Enabling
Organizational priority setting, leadership practices that motivate the pursuit of safety
The Patient Safety Culture “Bundle” is arranged in three main parts with subsections under each; as with other safety bundles, all components (vs. a piecemeal approach) are required to improve patient safety culture. Improving patient safety culture requires sequential, iterative and simultaneous interventions that ENABLE, ENACT and LEARN.
This section specifically examines the ENABLING components of the Bundle.
The table below addresses leadership’s responsibility for organizational priority setting and leadership practices that motivate the pursuit of safety. The ENABLING section provides tools and resources to support leadership in establishing organizational priorities; ensuring positive leadership behaviors; appropriate support for human resources and health information technology; and good health system alignment.
Click the hyperlinked text within the categories to access freely available tools and resources to support your work within this leadership area.
Organizational priority
| Component | Resource Author | Resource Type | Resource Title |
| Board educated, engaged, accountable, prioritizes patient safety | The Joint Commission (2017) | Article | The essential role of leadership in developing a safety culture |
| Board educated, engaged, accountable, prioritizes patient safety | CPSI (2017) | Article | Patient Safety & Quality Culture Bundle for CEOs & Senior Leaders |
| Board educated, engaged, accountable, prioritizes patient safety | Institute of Health Policy, Management and Evaluation University of Toronto (2015) | Report | Beyond The Quick Fix: Strategies for Improving Patient Safety |
| Board educated, engaged, accountable, prioritizes patient safety | CPSI (2017) | Report | The case for investing in patient safety in Canada |
| Board educated, engaged, accountable, prioritizes patient safety | High-Reliability.org/.com | webpage | High Reliability Organizations |
| Board educated, engaged, accountable, prioritizes patient safety | Joint Commission Resources | Guide | Patient Safety Initiative: Hospital Executive and Physician Leadership strategies |
| Safety/quality vision, strategy, plan, goals | U.S. Department of Health and Human Services’ Agency for Healthcare Research and Quality | Guide | How patient and family engagement benefits your hospital |
| Safety/quality vision, strategy, plan, goals | National Collaborative for Improving the Clinical Learning Environment (2017) | Guide | The role or clinical learning environments in preparing new clinicians to engage in patient safety |
| Safety/quality vision, strategy, plan, goals | Annu. Rev. Public Health (2013) | Report | Reducing Hospital Errors: Interventions that build safety |
| Safety/quality vision, strategy, plan, goals | CPSI | Education Program | TeamSTEPPS Canada™ |
| Safety/quality vision, strategy, plan, goals | HealthcareCAN | Education Program | Canadian Patient Safety Officer Course |
| Safety/quality resources/infrastructure | CPSI (2018) | Guide | Engaging patients in patient safety A Canadian Guide |
| Safety/quality resources/infrastructure | CPSI | Tools and Resources | General Patient Safety Quality Improvement and Measurement Resources |
| Safety/quality resources/infrastructure | Joint Commission Resources | Journal | The Joint Commission Journal on Quality and Patient Safety |
CEO/senior leadership behaviors
| Component | Resource Author | Resource Type | Resource Title |
| Relentless communication about safety/quality vision, stories, results | Memorial Hermann | webpage | Quality report relentless focus on quality and patient safety |
| Relentless communication about safety/quality vision, stories, results | CPSI | Patient story | Patient Stories |
| Relentless communication about safety/quality vision, stories, results | Patient Safety Movement | Patient stories | Patient Stories- Patient Safety Movement Foundation |
| Relentless communication about safety/quality vision, stories, results | IHI | Patient stories | Patient Stories, IHI Open School |
| Relentless communication about safety/quality vision, stories, results | NHS (2015) | Tools and Resources | Using stories to improve Patient, Carer and Staff experiences and outcomes. A resource to help you |
| Relentless communication about safety/quality vision, stories, results | British Journal of Community Nursing (2006) | Article | We listen but do we hear? The importance of patient stories |
| Leadership Regular/daily interaction with care settings/units, staff, physicians, patients and families | Alberta Health Services Patient & Family Advisory Group | Presentation | Leadership rounding, connect with patients, families and staff for valuable insights |
| Leadership Regular/daily interaction with care settings/units, staff, physicians, patients and families | My Rounding (2015) | Article | 5 QUESTIONS TO ASK WHEN LEADERSHIP ROUNDING ON THE FRONT LINES |
| Leadership Regular/daily interaction with care settings/units, staff, physicians, patients and families | Healthcare Business & Technology (2017) | Article | Leadership rounds: Create a ‘patient safety first’ culture |
| Leadership Regular/daily interaction with care settings/units, staff, physicians, patients and families | IHI | Website | Patient Safety Leadership WalkRounds™ |
| Leadership Regular/daily interaction with care settings/units, staff, physicians, patients and families | Patient Experience Journal (2014) | Article | Improving the patient experience through nurse leader rounds |
| Leadership Regular/daily interaction with care settings/units, staff, physicians, patients and families | Clinical Journal of Oncology Nursing ( 2014) | Article | Round and Round We Go: Rounding Strategies to Impact Exemplary Professional Practice |
| Leadership Regular/daily interaction with care settings/units, staff, physicians, patients and families | Medical College of Georgia (2010) | Guide | Navigating Patient- and Family-Centered Care Rounds: A guide to A guide to achieving Success |
| Model key values | Core Value Partners (2013) | Article | Core Values and Concepts- Healthcare |
