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Showing results for tags 'Organisational culture'.
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Content Article
A survivors guide to whistleblowing (19 January 2021)
Patient Safety Learning posted an article in Whistle blowing
This blog asks: What is a whistleblower? Why do whistleblowers endure all forms of retaliation for the sake of truth? What does the whistleblower's cycle of abuse often look like? How to blow the whistle without blowing your career? What might non-disclosure agreements settlements include? What do whistleblowers say about whistleblowing? What can be done to protect whistleblowers? -
Content ArticleThis issue of Hindsight concerns ‘the new reality’ that we are facing. It includes a wide variety of articles from frontline staff and specialists in safety, human factors, psychology, aeromedical, and human and organisational performance in aviation. There are also insights from healthcare, shipping, rail, community development and psychotherapy.
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Content Article
Safe to speak up? NHS Staff Survey Results 2021
Patient Safety Learning posted an article in Culture
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In this blog, Patient Safety Learning analyses the results of the NHS Staff Survey 2021, specifically focusing on responses relating to reporting, speaking up and acting on safety concerns. It reflects on the importance of staff feeling able to speak up about patient safety incidents and the implications when this is not the case. It describes the NHS’s current approach to creating a patient safety culture and emphasises the need for NHS England and NHS Improvement, in partnership with the National Guardian and Care Quality Commission, to bring forward robust and specific commitments to drive this work forward. -
Content ArticleThis report published by the National Guardian’s Office shows the experience of Freedom to Speak Up Guardians amid the continued pressure of the pandemic on the healthcare sector. Although the majority of guardians who responded to the survey were positive about the culture of their organisation, the results highlight a decline in factors that make it easy for staff to speak up, including support from leadership.
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Content Article
In this blog Patient Safety Learning sets out its initial response to the report of the Independent review of maternity services at Shrewsbury and Telford Hospital NHS Trust (also known as the Ockenden Maternity Review).- Posted
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Content Article
NHS Staff Survey Results 2021 (30 March 2022)
Patient-Safety-Learning posted an article in Culture
The NHS Staff Survey is one of the largest workforce surveys in the world and is carried out every year to improve staff experiences across the NHS. It asks staff in England about their experiences of working for their respective NHS organisations. 648,594 staff responded to the survey this year. The full results of the 2021 NHS Staff Survey are published on the NHS Staff Survey website. -
Content ArticleAt the moment, we’ve got maternity scandals day in, day out, which are pure evidence of the fact that our maternity units are just not up to scratch. They’re unsafe for mothers, unsafe for babies, and that is not acceptable. Suzanne White, a former radiographer and a clinical negligence lawyer for the past 25 years, looks at the maternity safety scandals across the NHS and considers if any lessons have been learnt.
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Content ArticleAlthough leaders might say they value inquisitive minds, in reality most stifle curiosity, fearing it will increase risk and inefficiency. Harvard Business School’s Francesca Gino elaborates on the benefits of and common barriers to curiosity in the workplace and offers five strategies for bolstering it.
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Content ArticleThe positive deviance approach seeks to identify and learn from those who demonstrate exceptional performance. This study from Baxter et al. sought to explore how multidisciplinary teams deliver exceptionally safe care on medical wards for older people. Based on identifiable qualitative differences between the positively deviant and comparison wards, 14 characteristics were hypothesised to facilitate exceptionally safe care on medical wards for older people. This paper explores five positively deviant characteristics that healthcare professionals considered to be most salient. These included the relational aspects of teamworking, specifically regarding staff knowing one another and working together in truly integrated multidisciplinary teams. The cultural and social context of positively deviant wards was perceived to influence the way in which practical tools (eg, safety briefings and bedside boards) were implemented. This study exemplifies that there are no ‘silver bullets’ to achieving exceptionally safe patient care on medical wards for older people. Healthcare leaders should encourage truly integrated multidisciplinary ward teams where staff know each other well and work as a team. Focusing on these underpinning characteristics may facilitate exceptional performances across a broad range of safety outcomes.
