New guide offers hospital execs a blueprint to create, lead a culture of safety

Patient safety experts have long urged healthcare executives to create, shape and sustain a culture of safety within their organizations. Now there is a manual to help them do just that and advance their patient safety and workplace safety efforts.

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The resource, "Leading a Culture of Safety: A Blueprint for Success,” was unveiled this morning at the 19th annual National Patient Safety Foundation (NPSF) Congress in Orlando. The guide is the culmination of work conducted over the past year by the American College of HealthCare Executives (ACHE) and NPSF’s Lucian Leape Institute.

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The guide is meant to inspire, motivate and inform executives as they lead their organizations on a journey to zero harm. “The blueprint is based on the belief that safety cannot be just another priority in healthcare,” said Charles D. Stokes, executive vice president and chief operating officer, Memorial Hermann Health System, and current ACHE chair, in an announcement. “Safety must be a core value woven into the fabric of our organizations and actively led by healthcare executives.”

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The blueprint identifies strategies and tactics known to contribute to a culture of safety so that healthcare leaders can use it as a practical resource to guide their organizations’ culture transformation. The guide is divided into six interdependent domains:

  • Establish a compelling vision for safety
  • Build trust, respect and inclusion
  • Select, develop and engage the board
  • Prioritize safety in selection and development of leaders
  • Lead and reward a Just Culture
  • Establish organizational behavior expectations

Strategies and tactics for each domain are outlined in two separate levels: foundational and sustaining. However, patient safety leaders said in the announcement that culture change is not a simple two-step process. Each organization will be at a different level in the journey, and honest, transparent evaluation of an organization’s current state is an important consideration.

“The goal in healthcare really needs to be zero preventable harm,” Gary S. Kaplan, M.D., chair and chief executive officer, Virginia Mason Health System, and chair of the Lucian Leape Institute, said in the announcement. “We know that culture is at the foundation of any organization’s response and approach to harm. We hope that leaders will use this blueprint in both a strategic and tactical manner in their journey to a culture of safety.”

Whether an organization is just starting the process to create a culture of safety or is working to sustain the safe culture, the blueprint recommends executives:

  • Share the blueprint with the healthcare organization’s board chair and leadership team
  • Complete the self-assessment included in the guide with input from the board, leadership team, clinicians, frontline workforce, and patient and family representatives, as appropriate.
  • Develop action plans based on an understanding of the current state of your organization. Use assessment results to frame discussions with the leadership team and the board that focus on identifying ways to close gaps and aligning the direction of your organization with key safety and culture initiatives.
  • Share the outcomes of the assessment, action plans and progress with your senior leadership team, the board, your workforce, and your patients and families, as appropriate and helpful.
  • Ask for periodic feedback from your board, your leadership team and the workforce.
  • Refer to this guide as a resource for systematic check-ins and adjustments, as needed.