Step 1. Commitment to Safety

Goals:

I.       Everyone in the organization understands the features of safety in patient care, employee care, and in processes

II. Everyone in the organization understands that safety is a top priority and the motive and driving force for actions, processes, and change

III.   Everyone in the organization is equipped with the tools (knowledge, discernment, voice ...) needed to provide safety in patient care, employee care, processes, and the culture of the healthcare facility

IV.  Everyone in the organization commits to safety in patient care, employee care, and in processes

a.  A top priority, higher than budgets, relationships, and personal needs

b.  From top leadership and include everyone

c.  Continuously nourished by ongoing actions

Expected Outcomes:

I.   Infrastructure strengthening as the safety approach matures as the common uniting thread, as the root question in actions and processes, and gives everyone a voice

II. Infrastructure strengthening as the safety approach matures becoming the starting point and goal in actions and procedures and as the motivation driving change

III.   Decreased patient injury and preventable death, thus better patient outcomes

IV.  Increased health and well-being of staff

V. Increased productivity and quality of care provided, thus lower operational costs and higher revenues

VI.  Return on investment (ROI) of two times the safety investment (~western cultures), but this will take time

Background:

I.      Today, patient harm due to unsafe care is a large and growing global public health challenge and is one of the leading causes of death and disability worldwide 1

I.   This approach makes standards of care, because they are rooted in safety and quality, the common uniting goals everywhere

II. This is in-line with WHO Global Patient Safety Action Plan 2021-2030 (who.int)

Investments needed:

I.      Planning

a.      Written team charter (for and goals, measurements, resources, needs…), charter name, topics (~I.b.), opportunity statement (General: Expected Outcomes, and for each target – presented later),  organizational team (sponsor, lead, planning members-their expertise and duties), communication plan (by whom, how, and frequency), mission, scope and boundaries, considerations (assumptions/ constraints/obstacles/risks), objectives, success measurements, available resources (people, materials, site, time, financial,…),  milestones (what will be accomplished and date, ie: 100% preparedness of items at perioperative points of care by 1/1/xxxx)

b.     Syllabus and topics for

                                                    i. Core Education of how things should be done at the facility, this includes: Accountability, hand off reports, documentation, using check lists, standardization, understanding job descriptions, unifying knowledge and procedures, processes, and more. (there are modifiable materials and forms of many of these in One Standard tools)

1.     Specific group education: Leaders- leadership and supervisory training,…

                                                  ii. Safety Education and communication, (the duty to speak), processes, the no-blame culture, and more

c.      Education format: Seminars, PBLs, small groups

d.     Expected outcomes

e.      Safety launch and community publicity: Per Tanzanian experience, there is more success if the press is notified of the safety launch, a high-ranking officer participates, and a celebration with each success  

II.    Educators, education material (projectors, books,…), employee time,

III.  Time for staff to attend: Safety courses, seminars, presentations, training, and ongoing education

IV.  Financial: Materials, time

Solutions: One Standard tools:

I. Videos: Introduction to infrastructure needs (communication, culture of safety, teamwork, accountability+)

II.  Documents: Checklists, hand-off reports, workflows and more