| Model key values | Catalysis (2017) | Website | PHYSICIANS LEADING | LEADING PHYSICIANS Five Changes Great Leaders Make to Develop an Improvement Culture |
Human Resources
| Component | Resource Author | Resource Type | Resource Title |
| Leaders/staff/physicians engaged, clear expectations/incentives for safety/quality | Agency for Healthcare Research and Quality (2008) | Book | Advances in Patient Safety: New Directions and Alternative Approaches (Vol. 3: Performance and Tools).The Use of Modest Incentives to Boost Adoption of Safety Practices and Systems |
| Leaders/staff/physicians engaged, clear expectations/incentives for safety/quality | Bailit Health Purchasing, LLC (2002) | Report | Provider Incentive Models for Improving Quality of Care |
| Just culture program/protocol | The Health Foundation (2012) | Article | How can leaders influence a safety culture? |
| Just culture program/protocol | NPSF Lucian Leape Institute, The National Patient Safety Foundation at the Institute for Healthcare Improvement. The American College of Healthcare Executives | Guide | Leading a Culture of Safety: A Blueprint for Success |
| Just culture program/protocol | Royal College of Physicians and Surgeons of Canada | Guide | Royal College of Physicians and Surgeons of Canada. Just Culture of Patient Safety |
| Just culture program/protocol | The Ochsner Journal (2013) | Article | Just Culture: A Foundation for Balanced Accountability and Patient Safety |
| Just culture program/protocol | Health Standards Org (2017) | Article | Leading Practices Building a Just Culture at The Ottawa Hospital |
| Disruptive behaviour protocol | CMPA | webpage | Addressing physician disruptive behaviour in healthcare institutions |
| Disruptive behaviour protocol | College of Physicians and Surgeons of Ontario (2008) | Guide | GUIDEBOOK FOR MANAGING DISRUPTIVE PHYSICIAN BEHAVIOUR |
| Disruptive behaviour protocol | Health Quality Council of Alberta (2013) | Guide | Managing Disruptive Behaviour in the Healthcare Workplace – Provincial Framework |
| Disruptive behaviour protocol | Pennsylvania Patient Safety Advisory (2010) | Article | Chain of Command: When Disruptive Behavior Affects Communication and Teamwork |
| Disruptive behaviour protocol | American College of Obstetricians and Gynecologists (2017) | Article | Behavior That Undermines a Culture of Safety |
| Staff and physician safety (physical/psychological/burnout); safe environment program | University of Massachusetts Amherst (2015) | Guide | The Just Culture, Second Victimization and Clinician Support: An Educational/Awareness Program |
| Staff and physician safety (physical/psychological/burnout); safe environment program | Healthcare (2016) | Article | Burnout and Doctors: Prevalence, Prevention and Intervention |
| Staff and physician safety (physical/psychological/burnout); safe environment program | CNA (2010) | Report | Nurse Fatigue and Patient Safety |
| Staff and physician safety (physical/psychological/burnout); safe environment program | PLOS (2016) | Article | Healthcare Staff Wellbeing, Burnout, and Patient Safety: A Systematic Review |
| Staff and physician safety (physical/psychological/burnout); safe environment program | Agency for Healthcare Research and Quality (2008) | Book | Patient Safety and Quality: An Evidence-Based Handbook for Nurses. Chapter 21Creating a Safe and High-Quality Health Care Environment |
| Staff and physician safety (physical/psychological/burnout); safe environment program | CMA | webpage | Canadian Medical Association Physician Health and Wellness |
| Staff and physician safety (physical/psychological/burnout); safe environment program | American College of Occupational and Environmental Medicine (2016) | Article | Interaction of Health Care Worker Health and Safety and Patient Health and Safety in the US Health Care System: Recommendations From the 2016 Summit |
Health information/technology/devices
| Component | Resource Author | Resource Type | Resource Title |
| E-health records support safety | CPSI | Education Program | PSEP. Module 6: Technology: Impact on Patient Safety |
| E-health records support safety | CIHI | webpage | How Is CIHI Data Used to Support Health Systems? |
| Technology/devices support safety | BMC Med Ethics (2018) | Article | Leaving patients to their own devices? Smart technology, safety and therapeutic relationships |
| Technology/devices support safety | BMJ Quality & Safety (2010) | Article | Technology as applied to patient safety: an overview |
| Technology/devices support safety | AHRQ | Article | Envisioning Patient Safety in the Year 2025: Eight Perspectives |
| Technology/devices support safety | Journal of Nursing Education and Practice (2014) | Article | Integration of health information technology to improve patient safety |
Healthcare system alignment
| Component | Resource Author | Resource Type | Resource Title |
| Community/industry-wide collaborations | Journal of Medical Imaging and Radiation Sciences (2017) | Article | Collaboration in Health Care |
| Community/industry-wide collaborations | Elsevier (2013) | Article | INTERPROFESSIONAL COLLABORATIVE PRACTICE IN HEALTHCARE Getting Prepared, Preparing to Succeed |
| Community/industry-wide collaborations | Institute of Medicine of the National Academies (2016) | Book | Collaboration Between Health Care and Public Health: Workshop Summary (2016) Chapter: 4 Collaboration Between Hospitals and Public Health Agencies |
| Align with national/international standards | CPSI | webpage | Integrated Patient Safety Action Plan |
| Align with national/international standards | PrescribeIT™ | webpage | PrescribeIT |
| Align with national/international standards | ISMP (2012) | Article | Medication Reconciliation in Canada: Raising The Bar – Progress to date and the course ahead. |
| Align with national/international standards | Health c Q (2016) | Article | Patient Safety Incident Reporting: Current Trends and Gaps Within the Canadian Health System |
| Align with national/international standards | ORNAC | webpage | ORNAC About us |
