Main Body
First, Do No Harm (to Yourselves): The Role of Leadership in Creating a Culture of Employee Safety in Healthcare
Lindsay Schwartz
Introduction
As the push for improving patient safety in healthcare continues, leading healthcare systems in the United States are expanding safety initiatives to incorporate employee safety. Employee safety is both cost-effective for the organization as well as serving as a contributor to patient safety (Organizational Safety Culture-Linking Patient and Worker Safety, n.d.). In order to improve both patient and employee safety in healthcare institutions, a culture of safety is a requirement. A culture of safety may be defined as an organizational ideology, which prioritizes safety over financial gain or benefit (Creating and sustaining a culture of safety, 2004).
This chapter will explore best practices for creating a culture of safety in healthcare institutions. We examine the primary components of creating a culture of safety including a just culture, in which employees are treated in a supportive rather than punitive manner when it comes to safety concerns, a safety reporting system to capture safety concerns and therefore intervene to improve concerns, a transparent approach to safety in which all employees are made aware of safety concerns and efforts to improve these concerns, and finally engagement by both leaders and frontline staff to improve safety. Additionally, this chapter will examine the importance of extending safety practices to incorporate employee safety. To illustrate these best practices, this chapter will examine the Zero Hero Employee Safety program at Nationwide Children’s Hospital in Columbus Ohio.
Background and Context for a Healthcare “Culture of Safety”
In 1999 the Institute of Medicine (IOM) published a report titled: “To err is human: building a safer health system” (Poillon, 1999). The paper reported groundbreaking statistics, which identified hospitals as one of the most dangerous places in the United States due to medical errors. The report detailed the detrimental impacts of medical errors including patient deaths, financial impacts, and loss of trust in the healthcare industry.
The IOM report identified major issues in medical systems including: lack of communication among providers, lack of incentives for improving quality and safety, and flawed systems. The report distinguishes that rather than individual person errors, most medical errors are a result of system issues. The report encourages national level changes including: a federal level focus on improving patient safety, mandated reporting of medical errors, improvements to standards of care on a national level, and a culture of safety across all medical institutions. As learned through the IOM report, system-wide initiatives are crucial to creating a culture of safety in healthcare institutions.
After the publication of the IOM report healthcare research related to patient safety increased. Along with an increase in