Improve your patient safety culture

Introduction

The culture of an organisation is important as it sets out the learned and shared behaviour among staff working within the organisation. A strong culture of quality and patient safety is always characterised by effective governance arrangements which place patient safety at the top of the organisation’s agenda (HIQA, 2015).

When there is an ineffective culture of safety, it can compromise the overall quality and safety of the service. In HCI’s research paper, The Healthcare System: Will We Ever Learn? HCI identified evidence of inappropriate cultures throughout a number of the UK and Ireland healthcare inquiry findings.

The Mid Staffordshire Trust Inquiry identified the Trust’s culture to be negative and uncaring, which it found to be detrimental to patient care (Francis, 2013). Criticism of management was not tolerated and any retractors were silenced through fear and disempowerment. In the case of Portlaoise Hospital, staff also reported working within a blame culture within the Inquiry, underlined by a lack of a clear vision and mission for the Hospital (HIQA, 2015).

Furthermore, the World Healthcare Organisation (WHO, 2023) state that above 50% of harm to patients is preventable. This staggering statistic, along with the findings in the inquiries highlight the importance of having a positive patient safety culture.

In this blog we identify the key factors that are vital for a strong culture of patient safety and offer guidance as to how to assess your patient safety culture so that you can address any potential areas for improvement.

Key factors associated with a strong patient safety culture

In order for a compassionate, quality and safety culture to exist, healthcare organisation should consider the key factors which are vital, including:

• Implementing effective arrangements in place to allow staff to be open on quality and safety issues, to raise concerns about the quality and safety of patient care and allow escalation of these concerns to the Board for consideration (HIQA, 2012) (HIQA, 2015).
• Valuing, listening, and engaging with patients to identify improvements the patient’s experience of care as well as overall service improvements (HSE, 2014).
• Routine checking of clinical practice (HIQA, 2015).
• Implementing a transparent, consistent approach to patients where things go wrong during the provision of care. Open disclosure must be central to the culture of healthcare if it is to be trusted and progressive towards continuous improvement. Organisations must ensure that their open disclosure processes are appropriately linked with their incident and complaints management processes.
• Continually working to instil shared values throughout the organisation, from top management to frontline staff.
• Providing strong, consistent leadership to motivate staff as well as ensure everyone understands and supports objectives of the service.
• Ensuring the governing body and leaders have direct contact with frontline staff, where they can reinforce the quality and safety culture message.
• Supporting all staff should have a “questioning attitude, a rigorous approach and good communication skills”.
• Ensuring that when errors are reported, this is seen as a “learning opportunity” rather than a punishable offence.
• Continual reinforcement of the idea of “patient-centred” care at every opportunity. Ensuring everyone with any involvement with a patient should take personal responsibility for making sure everything they do is for the benefit of the patient and this attitude is recognised and rewarded.
• Ensuring information on outcomes, such as patient experience and satisfaction, is made openly available to anyone who wants to view it, including the public.
• Ensuring patients are able to access their health care records and other information relevant to the provision of their care. (Nursing Times, 2013)

Staff Survey on Patient Safety Culture

In an effort to improve patient safety, healthcare providers have been encouraged to assess the current state of their safety culture with a view to designing interventions to improve the safety of their organisations (HIQA, 2015). HCI is working with clients to provide Staff Surveys on Patient Safety Culture developed by the Agency for Healthcare Research and Quality (AHRQ). The Staff Survey on Patient Safety Culture are best practice and evidence-based surveys which enable acute care providers to assess how their staff perceive various aspects of patient safety culture within their organisation. Once providers have their base line assessment, quality improvement initiatives can then be put in place to improve the organisation’s patient safety culture.

Click here for more information on the surveys.

Why work with HCI?

Utilising HCI to co-ordinate the data collection and analysis helps to ensure neutrality and credibility of the results. Staff may feel more assured that their responses are confidential if the results are collected and analysed by an independent third party.

HCI will provide you with a dedicated resource who will perform all necessary activities to facilitate the collection and analysis of your survey results. Our experts have many years’ experience in interpreting quality and patient safety data. From the baseline assessment we can work with you to identify key quality improvement initiatives and HCI can provide you with practical support to implement these initiatives.

Conclusion

When reflecting on the findings of HCI’s Research Paper, it is evident the vital role that culture plays in the overall quality and safety of a service. This is why it is crucial for providers of care to undertake an assessment of their patient safety culture to identify their areas of strength and opportunities for improvement.

HCI is a provider of professional services in relation to patient safety, quality improvement, and regulatory compliance. We has almost two decades of experience in supporting health and social care organisations in building robust Quality and Safety Management Systems. With our expertise you can independently review your Patient Safety Culture and implement quality improvement plans which will positively impact on your patient safety outcomes.

References

HIQA, 2012. Report of the investigation into the quality, safety and governance of the care provided by the Adelaide and Meath Hospital, Dublin incorporating the National Children’s Hospital (AMNCH) for patients who require acute admission. Available at: https://www.hiqa.ie/sites/default/files/2017-01/Tallaght-Hospital-Investigation-Report.pdf

HIQA, 2015. Report of the investigation into the safety, quality and standards of services provided by the Health Service Executive to patients in the Midland Regional Hospital, Portlaoise. Available at: https://www.hiqa.ie/sites/default/files/2017-01/Portlaoise-Investigation-Report.pdf

HSE, 2014. Report of the Quality and Safety Clinical governance Development Initative, s.l.: s.n.

Nursing Times, 2013. Francis Report; Francis in brief: Key nursing recommendations. Available at: https://www.nursingtimes.net/journals/2013/08/08/y/i/g/francis-report-3.pdf