Building a Culture of Safety in Healthcare: Strategies and Essential Tools

Patient safety culture refers to how the staff in a facility collectively protect and advocate for the safety and well-being of patients. Establishing a healthy, thriving culture of safety in healthcare settings can be incredibly challenging — even for experienced healthcare leaders — but it’s critical for achieving a high level of care and accountability. Whether you’re starting from scratch or looking for ways to improve an existing system, we’ve got you covered with research-backed tips.

What Is a Culture of Safety in Healthcare?

Establishing a culture of safety means harnessing collective attitudes, beliefs, and behaviors across each level of a healthcare organization in the effort to prevent patient harm. There are many key characteristics of organizations that successfully help to promote patient safety. Some of the key factors that help with creating a culture of safety in healthcare are summarized in the following table:

Why Is Safety Culture in Healthcare So Important?

The simple answer is that a commitment to safety prevents patient harm. As many as 400,000 people die every year as a result of hospital-associated preventable harm in the U.S. alone. Error rates are lower in organizations with a strong patient safety culture. Examples of other potential benefits are clear in nursing homes where safety is a priority: lower risks of resident falls, urinary tract infections, and pressure ulcers. Building organizational commitment can be a slow process and it may take as long as five years to fully ingrain an optimal standard that establishes a culture of safety in nursing and other healthcare professions.

How to Promote a Culture of Safety Across Your Organization

Every healthcare organization has its own unique strengths and weaknesses to consider when building a culture focused on safety. Once you’ve identified the areas you’d like to work on, use the following ideas to help formulate your plan.

1. Measure and Track Safety Culture Metrics

One of the best — and easiest — ways to start the journey is by conducting a safety culture survey to assess the current state of the facility. Once you establish a baseline score, compare the results to those of similar facilities to see how your team stacks up. You can continue to follow these metrics and surveyed patient safety culture examples annually to identify trends over time and evaluate the effectiveness of your improvement plan. Tips for assessment:

• Use a validated survey, like AHRQ Surveys on Patient Safety Culture (SOPS) or the Safety Attitudes Questionnaire.
• Measure beliefs, norms, and attitudes about safety practices to evaluate culture rather than relying on process measures like patient outcomes and safety metrics.
• When possible, assess culture at unit and facility levels.

2. Launch a Non-Punitive Reporting System

You can set up a reporting system to help identify any gaps in practice related to patient safety. Knowing when and where errors and near misses occur helps the facility address underlying process issues. Establishing a formal process to report errors and adverse events encourages active participation from everyone involved. One key to success is creating a policy that makes safety incident reporting non-punitive. Staff must feel confident they won’t be blamed or punished for speaking up when mistakes occur. If they think they’ll be reprimanded, or even lose their job, it’s unlikely they’ll use the system, and a culture of fear — rather than safety — will take root.

Essential Patient Safety Tools for Quality Improvement

Simple and easy-to-use tools can bring surprising insights and results. These tools are indispensable for safety and quality improvement in healthcare and provide practical applications for front-line healthcare workers to improve patient safety systems and processes.

Daily Huddles

A huddle is a short briefing or meeting for 10 minutes or less involving care team members, usually held at the start of each workday or shift. A daily huddle gives teams a way to focus on care coordination, identify potential or existing safety issues and flag concerns. Huddles provide the opportunity for team members to look back and review the previous day’s work and to look ahead to flag safety issues and other concerns for patients for the day. Daily huddles help to build a culture of safety and teamwork among healthcare professionals.

SBAR (Situation-Background-Assessment-Recommendation)

SBAR is an easy-to-use, structured form of communication technique that enables information to be transferred accurately between care teams. It is widely used to enhance patient safety by reducing the risk of miscommunication and promoting a common framework for sharing information among healthcare team members. The SBAR consists of four standardized stages that help staff formulate important communications with the right level of details: