Ensuring patient safety: Culture and communication

December 1, 2007
Neil H. Baum, MD

Neil H. Baum, MD, is a urologist in private practice in New Orleans. He is the author of "Marketing Your Clinical Practice-Ethically, Effectively, and Economically."

Robert A. Dowling, MD

Dr. Dowling is president of Dowling Medical Director Services, a private health care consulting firm specializing in quality improvement, clinical informatics, and health care policy affecting specialty care. He is the former medical director of a large,

Safety is an unspoken yet fundamental expectation of almost all personal and business relationships.

Key Points

Safety is an unspoken yet fundamental expectation of almost all personal and business relationships. When passengers book airline, boat, or train reservations with a provider of that service, they expect that reasonable steps have been taken to ensure they arrive safely at their destinations. When patients agree to undergo surgery, there is often an explicit discussion of the risks and benefits, but there remains an implicit understanding that they will not be confused with another patient, that the wrong organ will not be removed or repaired, or that they will not be subjected to an unsafe environment. Most physicians, however, may not have considered the relative safety of their offices, policies, procedures, and work flows. Patients, like passengers, expect to arrive at the end of the visit safely.

The objective of this two-article series is to provide you with specific examples of these best practices that can be applied in a community urology office. Part one discusses steps you can take to ensure safety through the culture of your practice and proper communication. Part two, next month, will focus on clinical aspects of patient safety.

Safety should be a regular agenda item at office meetings, and practices should assign responsibility to a "safety officer" who issues a regular report to the owners of the practice. Safety should be stressed in new employee orientation, and employees should be recognized and rewarded for suggestions to improve patient safety. Posted signs regarding safety send a clear message to patients, staff, and other visitors (such as OSHA inspectors). If the practice has a mission statement, it is a good idea to reference the importance of safety, and a section on safety should be included in the employee manual.