WORK FORCE I S SUE S
to gain the ‘bigger picture’ of operations.
– Just culture: high reliability organisations understand the importance of speaking openly about problems and fixing them without blame.
– Learning orientation: a focus on continuous technical training, open communications of accident investigation outcomes and regularly updating procedures in line with the organisational knowledge base.
– Mindful leadership: encourages regular engagement with staff and investing resources in safety management that balances profits with safety successfully.
l Introduce a just culture: Listed above as one of the attributes of a high reliability organisation, this resonates particularly at a time when leading healthcare organisations have written to Government Ministers, fearing the rise in litigation from COVID-19 deaths. They rightly argue it is fundamentally wrong that “healthcare professionals should suffer from the moral injury and long-term psychological damage that could result from having to make decisions on how limited resources are allocated, while at the same time being left vulnerable to the risk of prosecution for unlawful killing.”9
A just culture is fair treatment of staff that supports a culture of fairness, openness and learning by making staff feel confident to speak up when things go wrong, rather than fearing blame.10
Supporting staff to be open
about mistakes allows valuable lessons to be learnt so the same errors can be prevented from being repeated. Leaders who introduce a just culture strive to lead from the front with compassion, are visible – even virtually in these socially-distanced times – and make time to communicate change and help staff understand the reasons for change.
Hardwiring theory into everyday practice
Safeguarding caregivers requires investment in systems and processes that enable staff. For example, technology that automates processes to make life easier for clinicians while accurately recording patient incidents and successes. Leveraging the power of data is an ideal way to apply safety intelligence while driving high reliability and predictability around important caregiver safety processes. The latest patient safety technology is ideally situated to identify when a clinician is likely to be suffering from ‘moral injury’ that may lead to burnout. This gives leaders the intelligence they need to proactively, sensitively and appropriately reach out to caregivers, while providing the hard evidence to track the effectiveness of their support programmes. Data powers the systems and workflows that hardwire safeguarding theory into everyday practice.
In caring for the carers, regulators can take a pivotal role in ensuring that healthcare organisations apply the same processes, best practice principles and regulations of patient safety to the emotional well-being of clinicians and caregivers everywhere. If we want to avoid the predicted parallel pandemic of healthcare professionals that are too traumatised to carry on, as an industry, we need to act now.
CSJ
Reference 1
https://www.ncbi.nlm.nih.gov/pmc/articles/ PMC6224348/
2
https://www.bma.org.uk/media/3637/bma-covid- survey-results-all-doctors-dec-2020.pdf
3
https://www.nejm.org/doi/full/10.1056/ NEJMp2011027
4
https://jamanetwork.com/journals/ jamainternalmedicine/fullarticle/2588814
5
https://www.nejm.org/doi/full/10.1056/ NEJMp2024834
6
https://jamanetwork.com/journals/jamasurgery/
fullarticle/1107384
7
https://journals.lww.com/academicmedicine/ Fulltext/2016/09000/Peer_Support_for_
Clinicians__A_Programmatic.14.aspx
8
https://www.hse.gov.uk/research/rrpdf/rr899.pdf – ‘High Reliability Organisations’ by Dr Chrysanthi Lekka, Health & Safety Executive published in 2011
9
https://www.bbc.co.uk/news/uk-55689388 10 ‘A just culture guide’ published by NHS Improvement:
https://improvement.nhs.uk/ resources/just-culture-guide/#h2-about-our-guide
About the authors
Chief product officer, Phil Taylor, oversees the RLDatix’s product and development strategy. For the past 14 years, he has held a number of positions within the legacy Datix organisation and has a deep knowledge of the patient safety industry. Phil holds a BA from Manchester Metropolitan University and is a chartered accountant.
Chief patient safety and risk officer at RLDatix, Dr. Tim McDonald, MD JD, is an accomplished physician and attorney, with more than 35 years of experience in healthcare. By using the CANDOR approach, he has assisted over 500 hospitals and health systems worldwide implement a culture of ‘normalised compassionate honesty’ combined with the transformation to a ‘fair and accountable culture’ with a focus on hardwiring approaches to provide immediate and ongoing emotional first aid in the context of a care for the care giver programme.
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