Most Hospitals Working Toward Creating Strong Cultures of Safety

One other point that this question brings up about building a culture of safety is the role that error reporting plays. Though it may not be a bad thing that only 4% of respondents attributed the occurrence of near misses or medical errors to why the culture of safety has been given more attention, it does open up the possibility that many hospitals do not have comprehensive error reporting systems in place.

"A hallmark of a strong safety culture is that it is a reporting culture," says Mary Voutt-Gous, RN, BSN, CCRN, director of patient safety initiatives for Henry Ford Health System in Detroit, MI. "That helps us identify weaknesses and prevent errors. High reliability organizations do that."

Voutt-Goos suggests that facilities step back and evaluate how their error reporting is used. If it's used as a weapon, it's likely that most staff members will not report when an error or near miss has occurred. Although most staff members would answer on a survey "yes, I'd speak up if I committed an error," most staff members can also identify scenarios in which it might be difficult to speak up when asked personally. Leadership actions can precipitate the environment that exists within a hospital.

"There's a disconnect between what they know is right to do, and what they're comfortable doing in specific environments," says Voutt-Goos. It is imperative that managers find out where those weak spots are and focus on building trust between leaders and front-line caregivers. Though staff members usually have patient care at the core of their daily jobs, there's definite concern about their own personal reputation and future at the facility.

"When you speak up, that can be viewed as a troublemaker, and that can impact your career," says Voutt-Goos. She suggests that hospitals make the act of speaking up and reporting errors less personal and create consistent policies about how those types of situations will be handled.