Culture and leadership

Patient safety requires effective leadership at all levels of healthcare and depends on building open and fair cultures of safety.

Leadership and culture lie at the heart of patient safety. Improving patient safety requires the commitment and attention of leaders throughout an organisation, and at every level of healthcare. The culture of an organisation shapes everything that goes on within it and an organisation’s safety culture must be carefully monitored to ensure that the safety of patients is prioritised at all times.

Safety culture

Safety culture is a broad term that refers to a wide variety of organisational and individual features. There are many specific definitions of what an effective safety culture looks like. These span everything from the individual perceptions, attitudes and beliefs that people hold about safety, to the way that shared behaviours and routine practices unfold every day on wards and in surgeries. 

Common features of an effective safety culture include the open disclosure and sharing of safety information and the fair and just treatment of people who are involved in safety incidents. Leaders can also be highly influential in shaping an organisation’s safety culture. Many tools are available to measure and assess safety culture (such as the Manchester Patient Safety Framework), allowing organisations to identify areas that need improvement. 

The role of leadership

Effective leadership is essential to managing patient safety. Leaders must ensure that the appropriate resources are available and that the necessary structures are in place to manage safety. Just as importantly, they are responsible for setting the tone within an organisation and continually demonstrating that patient safety is an important and high priority. A range of different leadership practices can support this. These include:

  • conducting regular 'leadership walkrounds' of senior leaders to effectively and openly engage with staff 
  • supporting and developing leaders in safety at all levels of an organisation
  • ensuring that targets, priorities and resources are fully supportive of patient safety
  • making sure that detailed safety information and patient stories take priority at board meetings

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