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I feel comfortable raising concerns when I see something that may negatively affect patient care.
Survey Domain: Employee
Survey Theme: Quality/Customer Focus
Understanding the Issue: The first step is to understand the issues behind the survey performance scores. Unless you are absolutely sure that you understand the issues related to a particular survey item, the best place to start is identifying them, and the section Understanding Issues can help you do so. The activities described in Understanding Issues can be used for any of the survey items. Make sure you know what is behind your low score before you begin acting.
Trust is a key factor in employees' willingness to report adverse events. Environments in which there is strong collaboration and transparency among team members will foster the most supportive conditions for reporting negative or problematic observations. Team members must have trust that everyone will behave appropriately when problems arise, or they will not subject themselves to employees' adverse reactions. To build comfort around the outcomes of any reporting, department leaders must also display consistent, mature behaviors.
Improvement ideas:
Orient new staff to the expectation that everyone is responsible for patient care. Reinforce this message repeatedly with all employees. Use the organization's overall mission and value statements as the basis for establishing a unit-based mission/purpose statement about safe, high-quality care and service.
Investigate and resolve conflicts between employees promptly. Keep performance expectations focused on the unit's shared purpose rather than on individual needs.
Research all patient concerns brought to your attention and then follow-up with the employees who bring concerns to your attention and explain the resolutions. Be a role model for the accountability you wish to see among your employees.
Be visible and available for employees to speak privately with you if they are concerned about open discussion of a patient care situation.
Seek to understand others' perspectives on what represents patient care concerns. Be open to listening and responding with encouragement. Be aware of your own bias and reactions, especially when repeated complaints or concerns are made. Employees will stop bringing concerns to your attention if they believe you are too busy to listen or will pass judgment before investigating.
Educate staff on ways to raise concerns respectfully and appropriately, with the least amount of critical judgment, to create receptive listening.
Foster an environment of inquiry, in which ideas are welcome and it is safe to question what goes on. Employees should feel free to question the effectiveness of practices affecting patient care and engage in problem-solving together to continuously improve outcomes.
(MI 3337)