Building compassion into safety culture

By Dr. Rakesh Suri, CEO, Cleveland Clinic Abu Dhabi

Safety must always be the highest priority for hospitals and healthcare providers. Reinforcing safety requires leadership support and ongoing process improvement, as well as a commitment to a culture of safety that promotes high reliability across all systems.

Most importantly, it requires engagement across the organisation – from the leaders at the top through to the caregivers on the frontline. Everybody needs to be empowered to understand what could go wrong, prepared to speak up, and ready to improve it. An effective safety culture ensures that everybody can listen, learn, and then lead to create effective, enduring solutions.

Cleveland Clinic Abu Dhabi caregivers are encouraged to report events even if they did not cause harm to the patient. Reporting of ‘near misses’ provides an opportunity for our Quality & Patient Safety Institute to identify flaws in the system and to implement changes before they impact the patient.

In our effort to be the safest place in healthcare, Cleveland Clinic Abu Dhabi has introduced a range of measures to capture this feedback and assess the health of our safety culture. The hospital deploys a validated survey instrument that provides benchmarks and department-level results. It enables the team to assess specific safety measures around key areas, such as error prevention and reporting; organisational learning; communication openness; handoffs and transitions; and management support for safety.

This ongoing analysis generates a body of data that helps track and measure our development as a hospital. The survey findings have fed into specific strategies for preventing complications, hospital-acquired conditions and infections, and falls.
However, one of the key learnings we have realised is the importance of the intangible elements, most particularly the role of compassion in building a safety culture.

Compassion is best understood as the capacity to recognise other people’s suffering, combined with the motivation to try to help them. It can be summarised through three key elements – “I hear you”, “I feel your pain”, and “How can I help?”

First, when we make a connection with another person – recognising they are in trouble, we hear their voice and make an important step beyond our own personal needs. Focusing on other people is a crucial shift in the mindset from “I” to “We,” enabling us to grow as human beings, professionals, and leaders.

Then, when we respond to a situation that another person is facing with empathy, feeling another person’s pain, we are establishing a connection with the wider community. We are creating space for people to ask for support and letting them know that we are there for them, without judgment.

Finally, when we ask, “How can I help?”, we are demonstrating our shared commitment to change our environment for the better.

By building compassion into our efforts to enhance safety culture, we are encouraging everybody to actively listen. This ensures that near misses or adverse events are reported, shared and the learnings from each are built into effective solutions.

In 2019, one of our major focuses has been on ‘closing the loop’ regarding safety issues. We have trained managers to standardise the review process and provide feedback on every event reported. In parallel, we have created teams of subject matter experts to help quickly resolve and close safety events, which has led to a significant reduction in events staying open too long.

Throughout this process, we have kept the three key elements – “I hear you”, “I feel your pain”, and “How can I help?” – at the fore, ensuring that our patients and colleagues understand we are working to resolve these issues, and that our caregivers are motivated to keep striving. Building compassion into our safety culture has delivered a significant impact at Cleveland Clinic Abu Dhabi. It could make a measurable improvement across the wider healthcare sector.

Dr. Suri will be one of the panellists at the “CEO and leadership panel: Establishing a culture of patient safety” on October 24, day one of the Patient Safety conference, at Patient Safety Middle East.