5 Leadership Dimensions Needed for Patient Safety Initiatives
Scott J. Ellner, DO, MPH, vice chairman of surgery and director of surgical quality at Saint Francis Hospital and Medical Center in Hartford, Conn., led a patient safety initiative that reduced the operating room's infection rates by 75 percent. He shares the five dimensions of leadership needed to achieve success in a patient safety initiative.
1. Alignment. When introducing new processes or new ideas, leaders should first identify supporters who can help teach others about the change. After identifying the physicians and staff who are aligned with the patient safety initiative, leaders should then focus on the people who are more resistant to change, according to Dr. Ellner.
2. Self-awareness. Leading a patient safety project requires self-awareness and empowerment of team members. "You have to have self-awareness as a leader to effect a change in the culture," Dr. Ellner says. Leaders have to understand their leadership style and use their strengths to motivate others to take action.
Importantly, leading a patient safety initiative is not about mandating tasks to others without input; it's about giving physicians and staff the tools to drive improvement. "It's not about power; it's about empowerment," Dr. Ellner says. "It's about how you influence people to change their attitudes." A critical skill for leaders is the ability to listen to others in a stressful environment, such as in an OR, and build trust, he says.
3. Team-building. A checklist alone will not improve patient safety; a patient safety initiative needs to be supported by a "just" culture — a non-punitive environment in which people feel safe reporting near misses and adverse events. "Culture is so important in getting people to address certain behaviors or attitudes that will impact patient outcomes," Dr. Ellner says.
Patient safety leaders need to build trust not only between team members and themselves, but also among team members, so that no one fears retribution from each other. Dr. Ellner led team training at Saint Francis Hospital and Medical Center to develop open communication among members of the OR team in stressful environments. In addition, the hospital praises people who speak up about a near miss or adverse event.
4. Leading up. Another important dimension of patient safety leaders is the ability to communicate effectively with senior executives of the organization, according to Dr. Ellner. "If you don't have buy-in from the top, these initiatives will fail."
5. Leading across. In addition to communicating clearly with senior executives, patient safety leaders need to communicate effectively with front-line workers across the organization. Leaders need to listen to feedback from the people using the new process, and provide feedback on the new process's effect. "Talk to front-line staff and people in different service lines so there is a consistent message throughout the institution," Dr. Ellner says.
Incorporating these five dimensions into leadership of patient safety initiatives can help leaders gain buy-in and drive sustainable cultural changes.
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