Providing the right infrastructure to lead the culture change for patient safety.

BACKGROUND: In early 2000 the hospital leadership of Good Samaritan Hospital (GSH), a community teaching hospital in Dayton, Ohio, made patient safety a strategic priority and devoted resources to incorporate safety as a part of the hospital's culture and care processes. The vice president of clinical effectiveness and performance improvement, as a champion for safety, led a consensus-building effort to enlist the support of key physician and hospital leaders to a safety program. GSH added a Safety Board to its administrative infrastructure, which was to serve as an oversight body to ensure the advance of the safety program and to produce policies and procedures that are associated with safety.

ADDRESSING PATIENT SAFETY AIMS: To assess GSH's progress toward achieving three aims--demonstrate patient safety as a top leadership priority, promote a nonpunitive culture for sharing information and lessons learned, and implement an integrated patient safety program throughout the organization--the Safety Board evaluates GSH's performance bimonthly, using a 5-point-scaled self-assessment tool. For example, for the third aim, the Safety Board oversaw the formation of three subcommittees, which were to test ideas and achieve improvements in three areas--medication, clinical, and environmental.

DISCUSSION: The administrative structure provides the leadership and momentum necessary to fuel a cultural change in the way that patient safety issues are perceived and acted on throughout the organization. "To err" may be human, but so is the ability to increase patient safety awareness, to promote cultural change within existing systems, and to improve the patient care processes and outcomes.