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A new study of innovative patient-safety programs found an overriding “culture of safety” that transcends the six different initiatives analyzed.
“Almost everyone that gets into this business comes to believe that a culture of safety is a critical factor in changing organizational performance regarding the safety of patients,” said study co-author and health-policy expert David Blumenthal, MD.
The analysis offers health-system managers insight into the triumphs and challenges of colleagues who have tested initiatives to promote patient safety. It appears in the current issue of Milbank Quarterly, which tracks trends in healthcare policy.
Co-author Douglas McCarthy is president of Issues Research, an independent policy research firm based in Durango, Colo. Blumenthal is director of the Institute for Health Policy at Massachusetts GeneralHospital.
In 2000, the Institute of Medicine released the report, “To Err Is Human: Building a Safer Health System,” which found “a substantial body of evidence points to medical errors as a leading cause of death and injury.” The report recommended the creation of safety systems in health care organizations.
The Milbank study authors use a definition of safety culture originated by human-error guru James Reason. The hallmarks of a culture of safety include a climate where “people are prepared to report their errors and near-misses” and a just atmosphere where there is clear line between “acceptable and unacceptable behavior.” An environment that promotes safety is a flexible culture that emphasizes teamwork
