Culture – we talk about it constantly. And Patient Safety Culture – we all know what that is – right? And how to create it? This episode delves into the patient safety culture world to look for answers to common – but tricky – questions about the whys and hows of a patient safety culture.
1. QUALITY QUANDARY
What is patient safety culture and why is it useful to know?
Braithwaite, J., Glasziou, P. & Westbrook, J. The three numbers you need to know about healthcare: the 60-30-10 Challenge. BMC Med 18, 102 (2020). https://doi.org/10.1186/s12916-020-01563-4
ACSQHC Work on Patient Safety Culture:
Lorenzini, E, Oelke, ND, Marck, PB & Dall’Agnol, MD 2017 ‘Researching safety culture: deliberative dialogue with a restorative lens’, International Journal for Quality in Health Care, pp. 1-5.
Agency for Healthcare Research and Quality. ‘Patient Safety Primer: Safety Culture’, https://psnet.ahrq.gov/primers/primer/5/safety-culture
Singer, S, Lin, S, Falwell, A, Gaba, D & Baker, L 2009, ‘Relationship of safety climate and safety performance in hospitals’, Health Services Research, vol 44, pp. 399-421
2. TLDR (time 14:55)
A long – but useful – resource on Patient Safety Culture: stats, literature and tools.
Culture as a cure: Assessments of patient safety culture in OECD countries. OECD Health Working Papers No. 119. de Bienassis K, Kristensen S, Burtscher M, Brownwood I, Klazinga NS. Paris: OECD Publishing; 2020. p. 103. https://doi.org/10.1787/6ee1aeae-en
Safety Culture Assessment in Health Care: A review of the literature on safety culture assessment. Australian Institute of Health Innovation, Macquarie University for the Australian Commission on Safety and Quality in Health Care. https://www.safetyandquality.gov.au/our-work/indicators-measurement-and-reporting/patient-safety-culture
Australian Commission on Safety & Quality in Healthcare – patient safety culture page.
2. THE POINT (time 25:50)
What can a culture of empathy contribute to consumer outcomes – and safety?
Dambha-Miller, H et al. Association between primary care practitioner empathy, and risk of cardiovascular events and all-cause mortality amongst patients with type 2 diabetes: a population based prospective cohort study. Annals of Family Medicine; 8 July 2019
And…Jones’s cupboard clean-out reveals a pile of patient story tools! Find them here:
4. DRDR (time 34:34)
This Did Read Do Read reminds us that culture is a powerful weapon in the battle with adverse events.
Phipps, A et al. Reducing Serious Safety Events and Priority Hospital-Acquired Conditions in a Pediatric Hospital with the Implementation of a Patient Safety Program. The Joint Commission Journal on Quality and Patient Safety 2018; 44:334–340
5. QUALITY HACK (time 44:44)
Do not try this at home. (Or work!)
CIA. The Simple Sabotage Fieled Manual, 1944.
6. OTHER BITS:
Balding has a new article on her research into effective quality systems. It’s the ”John Farnham’ last one!
Balding C and Leggat SG. (2020) Making high quality care an organisational strategy: Results of a longitudinal mixed methods study in Australian hospitals. Health Services Management Research, July 2020. https://doi.org/10.1177/0951484820943601
And…a new course coming soon: Strategic Clinical Governance for Boards and Executives. A 90 minute video presentation including reflective exercises that can be done individually on line or in groups on line or face to face. Watch the website and QNews for details! www.cathybalding.com
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2 thoughts on “NHD Ep 27: Chasing a Culture of Safety”
Hey Ladies – another great cast.
I find the drive to have “safety culture” as part of the standards interesting. whilst the intent is sound, there are better ways to enhance culture than a, for want of a better word, regulatory requirement.
A challenge with any regulated approach is that it becomes driven by the need to meet a requirement, not a desire to improve. My experience in Health bore this out – lots of people going on about “achieving accreditation”, or “passing accreditation”.
it is a similar issue in my current paid domain, where the regulatory requirement is for a “positive safety culture”#, whatever that means. indeed, “safety” culture has been suggested to be one of the emergent folk lores in safety, with some of the literature suggesting a drive more to organisational culture (e.g. Cooper 2016)
As you note, culture is driven from the top of the organisation, and unless there is leadership leading – it won’t happen. Sort of like the “Thank you, Mr Grace” of Are You Being Served: platitudes don’t drive improvement. And on the other side, the name, blame, shame, sack and deregister approach does little for a proactive approach to either worker or patient safety.
Thanks for great work – enjoy these, (even the organ music is getting better 😉 ).
Personal professional opinion of the author, and not of any agency or business.
M, Cooper. (2016). Navigating the Safety Culture Construct: a Review of the Evidence. accessed via http://www.behavioural-safety.com/articles/safety_culture_review.pdf
# Rail Safety National Law National Regulations Schedule 1 accessed via https://legislation.nsw.gov.au/view/html/inforce/current/sl-2012-0617#sch.1
Thanks so much for your feedback Nic and taking the time to make the comments. And thanks also for the reference links – it’s fascinating how often these issues parallel across different industries. We couldn’t agree more – culture is everything and so much more effective than regulation (if only we could trust every business leader to pursue this on their own!)