The 4 Pillars Of A Culture Of Safety In Healthcare

Mary McClinton was a patient admitted to the hospital for a routine medical procedure. She has full confidence in her healthcare providers and is looking forward to returning home after the procedure and spending precious time with her family and grandchildren. Unfortunately, that is not the case.

She died during the procedure due to medication error. She was injected with chlorhexidine, a chemical antiseptic used to clean the skin, instead of another local IV injection. Both liquids were colorless, but the receptacles of the medication were not labeled, leading to a mix-up and fatal medication error.

Unfortunately, medical errors still occur in healthcare and healthcare organizations are working towards zero harm, but we still have a long way to go. Patients come to the hospital worried about their medical condition and its impact on their livelihood and their families. They put complete trust in medical providers. The last thing they expect is for them to be harmed or killed by medical errors.

That is why it is essential for organizations to develop a safety culture.

Let’s start with a definition of what a culture of safety is


Many of you have heard different definitions, but the one I like is short and simple: A culture of safety is how a healthcare organization and the people who work in it behave when no one is watching.

So, what does this mean?

Patient and workforce safety is embedded as a core value from the top of the organization to frontline staff and they will not take any shortcuts to compromise patient safety for productivity.

Let’s see how an organization can build a safety culture.

Organizations must build 4 strong pillars to support a safety culture

Healthcare professionals work together to address a safety issue


,Pillar #1: Psychological Safety. When frontline staff are empowered and not afraid to speak up. They are not punished or shamed, but praised for bringing out security concerns. Mental safety leads to better brainstorming, more possibilities, better evaluation and testing of ideas, and a faster cycle of learning. Staff are more valued and respected. This leads to employee engagement. Teamwork thrives in an organization with psychological safety.

Pillar #2: Active Leadership. Leadership in an organization uses strategies and has the skills to enhance staff engagement, staff development and staff well-being. A leader’s words resonate with their actions. Some important leadership skills are communication skills, creating a purposeful culture, giving employees a voice, developing a reward system, supporting career development, and promoting employee well-being.

Pillar #3: Transparency. This is where open communication thrives in an organization. Security information is shared with all stakeholders leading to increased trust. Transparency is used as a vehicle for learning in this organization.

Pillar #4: Fairness. This is where people are evaluated for their actions with the same lens regardless of their position and titles. Everyone is treated equally and fairly in the system.

When an organization develops all four of the above pillars, it has laid the groundwork to support a culture of safety.

If you would like to talk to me more about how to build a culture of safety in your healthcare organization, I can be reached by email sa7860@comcast.netor on LinkedIn.

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