"If you don't have a culture where people can speak up, you're never
going to find out how to fix the problem," says Ms. Calloway, president
of Patient Safety and Healthcare Consulting and Education in Dublin,
Ohio.
Her point: Creating a open, fair and just environment in which staff
can report and discuss errors is no easy task, especially considering his-
torical OR hierarchies, but it's an essential one. Where to begin? Follow
these 6 steps.
1. Start at the top. Without administrative support, staff won't
feel encouraged to speak up when they see behavior that could
endanger a patient's safety. Ms. Calloway uses the example of a nurse
refusing to hand a surgeon a scalpel when he hasn't completed a
proper time out. "He might run to the administration and say the
nurse is keeping him from doing the surgery," she says. "When there's
a culture of safety in place, the administration might respond by ask-
ing, 'Did you do a time out?' He'll answer, 'Well, no.' 'Then you can't
have the scalpel.' If the staff doesn't get that kind of support, they
wouldn't feel comfortable doing that."
2. Break down barriers. Establish an inter-professional task
force to meet about "culture work" often, if not daily, says Ramon
Berguer, MD, FACS, the former chief of surgery at Contra Costa
Regional Medical Center in Martinez, Calif. Dr. Berguer, who for 11 years
served on the Committee on Perioperative Care of the American College
of Surgeons, says it's helpful if these individuals have some background
or education in patient safety. Also, he says a mediator might be helpful
to iron out any substantive differences.
Jennifer L. Fencl, DNP, RN, CNS, CNOR, the clinical nurse specialist
and interim executive director for clinical support and research at
9 8 • O U T PA T I E N T S U R G E R Y M A G A Z I N E • M A R C H 2 0 1 7
SURGICAL
ERRORS