What’s the key to accelerating progress in patient safety over the next five years?

Dana Siegal
Dana Siegal

Dana Siegal, R.N., CPHRM, CPPS, is the Director of Patient Safety Services at CRICO Strategies in Boston, Massachusetts.

We still lack the universally shared vision of “safety first” across every aspect of care delivery, which is critical to accelerating our progress over the next five years.  We have demonstrated pockets of success but not yet achieved the sweeping engagement we need to build and sustain a culture of patient safety across the entire system. 

Something’s missing, and if we are to accelerate progress over the next five years, we must understand the gaps between the desired and actual state of patient safety. We have identified things that are foundational to a culture of safety: senior leadership engagement and commitment to “safety first,” clinical leaders and managers holding everyone accountable for practices and procedures proven to keep patients and providers safe, and providers and staff members reporting safety concerns and adverse events. “Just Culture,” transparency, and high reliability are accepted as critical to patient safety, but we’re not connecting the dots between these concepts and a real, personal commitment to patient safety on the front lines.

Something’s missing, …we must understand the gaps between the desired and actual state of patient safety.

We know handwashing prevents the spread of infection. What de-motivates us from doing it every time? We know “time outs” work. Why do we not do them every time? To take patient safety to the next level, we must understand how the systems that support our care processes do or – more to the point – do not align with what we know we must do to deliver safe care.

Patient safety is not a task, project or agenda item. It’s not the metric of the month. It’s a mindset – it’s the way we think, prioritize and act in every moment we are present in a care setting. It’s having a palpable thirst for understanding the vulnerabilities in our care systems and a personal commitment to preventing those vulnerabilities from becoming a reality.  And it means being part of a team that is equally committed to that shared mental model.

I remember the days when “everyone” smoked, (including at the nurses’ station!), and now there are entire “non-smoking” communities. Once upon a time, no one wore seat belts; now we can’t imagine not wearing them. I constantly wonder how we accomplished those sweeping, universal changes in other safety cultures. How do we embrace a similar universal change in health care? We must find the answer to that critical question – the magic, if you will – if we are to make the next significant leaps in the safety challenge.

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