The Art of Safety

Program offers a 'culture of safety' for large hospitals

/ Author:  / Reviewed by: Joseph V. Madia, MD

(RxWiki News) A prescribed set of patient-safety programs can contribute greatly to a "culture of safety" even in large, complex hospital and medical centers. And when followed correctly can reduce adverse health events to near zero.

The finding arrives according to a new study by safety experts at Johns Hopkins.

"It doesn't take decades or tons of money to get from a culture that says 'mistakes are inevitable' to a belief that harm is entirely preventable," says Peter Pronovost, M.D., Ph.D., a professor of anesthesiology and critical care medicine at the Johns Hopkins University School of Medicine.

Leadership is key, said Pronovost.

The study was conducted at the thousand-bed, 144-unit Johns Hopkins Hospital in Baltimore from 2006 to 2008, when Pronovost's team explored a comprehensive, unit-based safety program (CUSP) designed to increase transparency about mistakes. The team used the CUSP and other tools to improve the culture of safety.

CUSP relies on training that outlines how to identify problems, report them, measure them and then plan and implement corrections. The team then measures the problems again while incorporating discussions about communication and teamwork.

The goal of the program is to develop a culture "where nurses aren't afraid to raise concerns with doctors, where problems are solved not by looking at who is right but what is right for the patient, where staff believe that hospital leaders are committed to make health care safe," Pronovost said. "We don't want a place where the staff wouldn't be comfortable being treated as patients."

The first year of the study, 55 percent of the units surveyed achieved the safety culture changes set for them, a figure that jumped to 82 percent in 2008. The survey response hovered around 80 percent.


Ask your health care providers whether they practice the "culture of safety."

Reviewed by: 
Review Date: 
December 3, 2010
Last Updated:
December 3, 2010