Organizational Enabling Factors

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Organizational Enabling Factors

Organizational enabling factors impact all members of an organization or department to a similar degree. (e.g. hospital, emergency department, cardiac unit, ICU).

 

LEADERSHIP COMMITMENT AND PRIORITIZATION OF SAFETY

Definition: Leadership is perceived to hold a priority of safety over all other performance goals (e.g., profit, speed). Creating a culture of safety within an organization is driven by the leadership. A patient-focused safe culture involves a committed leadership that prioritizes excellence in patient care without causing unintended harm.

When leadership is perceived to hold a priority of safety over all other performance goals (e.g., profit), individuals in the organization may be more likely to engage in patient Safer Culture. This may be because employees tend to adopt safety-related behaviors from their leaders, perceiving them to be role models (Brown, Treviño, and Harrison, 2005; Hofmann & Morgeson, 1999).

Indication/Reflection of Culture Factor: Governing boards, executive leaders, and unit leaders all verbalize and demonstrate a commitment to safety

Healthcare examples of leadership commitment and prioritization to safety:

• Implementing intervention/s which decrease NICU length of stay despite experiencing a loss of revenue – prioritizing safety and quality
• Enforcing the 39 week rule-limiting induction may lead to losing a private practice physician but it is safer for patients
• Multidisciplinary participation including patient/family input occurs in all committees and activities

Tools to support leadership commitment and prioritization of safety:

• IHI boards on board

 

• Leading a Culture of Safety, a Blue print for Success

 

• Road map to a perinatal patient safety assessment tool

 

POLICIES AND RESOURCES FOR SAFETY

Definition: Safety-related policies and resources provided by the organization (e.g., training resources, maintained equipment, safety policies and protocols).

 

In addition to managerial commitment and prioritization of safety, healthcare personnel may be more willing to adopt and contribute to a patient Safer Culture when the organization provides sufficient policies and resources about safety-related issues. By establishing specific policies to reduce risk, organizations signal to employees the importance of safety. Hospitals should also have resources such as data analysts with an expertise in safety science, who can access data used to monitor and improve safety, process improvement, and leadership development.

 

Indication/reflection of culture factor: The organization has policies intended to support the delivery of safe patient care such as policies about just culture, safety event reporting, behavior expectations, and evidence-based safety practices. Resources would include support for data analysts who can access data in the EHR to monitor and improve safety, expertise in safety science, process improvement, leadership development, etc.

 

Healthcare examples:

• Policies are reviewed in a timely manner to reflect changes in best practice.
• Staff have access to equipment necessary to promote safe patient care.
• Budget is allocated for staff training on safety and quality improvement.
• Policies are in place to support staff escalation of serious patient safety concerns.

Tools: (Links to be included)

• Pathway for postpartum care (MH)

Patient/family advisory councils