Two years of training on team communication, leadership, and decision-making practices raised the perception of a culture of safety among employees of one Ohio medical center.
As the saying goes, "It's only a mistake if you don't learn from it." This philosophy of continual improvement is key in creating an organizational culture of safety to help reduce medical errors.
Organizations with strong safety cultures are places where individuals can report errors or near misses without punishment, where interprofessional collaboration to find solutions to patient safety problems is encouraged, and where there are dedicated resources to address safety concerns, according to the Agency for Healthcare Research and Quality.
A study, published in the American Journal of Medical Quality, has found that crew resource management (CRM) is one way to improve the perception of a culture of safety by hospital employees.
CRM is a training program that came from the airline industry and focuses on team communication, leadership, and decision-making practices.
The Ohio State University Wexner Medical Center is an academic medical center with more than 1,300 beds. Two years after implemented CRM at its six hospitals and two campuses, employees' perceptions of the organization's patient safety culture showed improvement.
Training consisted of day-long retreats where leaders and staff developed CRM safety tools such as checklists and standard protocols.
There was also role-playing around conflict management, respectful cross-checking, and assertive statements. System-wide internal monitoring processes were developed to evaluate adoption and use of safety tools as well as the occurrence of avoidable events.
Results
In 2011, the AHRQ's Hospital Survey on Patient Safety Culture was given to all employees before CRM implementation. In 2013, after receiving CRM training and using its concepts for about 2 years, employees were reassessed and reported:
- A 9% increase in organizational learning/continuous improvement
- A 9% increase in frequency of mistakes reported, enabling employees to address potential safety issues
- An 8% increase in communication openness
- A 6% increase in teamwork within departments
- A 4% increase in teamwork across departments
Based on these results, "cultural transformation is possible," write the study's authors, but it takes dedication from an organization's leaders.
"To be ultimately successful with a large-scale program of patient safety culture transformation, continual leadership engagement and endorsement is needed," the study concluded.