Partnerships with Aviation: Promoting a Culture of Safety in Health Care

Abstract

According to the Institute of Medicine (IOM, 1999, p. 1), "Medical errors can be defined as the failure of a planned action to be completed as intended or the use of a wrong plan to achieve an aim." The current health care culture is disjointed, as evidenced by a lack of consistent reporting standards for all providers; provider licensing pays little attention to errors, and there are no financial incentives to improve safety (IOM, 1999). Many errors in health care are preventable. "Near misses" and adverse events that do occur can offer insight on how to improve practice and prevent future events. The aim of this article is to better understand underreporting of errors in health care, to present a model of change that increases voluntary error reporting, and to discuss the role nurse executives play in creating a culture of safety. This article explores how high reliability organizations such as aviation improve safety through enhanced error reporting, culture change, and teamwork.

A mixed-methods evaluation of the MOREOB program in Ontario hospitals: participant knowledge, organizational culture, and experiences

“…Specifically, the use of Crew Resource Management (CRM) training helps to flatten the hierarchy, minimize power differentials, and improve communication by training all crewmembers, regardless of role, seniority, or experience, to speak up with safety concerns [33, 34]. Parallels have been drawn between aviation and healthcare related to safety management [35, 36] and the application of CRM training in health care was recommended in the 1999 To Err is Human Report [5]. Examples of CRM in the field of obstetrics specifically can be found in the literature [7, 37–40].…”

Just Culture: The Foundation of Staff Safety in the Perioperative Environment

“…Staff members understand that personnel at all levels of the organization are committed to sharing feedback, insights, or other information to improve processes, address systems gaps, and make the environment safe 6,8 . A just culture represents a paradigm shift in health care that replaces the traditional mindset of using punitive measures, assigning individual blame, and applying penalties with a mindset of understanding that because health care is a complex industry, being accountable for safety is everyone’s responsibility 11,12 …”

New technology and the chain of safety

“…System errors can be reduced through teamwork and voluntary error reporting. 9 It is often a standard practice to have rigorous clinical processes in place when introducing new equipment or procedures into the healthcare environment, but we must look beyond this to the impact that equipment will have on the entire system-the hospital, the patient, the healthcare team, other equipment, and so on. Patient safety is one of the major pillars of a health centre's Quality Improvement Plan and thus should be a major consideration when deciding what equipment to purchase.…”