Dr. Gunjan Dhawan
Culture is the ethos of the human society. It defines who we are. A form of expression through art, music, dance, rituals, food, and lifestyle, cultures amongst communities across the world showcase what they believe. It brings the society closer, aligns them to a common belief and together they work towards spreading and preserving that culture which helps them differentiate from the rest. The strength of the culture of a community is comparable to none other. The impact it has both within and outside the community is by far one of the strongest.
Patient safety is also a culture. It is an intangible aspect that instills in Healthcare professionals, the resolution to keep safety as their first priority at any and every given point in time. The Joint Commission International Accreditation Standards for Hospitals, defines ‘Culture of Safety’ as “a collaborative environment in which skilled clinicians treat each other with respect, leaders drive effective teamwork and promote psychological safety, teams learn from errors and near misses, caregivers are aware of the inherent limitations of human performance in complex systems (stress recognition), and there is a visible process of learning and driving improvements through debriefing”.
The concept of Culture of Safety originated outside the Healthcare sector. It has come from the High Reliability organization. Commercial air lines, the nuclear power sector, electrical power grids and even amusement parks, though different in nature, are perfect examples of High Reliability Organizations (HROs). These are the organizations that have a high potential for errors yet ensure nearly error-free systems and zero harm. HROs do not overlook their failures but rather use them as windows to look into their systems and processes. They anticipate the unexpected events and build the capability to manage them.
A Culture of Safety thrives and spreads in an environment where leaders are committed towards quality and set examples and expectations for the staff to contribute in that environment. Actions that do not support a culture of safety are condemned and a safe environment for both the patients and employees is ensured and encouraged. Other features would include identifying potential points of errors in the patient care process and create a mechanism to curb them. Also, support for an environment where the hospital staff is free to report errors without any hesitation of reprimand is needed. A constant reinforcement in the form of staff education, training and an interdisciplinary approach to identifying solutions has been a proven technique to create an environment for the culture of Safety to burgeon.
It all starts from the top and trickles right to the bottom most in the pyramid. Because culture embraces all!