When Alice Watt thinks about protecting patients from errors, she pictures a goalie stopping a hockey puck from getting into the net. Goalies depend on good defence to help stop the puck. Prior to and throughout the pandemic, pucks have been flying at all of us. We’re all trying to do the best we can to work together. To stop pucks from getting into the net, we need to protect both the goalie and the patient.
Alice, a hospital pharmacist and senior medication safety specialist with ISMP Canada, recently participated in Healthcare Excellence Canada’s Spotlight Series, a collection of webinars that explore innovative approaches to safety and quality improvement in healthcare. In All for One and One for All: How patient safety starts with healthcare workers, Alice and other panelists discussed the connection between worker health and safety and that of their patients.
Any risks to healthcare provider safety also heightens the risk of patient harm, and a safe workplace is the bedrock of a well-functioning healthcare system. The pandemic, however, is causing record levels of stress and burnout in the workplace. Promoting well-being and safety in the workplace— beyond preventing harm—is a starting point for creating proactive strategies that promote healthy work environments and protect patients.
Safety starts from within
Michael Gardam, CEO of Health PEI, is passionate about the bold new direction articulated in the organization’s strategic plan. One of its four main goals is to “establish a healthy, safe and high–performing workplace that supports and develops our people.” Michael’s mantra is that you won’t make progress on improving patient safety initiatives until you focus on staff safety initiatives.
To help build that sense of safety among staff, Michael says it’s important to move beyond a top-down approach. For example, when addressing a specific concern regarding workplace safety, he looks for diverse opinions and invites people who disagree with him into the conversation. This is essential for understanding the different types of experiences staff are facing and how they’re impacted.
Questions shape conversations
Clear communication is always top of mind for Danielle Bellamy, Director of Continuing Care, supporting Long Term Care homes in 11 communities in Saskatchewan. She strives to support her healthcare teams and help them focus on patient care. Knowing your organization’s workplace culture and where and how you can focus on improvements efforts is key. Daily huddles – short, stand-up meetings of 10 minutes or less – were established to help create connection among staff.
Healthcare Excellence Canada’s Measurement and Monitoring of Safety Framework was a tool to help them shape their conversations. In the huddle, questions like “what's going on today, are we safe, what do we need, and how are we changing what we're doing at this moment” are asked to enhance the focus on safety for patients and staff.
Engage patients in their care
Patient advocate and member of Patients for Patient Safety Canada, Wendy Nicklin recognizes the substantial stress that the pandemic and concurrent staff shortages have put on healthcare providers and the entire system. She says it's the perfect storm. Patients and families are hyper-vigilant when using the healthcare system. They know that the added stress and declining quality of care can increase the risk of adverse events occurring.
Now, more than ever, active engagement of patients and families (virtually or in-person) in their care is essential. Patients/families should inform their care provider if they see anything that could lead to a patient safety incident. Care providers should be candid with patients/families and inform them of any issues that may have an impact on their care plan and encourage them to speak up if they notice anything is missing.
Use networks to share learnings
For Alice Watt, developing a medication safety game plan at the onset of the pandemic was a critical step towards protecting staff from exposure and inadvertently transmitting COVID to others. And she’s not the only one doing it. Community pharmacists across the country are tapping their networks to share best practices and learn from one another as the profession adapts to new evidence and needs.
Pharmacists began taking medication histories by phone rather than face-to-face at a time when there was a PPE shortage, and parking lot drive-thru counselling by pharmacists helped relay valuable medication information on discharge when visitors weren’t allowed inside. Alice underlines the importance of cultivating a safety culture where people can feel safe to share their good catches and errors so others can learn from them.
All for one and one for all
Great hockey teams will tell you that it takes a team effort to stop pucks from getting into the net. And that all things are difficult until practice makes them easy. A similar 'all for one and one for all' approach can help improve safety in the workplace and build future resilience. And a culture of safety is a key part of healthy work environments that enable staff to deliver safe and high-quality healthcare consistently.
The panel and online participants shared these helpful resources to support safe care practices:
- Addressing the psychological safety of healthcare workers: Creating a Safe Space: Psychological Safety of Healthcare Workers (Peer to Peer Support and Other Support Models) (patientsafetyinstitute.ca)
- Mental Health Commission of Canada, National Standard for Psychological Health and Safety in the Workplace: Implementing the Standard - Mental Health Commission of Canada
- TeamSTEPPS Canada™, an evidence-based teamwork system program to enhance collaboration and communication to relating to patient safety.
- OECD working paper: The economics of patient safety Part IV: Safety in the workplace : Occupational safety as the bedrock of resilient health systems | OECD Health Working Papers | OECD iLibrary (oecd-ilibrary.org)
- Policy guidance for the reintegration of caregivers as essential care partners
- ISMP Canada issues safety bulletins to share key learnings from incidents reported by healthcare providers and consumers. Check out the recently issues discharge education and expired vaccines bulletins.
- Consumers can share their medication stories to www.mederror.ca and healthcare providers can share their medication stories here.
- Tend provides education and resources to help professionals understand and address the natural consequences of working in a high-stress and trauma-exposed workplace.
- Video: how hard it is to talk about safety incidents Brian Goldman: Doctors make mistakes. Can we talk about that? | TED Talk
- WellCan offers free well-being resources to help develop coping strategies that build resilience to deal with uncertainty, mental health, and substance abuse concerns.
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