Culture Of Safety
Patient safety has become the number one priority and guiding principle in health care. Nurses have a critical and determinative role in ensuring patient safety, yet their effectiveness is, in part, dependent upon characteristics of their practice environment. Institutions and facilities are increasingly called to ensure cultures of safety to promote best safety practices.
A culture of safety is more than a safe environment – it is a pervasive attitude and commitment to safety through openness and trust. More attention is paid to how the error occurred than to the individual that made it. The focus is on learning from mistakes in order to prevent them from happening again, so staff are encouraged to report errors and near misses.
Cultures of safety prevent errors and promote safe nursing practice by anticipating and eliminating opportunities for error in organizational systems. This is accomplished by involving direct care staff in identifying, communicating, fixing problem prone processes. Nurses can contribute to cultures of safety by alerting others to potential problems in the workplace so they can be addressed.
TNA leads workplace efforts toward safe cultures for nurses and patients. TNA is supportive of several initiatives directed toward establishing cultures of safety.
- Transforming Care at the Bedside™ is a model in which frontline staff are involved in fast turnaround performance improvement efforts that directly impact staff work processes and patient care.
- The Healthcare Alliance Safety Partnership (HASP) is a joint effort between several hospitals and the Texas BON to support a culture of safety by providing an alternative reporting and review process for nurses who self-report errors.
- TNA has worked to establish staffing rules that require hospitals to involve direct care staff nurses in the establishment of staffing plans and solicit their feedback on the adequacy of the plan.
- TNA has worked with the BON to modify reporting rules and allow minor incidents to be reviewed by a peer group at the facility. This approach enables evaluation of system causes of the error.
Agency for Healthcare Research and Quality : AHRQ is organized within the US Department of Health and Human Services and aims "to improve the quality, safety, efficiency, and effectiveness of health care for all Americans." Site provides wealth of evidence based information.
American Association of Critical-Care Nurses : Site includes Nurses' Standards for Establishing and Sustaining Healthy Work Environments.
American Nurses Association : Official website of ANA; offers papers and position statements on safety.
Association of PeriOperative Registered Nurses : Offers links to various patient safety resources including team tool kits for safety.
Center for American Nurses : An of the ANA focused on workplace advocacy, CAN provides resource material on safety including a position paper Restructuring and Redesigning Nurses’ Work Environments and a brochure The Nurse’s Role in Promoting a Culture of Patient Safety.
Healthcare Alliance Safety Partnership : HASP is dedicated to providing information about this initiative of the BON, Institute for Healthcare Excellence and the University of Texas Center of Excellence for Patient Safety Research and Practice.
Institute for Healthcare Improvement : Offers resources for improving healthcare.
Institute of Medicine : Contains wealth of information on healthcare and quality including the three hallmark reports on patient safety: To Err is Human (1999), Crossing the Quality Chasm (2001), and Keeping Patients Safe (2003).
Institute for Safe Medication Practices : Provides safety alerts and information regarding medication safety.
Joint Commission National Patient Safety Goals : The Joint Commission is an accrediting agency for health care organizations such as hospitals and clinics. Each year, goals and requirements for improving patient safety are identified. Organizations seeking accreditation must demonstrate recommended safety practices to achieve the patient safety goals.
National Center for Patient Safety : Site supported by US Department of Veterans Affairs; offers information for healthcare professionals.
National Patient Safety Foundation : Nonprofit, nongovernmental organization supporting patient safety initiatives.
The Just Culture Community : Provides information, including a newsletter and executive primer, on the concept of “just culture” and organizations that are progressing toward establishing them.
US Food and Drug Administration : The USFDA regualates drugs and devices and this site offers related information.
References
http://www.texasnurses.org/displaycommon.cfm?an=1&subarticlenbr=250
TNA White paper
Comparisons of Cultures of Blame and Cultures of Safety