Creating a Culture of Patient Safety

he Culture of Safety (COS) survey is a tool that helps identify areas of weakness within the practice setting and promotes feedback within the healthcare team. It has been widely adopted by hospitals and validated by entities such as the Agency for Healthcare Research and Quality (AHRQ). In order to promote this valuable tool in the medical office and ambulatory surgical-center setting, the AHRQ offers tailored surveys for each of these settings at no cost.
A COS survey identifies improvement opportunities within a medical practice and encourages a self-critical approach to operations and communications. The use of these surveys is important for the efficient operation of high-reliability organizations. It promotes enhanced communication, teamwork, and transparency within the organization.
Once the survey tool is completed, caregivers can check their results against a national database maintained by the AHRQ. Armed with these results, caregivers can use the measures to institute change. The adoption of the COS survey inherently indicates a willingness to critically evaluate your service delivery and improve your practice.
When areas of opportunity have been identified, there are many improvement ‘tools’ practices can use, including Lean, Six Sigma, and Kaizen (the model for improvement used by the Institute for Healthcare Improvement, root-cause analysis, and others). While the methodologies are slightly different, the goal is one of system analysis based on the teaching of Deming. These techniques may be new to practices as routine training of providers and other healthcare team members typically doesn’t include process-improvement (PI) theories. In order for a culture of safety to exist, the lexicon and tools of process improvement must be understood by all of those at the table.
Regardless of the descriptor presented, the team must speak the same language and understand the process-improvement method. Consider the following when strategizing the implementation of COS surveys:
• Select a champion who can educate and orient the team about the survey tool and corresponding PI plan, including senior management and new hires. This individual will also lead efforts for updated training.
• Create a PI comprehensive toolkit covering the basic elements for process improvement using the chosen methodology of the organization. Make it widely available and understood. You may also use the Action Planning Tool offered by AHRQ.
• Update skill sets so that the newest, best practices in process improvement are communicated to the key members of the team. The essential elements of new-member training and maintenance of knowledge will ensure that a culture of safety will thrive.
COS tools help caregivers be more self-critical; as a result, they will seek opportunities for improvement. In addition, adoption of COS shows your staff and your patients a commitment to excellence.