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Leadership

“Leaders play an extraordinary role in patient safety. ... You must make everyone in the institution understand that safety is part of his or her job description.”

-Jim Conway, Leadership Guide to Patient Safety, Institute for Healthcare Improvement

Take a safety-focused leadership approach

Leaders – from individual physicians in a small practice to top executives and board members in acute care hospitals – demonstrate through their words and actions the priorities they set for the organization. A safety culture will flourish in an organization with leaders who show a deep commitment to fostering a collaborative environment, responding to concerns, and improving patient safety.

  • Demonstrate commitment to patient safety
    • Good leaders will take advantage of every opportunity to show that they care about patient safety and want to hear concerns from the entire team.
    • Model these attributes in all interactions: collaboration, clear and open communication, asking questions to learn, encouraging suggestions from all staff regardless of their role in the practice.
    • Ensure that safety is on the agenda for all staff meetings and is approached in a constructive way.
      • Always thank staff for raising concerns to reinforce the important of bringing attention to potential issues.
      • Staff comments may range from a faulty piece of equipment that needs repairs to two similar medication abbreviations that are easily confused.
      • Actively work to meet staff needs. When feasible, take action on the spot (for example, contact facilities about a work order for faulty equipment). If the organization is unable to fulfill a request, brainstorm alternate approaches that can accomplish the same purpose.
    • Establish regular visits from leadership to frontline staff to listen for, track, and respond to safety concerns, often called "WalkRounds."
      • Visits may be as brief as 15 minutes. They might occur monthly or biweekly, circulating through every area in the organization at least once over the course of a year in a big organization.
      • Set dates in advance and stick to the schedule to show that the leadership is invested in the process.
      • Include executive leaders as well as the patient safety coordinator.
      • Consider visiting patients and families as well to gather feedback and demonstrate leadership commitment to patient safety.
      • Review this WalkRounds information sheet for safety rounds based on a Massachusetts system that started conducting visits.
  • ​Take responsibility for adverse and patient harm events
    • Actively seek answers to questions about what went wrong; expect and encourage staff to probe deeply for root causes of adverse events.
    • Insist that corrective actions be devised, implemented and evaluated for effectiveness.
    • See the Analyze tool for more resources for responding after an adverse event to find out why it happened and how to prevent it from happening again.
  • ​Encourage development of reliable processes
    • Support and encourage staff to build processes for standard care and communication.
    • Be sure the organization is soliciting input from patients and family members.
    • Invest energy and resources in improved reliability.
    • Be sure safety factors are weighed when considering changes to care delivery processes designed to improve productivity or efficiency.
    • Support continuous process improvement in all areas; patient safety work is ongoing and iterative.