Most Hospitals Working Toward Creating Strong Cultures of Safety

Heather Comak, for HealthLeaders Media , June 8, 2009

Building and maintaining a culture of safety has become a key part of a patient safety program. Since the Institute of Medicine's To Err is Human was published 10 years ago, the healthcare industry has made a concerted effort to focus more energy on creating systems by which patients are kept more safe, and staff members are set up to succeed.

This year's Briefings on Patient Safety Culture of Safety Survey results show that while the overwhelming majority of hospitals are addressing their cultures of safety, there are certain areas to which more attention could be paid in the future.

More than 900 patient safety professionals answered the survey questions, most of whom (84%) worked at hospitals. When asked if they thought their facilities had strong cultures of safety, 41% said yes, and 57% said "We are working toward improving our culture of safety." This is encouraging, although perhaps suggests that healthcare as an industry may not have one "strong" culture of safety definition.

"I think that's a very positive thing, but I think the healthcare industry really needs to be careful of not becoming overconfident and complacent," says Ken Rohde, senior consultant for The Greeley Company, a division of HCPro Inc. "What the healthcare industry considers a strong culture of safety might be actually relatively weak compared to aviation or nuclear power or other high risk industries. If everybody thinks they're getting an A in healthcare, that might only be a C- in the rest of high-risk industries."

Another question on the survey asked respondents to evaluate what has caused (if any) an increase in the attention paid to creating and maintaining a culture of safety. The majority of respondents said that their hospital was motivated by external agencies.

Twenty-five percent  said motivation came from increased requirements from accrediting bodies (The Joint Commission) and 34% said motivation came from large patient safety groups (IHI, National Quality Forum). Twenty-seven percent answered "It's just the right thing to do," 4% said a near miss or medical error had caused the facility to pay more attention to culture of safety, 1% listed an increased financial incentive, and 8% gave other reasons.

"We need to make sure we're getting away from being externally driven, because as soon as somebody backs off, the Joint Commission isn't pushing us, then people will slide right back to where they used to be," says Rohde. He also says he hopes that that next time the survey is conducted, more respondents answer with "it's just the right thing to do."


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