Did you know that nearly everyone’s job affects the safety of patients?
By Dane Wiig
For a long time now ‘patient safety’, as a function or area of responsibility within our healthcare organisations, has often ‘belonged’ to a single team or person. The wider system in place has meant that work at a local level is in the main limited to dealing with incident reports and responding to patient safety alerts. And, therefore, the perception has grown that to improve patient safety, someone needs to look at errors and work out ways and interventions to reduce the risk of those happening again.
This makes nice, neat, predictable sense. But if only it were that simple.
Because we now know two things. That working in healthcare isn’t in the least bit neat, tidy or predictable, and that this ‘traditional’ approach has not been an effective way to reduce harm, at scale, in the long term. Instead, that single team or person is often under a lot of pressure to increase the number of incident reports and deal with the churn of related investigations – which leaves little time for them to do anything else, such as learn what can be done differently or learn from what works well right now.
If you’ve been an avid reader of the our newsletters and our blogs over the last couple of years you will have seen all the emerging and amazing new ideas, research and schools of thought about safety that we have been discovering and sharing with our Sign up to Safety family. That keeping patients safer is about so much more that simply reporting when things go wrong and trying to stop those from happening again
We’ve learned from people like Sidney Dekker and Eric Hollnagel about the immense complexity and messiness of healthcare and the amazing ability of the people working in it to adapt minute by minute to ensure the best outcomes. That these people are an asset and part the solution when things go wrong, not a problem to be ‘dealt with’.
We’ve found a growing body of evidence detailing how the way we treat each other, talk to each other and the behaviours we exhibit affect people’s ability to care for their patients safely.
But also the importance of the health and wellbeing of those who care for patients is being recognised as one of the most important aspects in enabling them to care safely.
For years research within consumer-based industries has shown that healthy, happy, engaged staff are central to customer satisfaction. Now studies within healthcare are showing that poor wellbeing and burnout are associated with poor patient safety outcomes and errors.
The safety of patients is dependent on the members of staff who interact with them being physically, psychological and emotionally well, and able to cope with the complexity of their day to day work. To be physically, psychological and emotionally well, people need to be fed, watered, emotionally supported, thanked, rewarded, recognised, cared for, even loved, and helped to feel proud about what they do and to feel joy in their work.
When all this evidence comes together, and you think it through, it becomes obvious that something needs to change. Safer care needs to involve all parts of the organisation.
Those responsible for staff welfare and development, those who help nurture the relationship staff members have with their employer, those who decide how, where and when staff can take breaks to rest, eat and drink, those who decide what support is in place to help them cope with the strain of their daily roles, the processes and procedures that help them do their work, those who set the tone and behavioural norms of a team…
These things matter to safety. Taking just one of these examples; we routinely hear of staff going for 12 hours without taking a moment to have a drink or something to eat. The idea that a person can be expected to make 100% safe decisions after hours on their feet without nourishment is wrong. Human beings make errors under standard conditions, so adding to that hours of not eating or drinking can only add additional risk.
So if we are to accept the enormous amount of evidence that patient safety is far more complex and interrelated than just the team that looks after incident reporting, and that looking after the health and wellbeing of the people who care for patients is a crucial factor in providing safe care, then this is going to take a bigger team effort across the whole organisation to achieve the kind of safety culture we’re striving for.
Having the commitment and leadership of departments like HR, organisational development, finance, estates, and procurement all supporting the implementation of changes needed to improve staff health and wellbeing is going to be crucial.
And the best place to start? Ask your staff what matters to them.