Start check-ins by talking about a recent successful project or patient safety action. Include concerns and close calls as well as adverse events in the conversation.
Seek input from patients and families. For example, family members may tell you that appointment follow-up instructions are confusing, which may lead to patients not adhering to clinical recommendations.
Acknowledge ideas and concerns quickly, even when no immediate action can be taken in response. Thank staff for bringing attention to issues to reinforce the importance of open communication.
Publicly acknowledge staff members for notable successes such as stopping a procedure to prevent an adverse event or suggesting an effective new medication labeling system to reduce confusion.
Daily team check-ins that provide an opportunity to discuss immediate concerns
A board with sticky notes where staff can easily share ideas and issues
One example of a board might look like this:
At larger facilities, leadership may hold daily check-ins about safety
Add stories of “good catches” and other successes, challenges or tips to internal newsletters or email updates.
Regular individual check-ins with managers
Discuss patient safety terms (such as close call) and other terminology to ensure a shared understanding
Keep in mind that different clinical staff, such as nurses and physicians, may have different styles of communication. For example, a doctor may present information in a different order than a nurse might expect to hear it. Consider a tool such as SBAR (Situation Background Assessment Recommendation) to standardize the way people communicate with one another. The Institute for Healthcare Improvement has guidelines and a script for the SBAR technique. The examples were written for a hospital but may give you ideas to apply to other healthcare settings as well.
Maintaining open communication
Always keep the internal lines of communication open when it comes to safety and make it easy to effectively communicate across areas and functions. Establish more than one way for staff to report concerns and ideas.
Establish a formal reporting system and be clear about what must be reported to supervisors or facility managers
For smaller organizations, tools for reporting may include surveys of staff or paper forms.
Consider allowing all staff to see the progress of patient safety reports, including the response.
Fostering a collaborative culture encourages staff to speak up without fear of repercussions. If you know who expressed a concern, it allows you to follow up with questions and let them know how you are responding to a report. (See Culture for tips on fostering an open environment).
If you think staff are reluctant to raise safety concerns, consider an anonymous option. Over time, you can work on changing the culture in your organization so that no one in the organization is worried about consequences (e.g. to employment, relationships with colleagues, or reputation) for sharing safety concerns.
Adapt this survey, developed as part of a patient safety initiative in Massachusetts called the PROMISES project, to learn more about how your staff views the processes you have in place that help ensure patient care is as safe as possible.
This page was adapted from the Betsy Lehman Center's Patient Safety Navigator. Visit the Navigator website to learn more about analyzing adverse events, communicating in the aftermath of serious harm, and reporting medical errors to state and federal agencies.
