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How HR Can Promote a Culture of Safety

By Lena J. Weiner  
   January 18, 2016

2.Institute Executive Walkarounds
Partner With: CEO, CMO, CNO, Department Leaders  

Hospital workers cannot trust executive leadership if they don't know them. Instituting executive walkarounds can help.

As a former Director of Safety at Brigham and Women's Hospital in Boston, Gandhi remembers how she and her colleagues were able to ensure communication among departments, the C-suite, and healthcare workers.

"I would go on walkarounds with a team of executives—usually the CEO, the CNO, and the CMO." Each week, they would choose a floor or department in the hospital to visit and they would talk to people who worked in each department.

The topics discussed would vary as the workers got to know the leaders better, but the discussions would usually come back to safety—both of workers and of patients. "Initially people were nervous, but then they talked about their concerns," Gandhi says.  

So that workers knew their concerns were not falling on deaf ears, the executive team would create plans to address them on the spot, whenever possible.  

The walkarounds helped show the hospital's frontline workers that they could talk about their concerns without getting punished. The program also helped to remind the executive team what life is like in the hospital's trenches—and that the job of a healthcare worker is not easy.  

3.Establish a Physician Compact
Partner With: CMO, Physician Leaders

To clarify expectations as to workers' attitude and behavior, some healthcare organizations are asking clinicians—especially physicians—to pledge in writing that they're committed to good behavior and patient care, says Gandhi.  

Known as physician compacts, these documents sets expectations for physician behavior at the hospital, establishing the importance of respect toward other physicians, nurses, hospital leadership, frontline workers, even housekeeping staff—but, above all, patients.

"Many leaders in safety say disrespect is a cancer that will prevent you from getting to a culture of safety," says Gandhi. While a physician compact is not legally binding, it does establish that the hospital expects physicians to act in a certain way.  

But even that's not enough. "Leadership must be committed," Gandhi says.

In turn, she suggests adding a clause to compact stating that when physicians see a process they feel could be improved or which they feel is unsafe, they will not be punished for bringing attention to it.

Gandhi suggests expanding these compacts to other workers as well. They "really set expectations around behavior," she says.

Lena J. Weiner is an associate editor at HealthLeaders Media.

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