A Total Systems Safety Approach Can Help Navigate Healthcare Emergencies
The Institute for Healthcare Improvement
( IHI ) acknowledges that the existing stressors within the healthcare sector have been exacerbated by the COVID-19 pandemic but emphasizes that a return to a pre-pandemic state of safety is essential to reliable care : “ Our recovery trajectory requires long-term , intensive focus to create , rebuild , and sustain the foundations for safe care .”
One strategy for combating the fall-out from a pandemic or other major impact , the IHI suggests , is for healthcare organizations to examine their culture of safety beyond patient care to a total systems approach . Propelled by clinical risk management and medical error prevention , progressive healthcare providers can embrace an organizational culture that actively supports a total systems approach to safety , the IHI says .
In May 2022 , the IHI issued a declaration to advance patient safety on behalf of the National Steering Committee for Patient Safety ( NSC ). The IHI convened the NSC as a collaboration among 27 national organizations committed to advancing patient safety .
As the declaration document states , “ Together , the persistence of longstanding
challenges to patient safety and worrisome setbacks in patient and workforce safety performance during the COVID-19 pandemic have amplified the critical need for all healthcare leaders to take urgent action . It is the responsibility of every executive and governance leader in healthcare to commit to the moral , non-negotiable core value of safety for all and to foster collective action to uphold this value . These actions should establish safe , equitable , and reliable care as a central theme in the organization ’ s mission , the core competencies of leaders , and standard ways of working .”
Total systems safety involves four key areas , according to the IHI :
1 . Culture , leadership , and governance . The IHI ( 2022 ) says that “ Leaders greatly influence organizational culture by defining and demonstrating set values and norms that guide behavior and activity within the organization . Assessing organizational culture is one way to feel its pulse and identify what and if changes are needed … assessing organizational culture is just the beginning . Establishing priorities for action , identifying and implementing resources , and communicating with staff are key to enabling a true culture of workplace safety .”
2 . Patient and family engagement . Facilitating equitable engagement of patients and their support persons in the coproduction of care has proven to improve overall care outcomes and perceived value of care to the consumer .
3 . Workforce safety . As the IHI ( 2022 ) acknowledges post-pandemic , “ Never has it been so critical to build a healthy work environment that fosters joy and a genuine concern and accountability for the physical and psychological wellbeing of staff .” Advancements in the development of resources to support workforce health and safety include the National Plan for Health Workforce Wellbeing published by the National Academy of Medicine and the Total Worker Health approach developed by the National Institute for Occupational Safety and Health ( NIOSH ).
4 . Learning systems . Shifting from a reporting system to a system that fosters a continuous learning approach . According to the IHI ( 2022 ), “ Learning systems are organizational processes that integrate information , such as adverse events , clinical
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