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
https://www.cam.ac.uk/research/news/patients-with-an-empathic-gp-at-reduced-risk-of-early-death
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.
https://www.safetyandquality.gov.au/our-work/indicators-measurement-and-reporting/patient-safety-culture
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
https://www.cam.ac.uk/research/news/patients-with-an-empathic-gp-at-reduced-risk-of-early-death
And…Jones’s cupboard clean-out reveals a pile of patient story tools! Find them here:
https://drive.google.com/drive/folders/1Vo3ykFShIXVhYWYQg-zUth9a2OErVE6M?usp=sharing
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.
https://corporate-rebels.com/cia-field-manual/
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 from Balding: 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
Looking for a quality ‘tribe’ and resources to help with the challenges of quality and clinical governance roles? The Australasian Institute of Clinical Governance (AICG) membership community is now open! Find it here: https://www.aicg.edu.au/aicg-membership/?ar=CBLD
CPD hours – would you like to earn 1 CPD hour for every time you listen to our podcast? If so, let Jones know we can investigate producing a product for this: cathyjoneshealth@gmail.com
- Talk to Us:
- Leave a question on our website: www.noharmdonepodcast.com
- Twitter handles : @qualcat @CathyBalding
- Link In with us on LinkedIn.
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!)