Leadership and National Safety Month

Promoting a Culture of Safety in Healthcare: National Safety Month Spotlight

National Safety Month is an opportunity to recognize and reinforce the importance of safety across all industries especially in healthcare, where safety directly impacts patient outcomes, staff well-being, and public trust. Nurses, who are on the front lines of care, play a critical role in promoting and sustaining a culture of safety. The healthcare industry has adopted several proven strategies from other high-reliability organizations, like aviation and manufacturing, to support this mission. Nurses can promote safe practices and ultimately reduce preventable injuries and deaths by using different strategies as noted below. 

Key Strategies Driving Safety in Healthcare:

• Six Sigma -  Developed by Motorola, Six Sigma uses statistical methods to reduce variation and eliminate defects.

  
  

  • Uses statistical tools to reduce variation and prevent defects (e.g., medication errors, falls).

  • Promotes standardization and accountability in clinical procedures.

  • In the American Society for Clinical Laboratory Science (ASCLS), it discusses how using Six Sigma process mapping and failure mode effect analysis (FMEA) in the laboratory at NYU reduced reporting errors by approximately 50% (Smith, 2024).

    
    

• Lean Six Sigma - Originating from Toyota’s manufacturing practices, Lean Six Sigma is a blended approach that focuses on improving efficiency (Lean) and reducing errors (Six Sigma).

  
  

  • In healthcare, it helps streamline workflows, minimize waste, and standardize procedures—leading to safer, more reliable care.

  • Focuses on reducing waste, improving processes, and enhancing quality.

  • Empower nurses to identify inefficiencies and develop data-driven solutions.

  • Supports a proactive, problem-solving culture that minimizes errors.

  • By using the Lean Six Sigma DMAIC (Define, Measure, Analyze, Improve, Control) one hospital was able to reduce falls by 40% and falls with injury by 72% (Hill et al., 2022)

• Checklists from Aviation -  Aviation pioneered the use of checklists to prevent human error in high-risk situations.

  
  

  • Inspired by aviation safety protocols, checklists ensure critical steps are never missed.

  • Commonly used in surgeries, central line insertions, and hand-off communications.

  • Reinforce team communication and shared responsibility for outcomes.

  • A systematic review of the literature from 2013 - 2023 showed that checklists and error reporting systems enhance patient safety in hospitals “by standardizing care, improving communication, and identifying system weaknesses” (Chance et al., 2024, p.397).

    
    

• PDSA (Plan-Do-Study-Act) Cycles -  A method derived from quality improvement science and widely used in healthcare.

  • A rapid-cycle improvement method that encourages testing small changes.

  • Helps nurses implement, assess, and refine safety practices in real-time.

  • Fosters a continuous improvement mindset.

    
    

• TeamSTEPPS (Team Strategies and Tools to Enhance Performance and Patient Safety) -  Developed by the Department of Defense and AHRQ, TeamSTEPPS is an evidence-based teamwork system.

  
  

  • Evidence-based training program to improve teamwork and communication.

  • Tools like SBAR, huddles, and debriefs strengthen team coordination and situational awareness.

  • Encourages speaking up for safety across all roles and levels.

  • Check out the TeamSTEPPS website and see all the resources available to help improve quality and safety in healthcare https://www.ahrq.gov/teamstepps-program/index.html

• Leadership and Safety Culture

  • Safety must be championed by leaders who model transparency, learning, and respect.

  • Psychological safety is essential so nurses feel empowered to report concerns without fear of retaliation.

  • Strong leadership commitment to safety influences unit morale and outcomes.

  • Leadership is instrumental in creating a culture of safety that produces positive outcomes for healthcare workers and patients. Nurses should take every opportunity to engage in leadership development especially if it focuses on transformational leadership skills. This style of leadership has been associated with a decline in adverse safety events (Ystaas et al., 2023). 

  
  

Nurses are safety champions. By understanding and applying these frameworks, nurses help build systems where safe, high-quality care is the norm. During National Safety Month, let’s renew our commitment to these principles and lead the way toward safer healthcare environments for patients, families, and ourselves.

What are you doing in your institutions to improve safety?

References

Chance, E.A., Florence, D., & Abdoul, I.S. (2024). The effectiveness of checklists and error reporting systems in enhancing patient safety and reducing medical errors in hospital settings: A narrative review. International Journal of Nursing Sciences,11(3), 387 - 398. https://doi.org/10.1016/j.ijnss.2024.06.003.

Hill, K., Hawk, C., Frye, D., & Kutz,T. (2022).  Lean six-sigma significantly reduces hospital patient falls by 40% & falls with injury by 72%. BMJ Open Quality, 11(3), A1-A29. https://doi.org/10.1136/bmjoq-2022-IHI.20

Smith, K. (2024). Improving safety and quality through six sigma principles. The American Society of Clinical Laboratory Science, 38(6). Retrieve from: https://ascls.org/improving-safety-and-quality-through-six-sigma-principles/#:~:text=Six%20Sigma%2C%20a%20set%20of,errors%20and%20improve%20patient%20safety.

Ystaas, L. M. K., Nikitara, M., Ghobrial, S., Latzourakis, E., Polychronis, G., & Constantinou, C. S. (2023). The impact of transformational leadership in the nursing work environment and patients' outcomes: A systematic review. Nursing reports (Pavia, Italy), 13(3), 1271–1290. https://doi.org/10.3390/nursrep13030108