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Showing results for tags 'Organisational culture'.
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Content ArticleIn this report, Exploring Freedom to Speak Up: Supporting the introduction of the Freedom to Speak Up Guardian role in Primary Care and Integrated Settings, the National Guardian's Office illustrates the challenges and benefits of implementing Freedom to Speak Up in different primary care settings. In 2019, the National Guardian’s Office began a two-year project working with primary care providers to understand how the Freedom to Speak Up Guardian role could be introduced in primary care and integrated settings. This report describes some of the variety of organisations, and the different Freedom to Speak Up models they have adopted.
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Content ArticleSafety governance refers to the approaches taken to minimise the risk for patient harm across an entity or system. It typically comprises steering and rule-making functions such as policies, regulations and standards. To date, governance has focused on the clinical level and the hospital setting, with limited oversight and control over safety in other parts of the health system. All 25 countries that responded to a 2019 OECD Survey of Patient Safety Governance have enacted legislation that aims to promote patient safety. These practices include external accreditation and inspections of safety processes and outcomes. Safety governance models are also moving away from punishment and shaming towards increased trust and openness. Learning from success as well as failures represents a paradigm shift in safety governance, an approach that has been increasingly adopted in OECD countries.
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Content ArticleJoe Rafferty, Chief Executive of Mersey Care NHS Foundation Trust, explains Mersey Care's strategy to pursue 'perfect care' and why it requires a cultural shift that is dependent on a paradigm shift in mind-set, behaviour and practice.
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Content ArticleThe Patient Safety Incident Response Framework (PSIRF) sets out the NHS's approach to developing and maintaining effective systems and processes for responding to patient safety incidents for the purpose of learning and improving patient safety It is intended to support one of the key aims of the NHS Patient Safety Strategy, to help the NHS improve its understanding of safety by drawing insight from patient safety incidents. This will replace the Serious Incident Framework with organisations expected to transition to PSIRF within 12 months of its publication, by Autumn 2023.
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Content ArticleSkip the inspirational speeches and culture committees. Meaningful culture change comes about only when companies rethink how they manage, lead, and pursue strategic goals, says Michael Beer in this Harvard Business School.
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Content ArticleImproving patient safety culture (PSC) is a significant priority for OECD countries as they work to improve healthcare quality and safety—a goal that has increased in importance as countries have faced new safety concerns connected to the COVID-19 pandemic. Findings from this OECD benchmarking work in PSC show that there is significant room for improvement.
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Content ArticleA recent survey has found that one in four doctors in the NHS are so tired that their ability to treat patients has become impaired. In this Guardian article, doctors reveal how tiredness, fatigue and sleep deprivation are affecting their ability to provide the best care for patients in the NHS.
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Content ArticleAlthough debate continues over estimates of the amount of preventable medical harm that occurs in healthcare, there seems to be a consensus that healthcare is not as safe and reliable as it might be. It is often assumed that copying and adapting the success stories of nonmedical industries, such as civil aviation and nuclear power, will make medicine as safe as these industries. However, the solution is not that simple. This article explains why a benchmarking approach to safety in high-risk industries is needed to help translate lessons so that they are usable and long lasting in healthcare. Five successive systemic barriers currently prevent health care from becoming an ultrasafe industrial system: the need to limit the discretion of workers, the need to reduce worker autonomy, the need to make the transition from a craftsmanship mindset to that of equivalent actors, the need for system-level (senior leadership) arbitration to optimise safety strategies, and the need for simplification. Finally, healthcare must overcome 3 unique problems: a wide range of risk among medical specialties, difficulty in defining medical error, and various structural constraints (such as public demand, teaching role, and chronic shortage of staff). Without such a framework to guide development, ongoing efforts to improve safety by adopting the safety strategies of other industries may yield reduced dividends. Rapid progress is possible only if the health care industry is willing to address these structural constraints needed to overcome the 5 barriers to ultrasafe performance.
