"All frontline staff, not just nurses, should be engaged, as well as empowered to act, if we really want to see a change in our culture of safety," says Voutt-Goos.
One way to build a feeling of accountability in nurses is to empower them to solve the problems themselves—in conjunction with quality and patient safety professionals, of course. New procedures or processes are more likely to be met with acceptance and to become part of everyday practice when the caregivers themselves are involved in the design.
At Henry Ford Health System, the organization reviewed a synthesis of safety culture and safety climate research conducted by the Aviation Institute that identified global indicators of safety culture.
"We use these global indicators as a guiding framework for our culture of safety efforts," said Voutt-Goos. "One of the global indicators is employee empowerment."
Empowering employees involves giving them a level of responsibility and knowledge, which sometimes they may not want, but is vital to achieving an end result of quality patient care in a financially healthy organization.
One common practice to reduce outcomes-related to issues such as patient falls or CAUTIs is to pit units against each other in competition and reward the winner with a pizza or ice cream. While it's appropriate to celebrate success and recognize hard work, I think it's a mistake to rely too heavily on competition.
Rewarding the unit that most improves its customer satisfaction scores or reduces patient falls by the greatest percentage is great at building enthusiasm and recognizing hard work, but it's not an effective long-term strategy. Nurses should be treated like adults and involved in the imperatives behind process improvement, both those related to patient care and those related to the organization's bottom line.