Establishing a Patient Safety Culture in Hospitals During COVID-19

A culture of safety makes safety and harm prevention a top priority among an organization’s culture, processes, and technology. It involves organizational and individuals’ values, perceptions, and patterns of behaviors towards the organization’s safety management process. A safety culture involves (1):

• Collaboration across multiple disciplines and levels within the organization for the identification of safety solutions

• Commitment to address any safety concerns by encouraging employees to report errors, near misses, and other safety and quality issues

• A supportive, blame-free environment emphasizing staff’s ability to report issues without the fear of punishment
  

The COVID-19 pandemic exposed underlying areas of weakness within the healthcare delivery system as it brought an onslaught of uncertainty, anxiety, and strain to organizations. Despite the challenges, innovative advancements in care delivery, quality improvement, and adaptability have emerged.

To establish a safety culture during COVID-19, organizations can look to these 4 key elements:

1. Quality Structure

Implementing a quality structure can improve patient outcomes, reduce incident reports, and decrease costs associated with preventable incidents and events, therefore helping to establish a culture of safety. A quality structure includes implementing processes for reporting incidents and events, tracking quality outcomes, and communicating data in a way that drives decision making.

By establishing a multidisciplinary quality structure, WVU Medicine Children’s Hospital reduced central line associated bloodstream infection rate by 86% and saved approximately $700,000. (2)

Establishing a structured process for Root Cause Analysis (RCA) and mortality reviews are key factors in building a quality structure. Effective RCA’s should be standardized throughout the system, ask the right questions, and focus on finding underlying system contributions and areas for improvement. Electronic RCA’s not only increase efficiency and effectiveness but also allow organizations to identify trends in quality and safety. Additionally, standardizing mortality reviews has been shown to increase quality improvement. (3)

2. Daily Safety Huddles for a Culture of Safety

Lack of communication and miscommunication can lead to adverse events and errors. (4) Safety Huddles for a culture of safety provide opportunities for staff to communicate, identify safety concerns, develop action plans, and acknowledge successes.

Safety huddles are routine, brief meetings comprised of multidisciplinary staff members shown to improve quality information sharing and accountability, and spark system-wide changes that promote safety. (4) 

The COVID-19 pandemic has brought with it the challenge of accurate data sharing among healthcare professionals. Safety huddles ensure that team members across disciplines and ranks are receiving accurate information and that everyone is up to date on patient safety issues. It also provides a sense of community and collaboration during a time when support and teamwork are essential.

3. Employee Engagement and Peer Support

Now more than ever, healthcare professionals are likely to face uncertainty, stress, and fear. Employee wellbeing influences their performance and ability to provide safe, quality care. Establishing strong employee engagement and cultivating a network of peer support is crucial to building a safety culture. Approaches to fostering a culture of employee engagement and peer support include:

• Increase transparency about challenges and successes facing the organization and department. Transparency helps staff feel connected to their organization and fosters an environment of honesty and collaboration.
• Encourage communication through regular brief meetings such as safety huddles. Leaders should keep communication channels open and encourage staff to express concerns, questions, and suggestions.
• Involve front-line workers in decision processes. Keeping staff engaged in process changes helps them feel heard and valued, which fosters an inclusive and engaged environment.

• Caring for employee’s mental health by providing telehealth or mental support services increases employee wellbeing, satisfaction, and their ability to provide safe care. Some organizations have introduced peer support groups, especially for front-line workers, in response to the pandemic. (2)

4. Rapid Innovation

Performance Health Partner's Solutions

With reduced patient safety events, increased data accessibility and efficiency, and lowered overall costs, the impact of establishing a safety culture is clear. With Performance Health Partner’s Safety Culture Software, healthcare organizations can access the data they need to increase patient and employee safety while improving outcomes.

References:

1. https://psnet.ahrq.gov/primer/culture-safety
2. https://www.childrenshospitals.org/Newsroom/Childrens-Hospitals-Today/Articles/2020/07/Growing-A-Safety-Culture-During-the-COVID-19-Pandemic
3. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3382446/
4. http://www.wsha.org/wp-content/uploads/Worker-Safety_SafetyHuddleToolkit_3_27_15.pdf
5. https://sloanreview.mit.edu/article/lessons-in-rapid-innovation-from-the-covid-19-pandemic/