The belief is that, by following stringent regulations and procedures, positive health outcomes will follow. Unfortunately, this is not usually the case. Today, medical errors are the third leading cause of death in the United States.
To achieve the highest levels of patient and clinician safety, healthcare organizations should reevaluate their approach. Rather than viewing safety as a procedural measure, make it a cultural keystone by creating new experiences and beliefs around what safety really means to your organization.
The actions-results trap
Most healthcare organizations focus only on the actions of their practitioners in the hopes of driving desired results. This approach is a trap, because it fails to acknowledge that actions are predicated on beliefs — which themselves are the product of individual experiences.
Take this example: an emergency room was facing a continual challenge in identifying patients’ emergency contact information. It seemed that clinicians were unable or unwilling to locate these valuable phone numbers and addresses within the six-page patient information form. As a result, clinicians were only obtaining the correct information 42% of the time.
In an attempt to combat this problem, the organization created a new single-page form with the intent of making it easier to locate contact information. Leaders organized a training to teach clinicians how to use the new form. Yet after a number of months, accuracy had only increased by 5% — an almost negligible number for the amount of effort that had gone into the initiative.
This lack of progress was due to a pervasive cultural belief: clinicians viewed patients’ emergency contact information as an afterthought. By focusing on actions and results before establishing new cultural beliefs that recognized emergency contact information as a crucial part of ensuring patient safety, the hospital failed to significantly improve results.
Recognizing the role of experiences and beliefs
It is not usually the case that healthcare organizations fail to prioritize safety, but rather that the focus on safety is insufficient until it addresses the underlying experiences and beliefs of all employees.
Consider another scenario: Discharge times at a hospital were slow and inefficient — in part because all of the organization’s wheelchairs were stored in the facility’s basement, requiring time and effort to retrieve and transport them to patients. With the goal of cutting discharge times, leaders initiated a protocol to store wheelchairs in hallway closets on each floor of the hospital rather than in the basement. After a few months during which discharge times remained sluggish, a leader discovered that many members of the transport team had chosen not to follow the new procedure. When asked why, they cited an incident many years back in which a wheelchair was stolen from a hallway closet.
This example reveals the intimate relationship between experiences, beliefs and actions. Because members of the team had a negative experience (the wheelchair being stolen), a belief was created (it is unwise to store wheelchairs in hallway closets) — which led to an action (do not follow the new protocol). To meet its desired result of shortening discharge times, the hospital needed to manage beliefs before actions. In the end the hospital chose to store wheelchairs behind nursing stations, thus creating a new experience and cultural belief of trust,
and inspired all employees to take action in accordance with the desired result.
Managing experiences and beliefs to create a culture of safety
The most important step a healthcare organization can take in creating a culture of safety and driving better health outcomes is to weed out beliefs that are derailing the achievement of those results, and replace them with new beliefs that generate safe, results-driven action. Here is the blueprint for fostering a culture of safety:
1. Experiences: create new experiences for all employees through awareness training. All employee beliefs are colored by belief bias — the tendency to look for evidence that confirms what we already believe. Effective training suspends belief bias and raises awareness of universal at-risk behaviors that can lead to medical error.
2. Beliefs: help all clinicians, from physicians to nursing assistants, cultivate safety-focused cultural beliefs, including:
● Acting courageously and speaking up to superiors if you believe patient safety is in jeopardy
● Developing collaborative, cross-functional trust within the care team
● Being personally accountable for continuously improving safety
3. Actions: operationalize action with tangible tools such as a consistent, egalitarian feedback model that align with cultural beliefs.
4. Results: ensure that all clinicians and patients are safe at all times. Guaranteeing great health outcomes builds trust within your healthcare practice, which in turn leads to higher patient retention rates and better business results.
Achieving a culture of safety in your healthcare organization begins with shaping employees’ experiences and beliefs to reflect this goal. Building a workplace culture in which accountability, open communication and cross-functional collaboration can thrive has been shown to minimize at-risk behaviors and actively reduce rates of medical error. In turn, these behaviors generate better patient outcomes, increased return on investment and sustained topline results, positioning your healthcare organization for long-term success.
Bio
Jared Jones is a Senior Partner for Partners In Leadership, delivering the company’s award-winning content, training and consulting solutions to hospitals, pharmaceutical teams, medical devices, healthcare information technology, and insurance organizations worldwide. Jared plays a critical role in content development, authorship, and ongoing development of the organizations field practitioners.