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Content ArticleThe “WHO handbook for national quality policy and strategy” outlines an approach for the development of national policies and strategies to improve the quality of care. Such policy and strategy can help clarify the structures, roles and responsibilities within national quality efforts, support the institutionalisation of a culture of quality, and secure buy-in from health system leaders and stakeholders. The handbook is not a prescriptive process guide but is designed to support teams developing policies and strategies in this area, and very much recognizes the varied expertise, experience and resources available to countries. It outlines eight essential elements to be considered by teams developing national quality policy and strategy: national health goals and priorities; local definition of quality; stakeholder mapping and engagement; situational analysis; governance and organizational structure; improvement methods and interventions; health management information systems and data systems; quality indicators and core measures. The NQPS handbook was co-developed with countries each finding themselves at different stages of the development and execution of national quality policies and strategies and was informed by the review of a sample of more than 20 existing quality strategies across low-, middle- and high-income countries globally.
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Content ArticleBurnout is a serious problem for clinicians as well as the patients who rely on them for safe care, and the challenge has only been compounded by the stresses and trauma of the pandemic. A recent study by Pearl et al. showed that healthcare administrators could use a single survey item to see how their clinicians are doing. The question it asked was, “Are there individuals at your work location who are so burned out that the quality or safety of research, clinical care, or other important work product is impacted?” The respondents’ perception of the impact of burnout on quality safety of healthcare was self-reported using a 5-point system, ranging from 1 (“no burnout or it doesn’t impact safety and quality”) to 5 (“a serious impact on quality and safety”). This nonproprietary, single-item burnout-impacting safety scale showed a sensitivity of 82% using 4 on the scale as a cutoff (“there is quite a bit of impact of burnout on safety and quality”), indicating this tool may be effective in helping determine what healthcare providers may be at high risk for safety events affecting patients.
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Content ArticleIn this opinion piece for The Hill, the authors argue that urgent action is needed to prevent huge amounts of avoidable harm in the American healthcare system. They point to successful strategies under the Obama administration to demonstrate that the right political will can both improve patient safety and save money. They highlight actions that policy makers, official bodies and patients should take to promote the patient safety agenda.
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Content ArticleThe wellbeing of NHS staff is now recognised as a priority, as evidenced by the introduction of Wellbeing Guardians into the NHS. The NHS needs to appoint a National Wellbeing Guardian to provide a leadership role for the work of these guardians, and more generally to actively promote wellbeing in NHS staff, write Narinder Kapur, Christian Harkensee and Terry Skitmore in HSJ.
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Content ArticleThe importance of employee voice—speaking up and out about concerns—is widely recognised as fundamental to patient safety and quality of care. However, failures of voice continue to occur, often with disastrous consequences.
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Content ArticleWith a global nursing workforce shortage upon us, governments and health system decision makers are becoming alarmed at the potential risk to service delivery if solutions are not found. However, nurses know that what constitutes the fundamental threat to a healthy healthcare system is not the hard work of nursing, but rather the demoralizing conditions under which many nurses strive to practise their profession. This commentary examines the context for some of those conditions and encourages a collective commitment to articulating our vision for the profession in a manner that is sufficiently forceful to be effective.
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Content ArticleClinical and nonclinical staff at the Rotterdam Eye Hospital have improved patient care and raised staff morale at a very modest cost: 10 minutes a day and a special deck of cards. At the start of every shift, the team members get together for a brief “team-start.” Each team member rates his or her own mood as green (I’m good), orange (I’m okay but I have a few things I’m concerned about) or red (I’m under stress). The rest of the team doesn’t need to know that you’re under stress because you’re having a dispute with your landlord or you are worried about your ill toddler. How you feel, however, is important because it affects how you should be treated. Next, the team leader asks if there is anything in particular the team needs to know to work more effectively together that shift: For example, “Is there a delay in public transport so we can expect patients to be late for their appointments?,” or “Is there a patient with some kind of special need coming in?” Sharing the answers or results generated by the card questions and activities with the group ensures that the insights stick.
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Content ArticleDoctors and other healthcare professionals are often trained to mask their emotions. The argument is that patients trust them when they “act professional.” But that model of health care leadership is changing, write Roel van der Heijde and Dirk Deichmann in this opinion piece. Roel van der Heijde is a trainer in fear reduction and vulnerable leadership for several hospitals and nursing homes in The Netherlands and a partner at Patient-Centered Care Association in The Netherlands. Dirk Deichmann is an associate professor at Erasmus University’s Rotterdam School of Management.