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Content Article
Civility Saves Lives Infographics
Patient Safety Learning posted an article in Good practice
Civility Saves Lives have created a number of infographic each with a key message of civility. A selection are shown below and more can be found through the link at the bottom of the page. -
Content Article
How are Trusts measuring safety culture? A blog from Annie Hunningher
Annie Hunningher posted an article in Culture
Annie Hunningher highlights the difficulties in measuring an organisation's safety culture and the lack of validated measurement tools available.- Posted
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Content ArticleAn introduction to Appreciative Inquiry from NHS England and some team-based exercises for staff.
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Content ArticleSafety culture refers to the way patient safety is thought about, structured and implemented in an organisation. Safety climate is a subset of this, focused on staff attitudes about patient safety. In recent years, a great deal of research has explored ways to measure safety culture and safety climate in health care. There is a growing emphasis on interventions to improve organisational safety culture and staff attitudes towards safety. It is assumed that improving safety culture will directly or indirectly affect patient outcomes. This evidence scan examines whether there is any empirical evidence to support this assumption.
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Content Article
Safety culture discussion cards (Eurocontrol)
Patient Safety Learning posted an article in Good practice
Safety culture has been shown to be a key predictor of safety performance in several industries. It is the difference between a safe organisation and an accident waiting to happen. Thinking and talking about our safety culture is essential for us to understand what we do well, and where we need to improve. These cards from Eurocontrol are designed to help us to do this. -
Content ArticleThe Maternal and Neonatal Health Safety Collaborative (MNHSC), is providing each maternal and neonatal service with an opportunity to assess their safety culture as part of the programme of improvement work across England. Organisations within each wave of the collaborative will be given the opportunity to undertake a culture survey, and then a repeat survey after 12-18 months. The culture of an organisation, team and staff attitudes can have a tangible impact on patient safety and outcomes. There is great value in assessing the safety culture; the results can inform the local improvement plans. The organisation will be supported through the process. This document explains more about the SCORE survey, what it measures, and what it means for the team and improvement projects.
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Content ArticleThis article in The Journal of Post-Acute and Long-Term Care Medicine looks at the issue of systemic racism in long-term services and supports (LTSS) including nursing homes and home- and community-based care in the USA. The authors highlight segregation and disparities, with Black, Indigenous, and persons of colour (BIPOC) users having less access to quality care and reporting poorer quality of life. The authors make a number of policy recommendations to address these health inequalities in LTSS: Targeted increases to Medicaid reimbursement tied to direct care, and targeted enhanced Medicare and/or Medicaid reimbursement to LTSS providers that serve a disproportionate share of Medicaid or underserved older adults. Pay for performance incentives should focus on improving care among LTSS providers who serve individuals with disadvantaged status because of systemic racism and that operate above and beyond a person's clinical severity and comorbidity. The Centers for Medicare & Medicaid Services (CMS) should develop an overall health equity measure which would help capture how well providers meet the needs of diverse populations. Care Compare quality scores by race and ethnicity should be used internally and shared with states to develop culturally appropriate policies. Race and ethnicity-specific quality measures should be included on state-level report cards to incentivise action among states and tailor solutions to the local context. Promote culture change in nursing homes, with an ultimate goal of creating a person-centred, homelike model of care. Expand access to Medicaid-waivered home- and community-based services. Ensure that home- and community-based services are culturally appropriate. Promote integrated home- and community-based programs that can be targeted to BIPOC users to address existing disparities in outcomes.
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Content Article
Five fundamentals of civility
Patient Safety Learning posted an article in Good practice
Graphic showing the five fundamentals of civility. -
Content ArticleIncivility in the healthcare system can have an enormous negative impact and consequences. In contrast, civil behaviour promotes positive social interactions and effective workplace functioning. This article focuses on the first two fundamentals of the five fundamentals of civility: respect and self-awareness.
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Content ArticleThrough her work on a range of different elements of the Midlands leadership learning offer, Emma Coller has had great success in facilitating the development of the leadership skills and behaviours needed for positive change. Here she shares her insights on the appreciative inquiry process and how it works.
