acknowledge that mistakes areinevitable. When mistakes happen, you need to recognize whether the error wascaused by a system or process, or by a human being. A crucial component of thisenvironment of trust is fairness in holding individuals accountable fordecisions and for adhering to established safety protocols.

What is needed is an environment of mutualcompassion, respect and common goals, where providers, patients and familiesactively participate in open communication, accountability and support.Compassion and respect are essential for effective communication,collaboration, team building, decision-making, and the implementation ofsystems and processes that ensure patient safety. This compassion and respectshould be extended to patients and patient advocates as well.

You must also support this new culturalparadigm with an infrastructure of systems and processes that makes transparentreporting and communication easy and unintimidating, provides training,oversight committees, and more. Implementing a change management tool can easethe transition to a culture of safety by helping to document and enforceprocess improvements.

Setting up an electronic reportingapplication that allows people to report incidents or near-misses also helps todevelop a learning culture within the organization and demonstrates thatleadership’s focus is on safety issues, not on the people reporting them.

Finally, your safety culture must measureprogress and strive to continuously improve the safety culture, as well asimprove processes to prevent harm to future patients. You must establishinternal communications processes and use them to consistently and openlycommunicate goals, expectations, outcomes and new protocols to follow to ensurepatient safety. Build accountability into job requirements and evaluate staffon their contributions to improving quality and patient care.

Having measurable goals by which to trackperformance and progress shows your commitment to patient safety and emboldensstaff to take further steps in achieving stated goals.

Preventable medical harm is the thirdleading cause of death in the US - there are still more than 200,000preventable deaths in US hospitals each year, and as many as one in every threepatients are unintentionally harmed. These numbers are simply unacceptablegiven clinical and technical advancements.

That is why the Patient Safety Movement Foundation has identified Culture of Safety as its first Actionable Patient Safety Solutions (APSS #1). Each APSS is developed by a workgroup made up of healthcare industry professionals and patient advocates. It can help you transform your organization’s culture to one that emphasizes patient safety, trust, transparency and accountability.

Originally published in  Issue 3, 2019 of MT Magazine.