Empowering hospital staff to speak up about safety: 4 tips

Jennifer Lenoci-Edwards, RN, director of patient safety at the Institute for Healthcare Improvement outlined four ways to encourage healthcare workers and hospital staff to speak up about patient safety in a recent IHI Improvement Blog post.

Ms. Lenoci-Edwards authored the blog post in response to a question submitted as part of a Dear Abby-like advice column for healthcare experts and quality improvers. It is the first post in the IHI's new series.

The question submitted reads, "I'm a charge nurse on a hospital ward, and I'm convinced that people on my team don't feel safe about speaking up. I actually want to hear their feedback, but I realize that not all managers in my organization have the same attitude. We also have high turnover, so it's hard to change the culture when staff come from other organizations or departments with a weak culture of safety or, even worse, have actually been burned in the past. How can I encourage people to speak up?"

According to Ms. Lenoci-Edwards, some ideas organizations in a similar position should consider include:

1. Walking the walk. If hospitals want their staff to speak up about safety issues, they should lead by example and have leaders share their own concerns about patient and staff safety first.

2. Addressing psychological safety. Hospitals should get employees comfortable with the concept of psychological safety — a common belief among members of a team that they can share mistakes, ask for help and seek feedback without negative consequences.

3. Responding to feedback constructively. Hospitals must be sure to "close the loop" when employees report safety concerns. If the system fails to respond when employees report a problem, workers may lose trust in the system and stop contributing feedback altogether.

4. Connecting the dots between feedback and outcomes. Hospital leaders should link the cycle of reporting concerns, giving feedback and implementing preventive actions back to improved clinical outcomes for patients, since that is what motivates many healthcare workers.

"Remember that culture does not develop overnight, so be patient," wrote Ms. Lenoci-Edwards. "The fact that you are recognizing this challenge means you have already started on your journey to a safer culture. Good for you!"

Those interested in submitting a question to "Dear IHI" can do so by emailing info@ihi.org or by tweeting the questions @theihi using the hashtag #DearIHI.



More articles on patient safety:
3 information gaps that hinder patient safety, and how to solve them
GAO: 3 barriers hospitals face when implementing patient safety practices
Arizona State Hospital self-inspection highlights gaps in patient safety

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