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Content ArticlePeople like being treated well. A civil approach to relationships in the healthcare workplace – any workplace – has merit, but there are many questions to explore. While most doctors interact with others in a civil manner most of the time, anyone can experience lapses occasionally. When the many dimensions of civility are considered more closely, it appears that there is much that can be learned about the causes of incivility and the strategies that can be adopted to foster civil behaviour, even at times of risk. Physician Health Programme offers a series of articles below as Five Fundamentals of Civility for Physicians.
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Content ArticleMeasures of patient safety culture from the perspective of health workers can be used – along with patient-reported experiences of safety, traditional patient safety indicators (see indicator “Safe acute care – surgical complications and obstetric trauma”) and health outcome indicators (see, for example, indicator “Mortality following acute myocardial infarction”) – to give a holistic perspective of the state of safety in health systems.
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Content Article
Crossword counterpoint: glimpses of NHS whistleblowing terrain
Hugh Wilkins posted an article in Whistle blowing
This blog is prompted by a recent newspaper crossword in which one of the clues, quadruplicated, was 'Whistle-blower'. The four answers were, respectively, 'canary', 'snitch', 'telltale' and 'betrayer'. The blog draws attention to negative perceptions of whistleblowers in the eyes of some people. It emphasises how wrong these perceptions are and how damaging this can be, with serious patient safety implications. In this blog I provide a crossword counterpoint (attached below to solve), which seeks to support learning about the realities of hostility against some staff who speak up in the NHS. I will share a follow-up blog which contains the solution to this crossword and seeks to provide further education on this topic where there is so much confusion and misunderstanding. -
Content ArticlePeter Duffy’s first book 'Whistle in the Wind' detailed his whistleblowing to the Care Quality Commission and General Medical Council about deteriorating clinical and surgical standards in a National Health Service Trust in England. In Peter’s new book ‘Smoke and Mirrors’ he speaks about "the corrupt, disorientating and Orwellian world into which the vulnerable, naive and solitary whistleblower stumbles." What truth he speaks; in this sequel to his incredibly important exposure of whistleblowing retribution at Morecambe Bay’s NHS Trust he reveals the depths to which those trusted with IT services in the NHS will go to defame and smear an employee who dares to speak the truth. Peter’s courage and tenacity against those who have tried to destroy him provides valuable insight and a guiding light for all those who may find themselves in a similar position fighting toxic management in the NHS.
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Content ArticlePromoting a ‘just culture’ is a key theme in patient safety research and policy, reflecting a growing understanding that patients, their families and healthcare staff involved in safety events can experience feelings of sadness, guilt and anger, and need to be treated fairly and sensitively. There is also growing recognition that a ‘blame culture’ discourages openness and learning. However, there are still significant difficulties in listening to and involving patients and families in organisations' responses to safety incidents, and for healthcare staff, a blame culture often persists. This can lead to a sense of sustained unfairness, unresponsiveness and secondary harm. The authors of this article in BMJ Quality & Safety argue that confusion about safety cultures comes in part from a lack of focused attention on the nature and implications of justice in the field of patient safety. They make suggestions about how to open up a conversation about justice in research and practice.
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Content ArticleThe West Suffolk Review, commissioned by NHS England on behalf of the Department for Health and Social Care, was published last month. NHSE/I asked the West Suffolk Board to produce an action plan for the 28 January meeting of the Board of Directors. This paper summarises the current position in relation to the learning, reflection and response thus far, including the organisational development actions that have already been taken and require further embedding. It also highlights the engagement undertaken to date, and what more needs to happen, to ensure our plans are based on the priorities for staff, governors, patients and teams and can carry the confidence of stakeholders. The report, 'West Suffolk Review – organisational development plan (p. 217)', sets out nine broad themes of work, linked to the trust’s core functions, “that capture the priority areas for organisational and cultural development at WSFT in light of the learnings from the report”. The document sets out how the trust’s governance, freedom to speak up, HR, staff voice, patient safety and other parts of its corporate infrastructure failed and contributed to a scandal.
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