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The Culture of Safety

A culture of safety shouldn’t just be about patients. Donna Nicholson shares her thoughts on the importance of applying it to employees as well.

When most of us with a clinical background hear the phrase, “Culture of Safety,” our minds take us to the traditional definition involving patient safety. Since its founding in 1951, The Joint Commission has highlighted the importance of patient safety. Based upon training and in-services while working in a facility setting, I too fell in line with that traditional patient safety focus.

After spending thirty plus years in the physician practice setting, working in a compliance officer role, managing patient complaints, and doing service recovery training, my thinking about culture and safety evolved. My perspective does not diminish in any way the importance of patient safety work. Keeping our patients safe while delivering the very best care possible is second to none, but could there be another aspect of the Culture of Safety precept that contributes to patient safety and optimal outcomes?

Taking Culture of Safety to the Next Level – Practice Employees

Admittedly, the thought of extending the idea of culture of safety to include the full scope of the practice employees is not a new concept, but I still feel like we are falling short in embracing and integrating these concepts into everyday practice.

Attempting to unpack all the attributes surrounding a culture of safety in a blog post is not realistic, so let’s just start with some basics related to scenarios you may face in your day.

Suppose there is an employee who is faced with a situation that they do not know how to answer or resolve, and they come to you for assistance. How would you address that person? Here’s a scenario I think all of us can relate to…

It’s a busy day in the practice, and you are behind and stressed. You don’t have time for any interruptions. Your intentions are good, but you send non-verbal cues and sometimes verbal responses to the employee needing help that you don’t have time, don’t want to be bothered, think their question is menial, or that you’ve answered that question before. Why don’t they get it?! You roll your eyes, utter an audible sigh, keep walking down the hall, do not make eye contact, and offer a cryptic answer in a cold tone, making it quite clear that you are annoyed.

Does that behavior support a culture of safety for your employees? What do you think that employee will do next time they have a question? It’s unlikely they will feel comfortable bringing the question to you. More likely, they will rely on their own judgement, which could easily start the chain of failed patient safety due to the transmission of incorrect information.

In the times of staffing shortages and expanded scope with our employees, it is so very important to be approachable, create and sustain a culture of safety, continuously encourage questions and learning, and be reassuring. If there is ever a time to make time to support your employee team, it is now. You may say, I really just don’t have time to do that right now. OK, well do you have time to address the consequences of potential, unintentional patient harm?