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How Nurses Can Support a Culture of Patient Safety

Published on 9/12/2018

What exactly does patient safety mean? In 2015, a study was conducted to analyze the concept of patient safety. The authors felt that standardizing the term could enable patient safety data measurements across different health care organizations. The study revealed that the patient safety concept was used to describe a process, a discipline, a health theme, a condition and competencies. Patient safety was defined as medical error prevention, protection of patient from harm or injury and care team collaboration. 

In other words, there were a lot of different ideas about what exactly constituted patient safety. As a nurse, I think of patient safety as a clinician doing everything within their power to prevent medical errors and protecting patients from harm. For that to happen, health care organizations must create a culture that supports patient safety and implement practices that promote it.

The role of nurses in patient safety

In 2001, the Institute of Medicine (IOM) shared a patient safety impact report, examining quality issues and detailing changes needed for patient safety. The IOM identified six aims for improvement noting that health care should be safe, effective, patient-centered, timely, efficient and equitable. In 2004, another IOM report discussed the value of nurses and the environments in which they provide care, offering examples of how to design nurses’ work environments to enable delivering safer patient care. All these studies and this data is to say that nurses, who represent over half of health care workers in the nation, play a critical role when it comes to ensuring not just patient safety, but quality patient care.  

At a Cerner Health Conference several years back, I had the opportunity to hear personal stories and testimonials from Cerner clients, associates and leaders about what led them into health care. While the stories varied from the birth of a child to chronic condition management to the loss of a loved one, the impact and perception of care received was similar. All of it was tied to the care delivery, quality and outcomes – all areas where nurses have a direct impact.

Support a culture of patient safety

As a nurse, I strive to provide safe patient care – but I’m at my best when I feel like my organization also emphasizes patient safety. 

Creating a culture that supports patient safety includes promoting communication and visibility of medical error misses, near misses and successes that can be shared across the organization. The Institute for Healthcare Improvement (IHI) created a list of changes for leaders to create a culture of patient safety. IHI’s recommended improvements include: 

  • Conducting patient safety leadership rounds – Senior leadership needs to be the boots on the ground making sure that everyone in the organization understands, from the top down, that patient safety is critical. Making regular rounds specifically to discuss patient safety with nurses and other clinicians is an excellent way to learn about the issues the staff is facing.
  • Creating a reporting system – When clinicians feel supported by a culture of patient safety, they’re more likely to report safety issues – especially if the organization takes an approach that doesn’t punish anyone for providing feedback or making errors. Ultimately, the goal should be making patient care more secure.
  • Appointing a patient safety officer – This is someone who provides training on patient safety procedures for staff and helps implement safety measures and methods.
  • Involve patients in safety initiatives – Patients and their families can provide critical information to clinicians. Staff should pay special attention to their questions or comments – these could indicate safety issues.
  • Share safety reports at shift change – Communication is key. When the entire staff knows about safety issues at hand, it’s better for everyone.
  • Creating an adverse event response team – In the event of a safety issue, it’s crucial that there is an adverse event response team in place to do what they can to mitigate harm to the patient and prepare the staff for the best next steps.

High reliability organizations (HRO) often implement programs to prevent errors. Similar to the IHI-recommended improvements, these programs often include interdisciplinary safety rounds, enhancing hand-off communication and creating dashboards for safety prevention and evaluation. Patient acuity systems, analytical tools and information technology can be leveraged by health care leaders to identify safety issues and strategies. Health IT tools can further help organizations promote and monitor patient safety via clinical decision support, device integration, analytics and more.

Making patient safety a priority

In the modern health care industry, patient safety is non-negotiable. Patients expect it, clinicians strive to deliver it and health care organizations rely on it.

And yet, achieving total patient safety isn’t always straightforward. A 1999 IOM report estimated that up to one million people were injured and 98,000 died annually in the United States because of medical errors. While patient safety has always been a focus for health care organizations, this eye-opening public report spurred patient safety movements across the globe. 

Today, creating a culture of patient safety should be top of mind for modern health care organizations.  Reports released from the IOM reinforce the importance for leaders to design environments for delivery of safe patient care, and increasingly (through programs like Advancing Interoperability) financial incentives are tied to delivery of quality care. Leveraging smart technologies and dashboards and standardizing practices enables organizations to improve quality, bring down cost and create value-based care. 

No matter what faction of the health care industry we come from – be it the clinical side or the health IT provider side – we must continue to work together to leverage innovative strategies that promote patient safety inside and outside the four walls of the hospital.

Cerner’s solutions focus on advancing care coordination, nursing documentation and clinical workflows in a variety of settings and venues to facilitate patient safety and care delivery for optimal outcomes. Learn more here.