Our Culture of Safety: A Colleague Speaks Up

In last week’s blog, I used the example of our volunteers in the GOR waiting room reminding me to wash my hands as an illustration that our culture of safety was improving. The fact that volunteers or others would feel comfortable stopping a senior executive is a great example of people feeling secure to do the right thing.

Well, one of our colleagues read the blog and sent me an email. Her message was clear (although she did not use these precise words): “Not so fast! We still have those that abuse their position on the authority hierarchy. Our safety culture needs more work”. She told me of instances where a very few physicians were still getting angry when a staff member, usually a nurse, stopped them if they were going to deviate from a procedure designed for safety. Our colleague was concerned that even a manager who confronted a physician who didn’t want to follow the rules would be at risk for retribution by administration.

I met with our colleague directly to reassure her that no one would suffer retribution if they “stopped the line” to get the safe practice followed. I also met with the manager who reassured me that she believed that she was safe in confronting anyone who wouldn’t follow a safety procedure but she was getting a bit tired of confronting a very small number of individuals.

I again thanked the manager for her hard work and I reassured our colleague that we would get all of our leaders involved and if individuals persisted in acting up, that there would be further action.

I know that almost all of our physicians and nurses are marvelous collaborators who treat their colleagues with respect every day. And I also know that the evidence is not always crystal clear and that there is room for honest debate about some of our safety procedures. We want our clinicians to speak up if they think a rule needs to be changed. But everyone needs to know that we shouldn’t debate the rule at the bedside of an individual patient (unless of course we have evidence that following the rule will hurt that patient). The correct approach is to follow the rule in the moment and then meet with the leader who can change the procedure. Those leaders are usually our clinical department chairs, our physician service line leaders and our nurse managers and directors working together as a team.
 
I did not intend last week to suggest that our culture of safety is now perfect – it clearly is not – but we have made progress. Now, we must unite as a family to make the culture even better to protect our patients and ourselves. We must respect those with differing opinions and channel them to effective forums where their voice can be heard and when appropriate, the procedure changed. But we must simultaneously stop abusive behavior even if the abuser believes that their intent is pure. We must always make it safe and comfortable for people to speak up.

National Doctors’ Day
This past Monday (Mar. 30th) was National Doctor’s Day. This is the one day of the year that we reflect on the many contributions made by our physicians. I want to thank all the doctors on the GBMC medical staff who work extremely hard to care for patients as they would want their own loved ones cared for. We have physicians throughout our healthcare system that are making a tremendous difference in the lives of patients every day.  From the surgeons and hospitalists to the ED physicians, primary care doctors and specialists all throughout GBMC, thank you for caring for patients and their families.

Town Hall Meetings
Starting next week, through the end of June, we will be holding a series of Town Hall Meetings. These meetings present an opportunity for direct and provide an opportunity to ask questions, raise issues and share ideas.  All are encouraged to attend a meeting!  The value of these meetings is directly related to your participation so we look forward to seeing you there! For more information please visit http://infoweb/body.cfm?id=23&action=detail&ref=614

Happy Holidays
On a final note, the GBMC HealthCare family sends its best wishes to everyone celebrating Easter this Sunday and the eight-day festival of Passover.