Developing cultural change in healthcare: Part 1 – by Dawn Stott

Summary

If we are to continue improving healthcare services, then developing cultural change in healthcare is crucial. Improving the quality of care, reducing medical errors and, ultimately, enhancing patient outcomes is essential for the future. Transforming the culture within healthcare organisations requires a comprehensive approach that involves leadership commitment, employee engagement, continuous education and a focus on patient-centred care. 

In a two-part blog for the hub, Dawn Stott, Business Consultant and former CEO of the Association for Perioperative Practice (AfPP), talks about the strategies that can help you develop cultural change in your organisation. In part one, Dawn sets out the steps to develop a programme of change to support you to achieve good solutions.

Content

There have been many incidents in healthcare that have led to employees feeling less than empowered and frightened to speak up and speak out. Ongoing scandals and behaviours will forever challenge all of those who work within the healthcare environment, particularly if cultural issues are not addressed.

Working towards cultural change in healthcare will take time and persistence. It involves not only implementing new policies and procedures but also changing mindsets and behaviours. Consistent effort, leadership support and a commitment to patient safety will be key to your success, no matter who you are or at what level you work.

It will take a sensitive and pragmatic, evidence-based approach to challenge culture and practice within any speciality.

Corporate culture and corporate memory are manifested in how decisions are made and the results of those decisions; i.e., the actions taken to support better outcomes. It is also about how we engage with individuals to encourage them to give of their best, support best practice and not be maligned for speaking up if things are not as they should be.

Across the healthcare sector, organisations will endeavour to provide a safe and sustainable service that improves outcomes for patients and their families. To develop a programme of change the following steps may support you to achieve good solutions:

Leadership commitment

• Engage leaders: gain commitment from top-level executives, administrators and department heads. Leaders must champion the cultural change and lead by example. The enormity of this may seem daunting; however, it is achievable if you have a structured plan and a strong vision. It takes one person to stand out in the crowd to ensure they have followers. There is a great video on YouTube that shows how important followers are to anyone in a leadership position.

Assessment and awareness

• Assess current culture: carry out a thorough assessment of the current organisational culture. Identify areas that need improvement, especially related to patient safety (see point below about cultural assessment).
• Awareness building: raise awareness about the importance of patient safety and its impact on overall healthcare quality among all staff members and the patients they support.

Define cultural values

• Establish core values: define and communicate core values relating to patient safety, such as transparency, open communication, accountability and a commitment to continuous improvement.

Communication and training

• Training programmes: develop comprehensive training programmes for health teams at all levels. This should include training on patient safety, communication skills, teamwork and conflict resolution.
• Effective communication: Promote open and effective communication among healthcare teams. Encourage staff to voice concerns and report errors without fear of reprisal. This isn’t about putting your colleagues into the spotlight if they are underperforming, it is about improving standards and reducing blame.

Patient-centred care

• Patient involvement: involve patients in their decisions, making them active partners in the healthcare process.
• Empathy and compassion: emphasise empathy and compassion in patient interactions. Practitioners should understand and respect the unique needs and preferences of each patient.

Data and metrics

• Collect data: implement data collection systems to track patient safety metrics and outcomes.
• Feedback loops: establish feedback loops that allows colleagues to review and learn from incidents and near misses.

Accountability and reporting

• Accountability measures: define clear lines of accountability for patient safety at all levels of the organisation.
• Reporting systems: create systems for reporting adverse events, near-misses and safety concerns. Encourage a culture of reporting rather than blame. Encouragement can come through using corporate governance structures to ensure greater transparency and accountability.

Continuous improvement

• Quality improvement teams: form multidisciplinary quality improvement teams to identify areas for improvement and to implement evidence-based practice. These may already be in place in many organisations; however, sadly they may not or may not be fully utilised.
• Regular audits: conduct regular audits and reviews to ensure compliance with patient safety protocols.

Recognition and rewards

• Recognise achievements: acknowledge and celebrate successes and improvements related to patient safety. Raise awareness of your organisation and put yourselves up for national awards such as the annual HSJ awards. We often work in an environment and don’t realise we are doing great things that should be celebrated.

Sustainability

• Embed into the organisations culture: patient safety and a culture of continuous improvement should become ingrained in the organisational ethos and not just be a temporary initiative. Sustainability is key on achieving success.

External benchmarking

• Benchmark against industry standards: compare your organisation’s patient safety practices with industry benchmarks and best practices. Seek external guidance and certification if possible. (The Association for Perioperative Practice offer an Audit and Accreditation Programme to support the NHS and private sector.)

Feedback and adaptation

• Regular feedback: continuously seek feedback from patients, families and staff to adapt and refine your patient safety initiatives.

In part two, Dawn will give you tips on how to assess the culture of your organisation and establish a programme of standardisation.

About the Author

Dawn has worked in healthcare for around 30 years in many different roles.  She is a published author and a human factors/quality improvement consultant.  After 14 years, she recently stepped down from her role as AfPP CEO and is now – rather than putting herself out to pasture – pursuing
opportunities that are her passion.

She has an all-round understanding of healthcare from primary care commissioning through to secondary care interventions.  Some of her previous roles have included commissioning new hospital and GP surgery builds, IT implementation programmes, customer care, team building and leadership training strategies. She also has a strong knowledge of charities and the legalities around running a successful and sustainable charity. Along with a colleague she has recently started a Yorkshire Charity Leadership group to support senior leaders in charities. From experience she knows it can be quite lonely at the top.

Since ‘retiring’ Dawn has also joined the British Association of Day Surgery as their Lay Member. She is looking forward to supporting their values and strategy. Her philosophy is that kindness is infectious and should be at the core of everything we do, kindness can support change and encourage growth for everyone around you, so BE KIND.