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Learning more about your patient-safety culture

Nurse Leader Weekly, July 16, 2004

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Many managers and leaders may think they have a good grasp of their organization's culture. However, there is frequently a significant chasm between what they think and what actually is. It's impossible to know where you need to go and what you need to do to get there if you do not have a clear understanding of where you are now.

Staff input is one of the best ways to determine the true culture of your organization and should be an essential component of your baseline data. A survey is one way to collect staff input, and a careful preparation is essential to ensure that you collect useful, relevant information.

First, identify your objectives. For the best results, your goals should include the following determinations:

• What knowledge of the present patient-safety efforts exists among the various disciplines?
• What barriers exist to creating a culture of reduced medical errors?
• What are employees' impressions of management support when errors are discovered?
• What is needed to accomplish change within your organization?
• What are employees' impressions regarding management's commitment to patient safety?
• Do people think your organization fosters a non-retaliatory environment where medical errors are concerned?
• Do they believe that your organization is truly committed to a patient safety program as opposed to creating a program to please the JCAHO?

Your survey's design will greatly effect your efforts. Remember the following tips:

• Keep it short. One page, rather than two or three, is sufficient. Consider including only questions that ask for the information you truly need.
• Offer anonymity, if desired, to the individual who completes it. Honest and open answers are easier to obtain if employees are not concerned about possible retribution.
• Provide drop boxes or preaddressed internal envelopes to further foster anonymity.
• Test your tool on a small group to ensure that your questions solicit the information you need.
• Use a multiple-choice format to decrease subjectivity in responses and to allow for specific collation of data to provide a good baseline for future comparisons.
• Give staff a heads-up. Explain to employees beforehand why you're conducting the survey, why it's important, and what you'll do with the results.

Once staff have completed and returned the surveys, you can begin to understand the true nature of the present culture of safety within your organization.

- Adapted from Briefings on Patient Safety (July 2004), published by HCPro, Inc.

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