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A culture of care

Patient safety isn’t just something discussed in staff orientation or monthly meetings – it’s the culture of our care.

At Providence, we are committed to providing the safest possible care for patients, which makes our patient safety culture a necessary foundational piece.

A ‘safety culture’ is the fundamental core to the success of safety management, which involves shared attitudes, values, beliefs, and practices related to safety, including mindfulness to danger, appreciation of systems approach to improvement, and a willing to be open to sharing information, especially when you have contributed to a patient safety event.

“Safety is such a common word,” says Sarah Carriere, leader, Patient Safety. “We all regard safety as the absence of harm, accidents or incidents and therefore, we treat safety as a static entity – things are either safe or unsafe and, if they are unsafe, we have to control the situation to make it safe again. When things go well at work we think it is because people followed the rules and the procedures; however, I bet staff can imagine times where they did everything right and the outcome they wanted never happened. In fact, the complete opposite happened and someone was harmed.”

Instead, Sarah counters that safety is about acknowledging that things go well because we make sensible and safe adjustments to cope with the unpredictable nature of our environment, and that to learn how we flex and adapt to complex situations, we need both the story for context, and the report for learning.

“Patient safety is everything that we do, and that also includes focusing and recognizing when things go right, as well as learning from what goes wrong. We’ve all experienced a shift where things just go sideways – it’s unpredictable, it’s chaotic and yet, we make sure that patients received phenomenal care – that is patient safety. It’s our ability to be flexible, to critically think, and be resilient.”

One way of  ensuring staff feel safe and respected is introduction of monthly “Good Catch” awards, which celebrate staff’s timely interventions and lessons learned in care events. Reporting good catches helps all of us to:

  • Reduce risks for all patients by not waiting for harm to occur
  • Trigger improvements in weak spots in the processes of care
  • Alert other providers to possible vulnerabilities and gaps in training
  • Contribute to planning, recovery testing, and harm mitigation strategies following events that do result in harm

Another way is shining a light on the work staff do every day to maintain patient safety, every chance we get. Like during Patient Safety Week 2017, which saw a fleet of Patient Safety Superheroes being identified across our sites to spread the patient safety good word, create a heightened awareness of all of the work that staff put into excellence in care, and provide an opportunity to wear a shiny mask and cape, naturally.

Patient Safety Superheroes takeover St. Paul’s.

We are continually working with our staff on deepening this culture, creating more trust and awareness of the importance of transparency and opportunities to report and prevent harm to patients in the future.

“Reporting and closing the loop on patient safety learning an integral part of sustaining a culture of patient safety and excellence in care,” says Sarah. “Staff live and breathe patient safety and are encouraged and supported to use best practices. In turn, because the team feels safe and respected when reporting events, a true partnership is formed between them, the patients and families.”

In a nutshell, patient safety at Providence is:

  • A focus on learning about what goes right,  in addition to learning from what goes wrong.
  • About proactive safety and risk management, rather than waiting for something bad to happen and then reacting.
  • About focusing on increasing the number of times you succeed, in order to reduce the number of times we fail.
  • About being humble, building trust and transparency – have people tell their story on why things happened to you can make sense of their decision making process and learn with empathy.
  • About learning and improving care with patients and families.
  • About recognizing that safety is more than the absence of physical harm; it’s is also the pursuit of dignity and equity.
  • Recognizing that as care providers,  staff are also harmed, psychologically and mentally, from patient safety events. Rather than bottling those feelings up, the goal is to see staff sharing experiences, listening to other’s experiences and, as an organization, helping staff process and return to thriving in their role.