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Content ArticleListen for weak signals to avert potential disasters, urges Columbia Business School professor, Rita Gunther McGrath. We’ve all heard the stories. The multi-patent-holding chemist at Kodak who warned of the digital revolution. The experienced research and development person at Nokia who pointed out that the bean counters had taken over and the company couldn’t get new products out the door anymore. The scary-smart top engineers at General Electric who urged the company to bet on renewable energy rather than tying its fortunes to fossil fuels. It’s nearly always the case that someone, somewhere, saw a significant inflection point coming and tried to warn the ‘powers that be’ – to little avail. Ignoring these warnings imperils everyone. And yet, it happens over and over again. Let’s explore why, and what you as a leader might do about it.
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Content ArticleNHS England has set out 10 priorities for the 2022-23 financial year in its annual planning guidance. NHSE chief executive Amanda Pritchard makes clear in the introduction that many of its goals remain contingent on covid, stating: ”The objectives set out in this document are based on a scenario where covid-19 returns to a low level and we are able to make significant progress in the first part of next year.”
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Content Article
ECRI's Risk Assessment
Patient Safety Learning posted an article in Improving systems of care
Keeping patients and staff safe is a top priority for every healthcare organisation. Leaders must be vigilant in continually monitoring, measuring, and improving risk, as well as identifying processes, environments, cultures and other factors affecting patient safety and organisational performance. ECRI’s Risk Assessments provide an efficient web-based solution for conducting such evaluations. These assessments collect multidisciplinary safety perspectives—from front-line workers to the executive suite—with reporting and analysis dashboards to help identify opportunities for improvement. -
Content ArticleClinician burnout in healthcare is a growing area of concern, especially as the COVID-19 pandemic stretches on. Research from the U.S. Department of Veterans Affairs and Regenstrief Institute looked at ways organisations can address burnout.
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Content ArticleHealthcare leaders are bringing renewed attention to patient safety issues that have been overshadowed by another year of the COVID-19 pandemic. Becker's Hospital Review asked patient safety experts the following question: "If you could fix one patient safety issue overnight, what would it be and why?" Read the answers Cynthia Barnard, Vice President of Quality at Northwestern Memorial Healthcare (Chicago), Patricia McGaffigan, Vice President of Safety Programs at the Institute for Healthcare Improvement, Ana Pujols McKee Vice president and CMO and Chief Diversity, Equity and Inclusion Officer at The Joint Commission and Gary Stuck, CMO at Advocate Aurora Health gave.
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Content ArticleRacially and ethnically minoritised healthcare staff groups disproportionately experience and witness workplace discrimination from patients, colleagues and managers. This is visible in their under-representation at senior levels and over-representation in disciplinary proceedings and is associated with adversities such as greater depression, anxiety, somatic symptoms, low job satisfaction and sickness absence. In the UK, little progress has been made despite the implementation of measures to tackle racialised inequities in the health services. Drawing on qualitative interviews with 48 healthcare staff in London (UK), Woodhead et al. identified how micro-level bullying, prejudice, discrimination and harassment behaviours, independently and in combination, exploit and maintain meso-level racialised hierarchies.
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Content ArticleNorthumbria Healthcare NHS Foundation Trust were awarded the Freedom to Speak Up Organisation of the Year Award at the 2021 HSJ Awards with their demonstration of an integrated approach to speaking up. Kirsty Dickson was appointed as the first Freedom to Speak Up Guardian at Northumbria, following recommendations in the Francis Report. Since then, she has been working proactively to make sure that Freedom to Speak Up is woven into the fabric of the organisation.
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Content Article
4th Learning from Excellence Conference videos (8 October 2021)
Sam posted an article in Improving patient safety
The theme for the 4th Learning from Excellence Community Event was “Being better, together”, reflecting LfE's aspiration to grow as individuals, and as part of a community, through focussing on what works. For this event, LfE partnered with the Civility Saves Lives (CSL) team, who promote the importance of kindness and civility at work and seek to help us to address the times this is lacking in a thoughtful and compassionate way, through their Calling it out with Compassion programme. -
Content ArticlePandemic and backlog pressures may make candour more challenging but do not make it any less essential, the panel at a recent HSJ webinar argued.
