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Two Questions to Improve Patient Safety Culture in Healthcare

May 01, 2013
Patient Safety Culture

Increasing safety within healthcare culture is recognized as one of the most important drivers in patient care. Whether you are a large teaching hospital or a 10 bed nursing home, all healthcare facilities must take the steps to examine safety culture in their organization and find areas for continuous improvement. However this is not a simple process.


Moving towards a safer healthcare system involves shifting our culture from one of blaming individuals for mistakes to one in which errors are treated as opportunities to improve care and prevent harm. If your organization’s culture is preventing your facility from achieving its goals then there are two critical questions you must ask yourself.


Carve Your Path


The first question is, “Who do I have to become in order to achieve the goal that I want?” We start with this question because it forces you to look at the problem you’re trying to solve from an inward perspective. We all ask for things yet we rarely consider who we need to become in order to achieve and maintain our goals.  Answering this question prescribes lifting yourself out of your current mold. It prescribes becoming incredibly clear on why a goal is important to you.  If, for example, you are a hospital struggling with poor hand hygiene compliance despite education and training (e.g. employee in-servicing, educational posters, department huddles, etc.) this question causes you to generate a list of deeper questions:  


  • What skills, knowledge and qualities do I lack that are keeping me from achieving my goal?
  • What behaviors, characteristics and disciplines must I acquire?
  • What outside expertise will we need to seek?


The “Who do I have to become” question becomes an effective tool to achieving culture change. Lakeridge Health, one of Ontario’s largest community hospitals, is putting this approach into action. 


 “The safety of our families has always been important to us” says Kevin Empey, President and CEO of Lakeridge Health. “When it came time to develop a Strategic Plan, our community told us it was very important to them as well.” Kevin believes that when it comes to patient safety, striving to do better isn’t enough.  “We should strive to be the best.” Lakeridge Health has adopted the goal of becoming the safest hospital in Ontario.


This organization has identified key performance indicators within their overall Quality Improvement Plan. Improving hand hygiene rates is one of the hospital’s top priorities when it comes to improving the safety of their patients. “Having hand washing stations available throughout the hospital has played a large role in bringing our rates up and the result is a 17% increase in hand hygiene just in the past year” says Kevin. The hospital also measures how safe they are by the results of the care they provide. “Our surgical teams are using the surgical safety checklist each and every time they do a procedure and our number of surgical site infections is at an all-time low: zero.”


“We’ve been able to accomplish all of this in such a short time because we are making a relentless team effort,” says Kevin. “We know that the people coming through our doors are our neighbours, families and friends, and that’s a powerful motivator to keep improving the quality and safety of care we provide.”


Define Your Purpose


The second question you need to ask is, “Why do we do, what we do?” How well do your Patient Safety and Hand Hygieneemployees understand their purpose? Do they know why they are important to your facility? If I gathered a group of 10 employees in your facility and ask them that question, what would I hear? Would they all have the same answer? Every single employee in your facility should have a crystal clear understanding of their role. Ohio-based Cleveland Clinic is an organization that has invested heavily in their workforce to make sure that their staff understands the significance of this question.  


Like many healthcare organizations, Cleveland Clinic has been undergoing many changes over the past few years all in the face of new industry regulations and a difficult U.S. economy. Already recognized for world class outcomes they wanted to be recognized for world class service outcomes as well. In 2008, Cleveland Clinic established a major employee engagement initiative called “Cleveland Clinic Experience”. This was a 42,000 person intervention and it was built around a common way of thinking. Everyone at Cleveland Clinic is a caregiver and it says this on all of their name badges. Whether you are a thoracic surgeon, a nurse or a janitor, every Cleveland Clinic employee has the same role. Since the launch of this initiative they have observed measureable improvements in employee engagement and higher patient experience scores. By answering the “Why do we do, what we do?” question they’ve created a shift that drives engagement and aligns their culture.  Their employees do what they do because they are all caregivers.


Answering these two questions will not magically transform the patient safety culture in your organization but they are pivotal. Change takes time. Change demands discipline. Change requires a well thought-out plan. What these two questions will provide, however, is the fuel you will need to jump start the culture changing process.


About Colin Joseph 

Colin JosephColin Joseph is a Hand Hygiene Compliance Specialist. Bringing over 15 years of healthcare industry experience, Colin is committed to empowering infection control professionals globally. You can follow him on Twitter @handhygienepro or LinkedIN.

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