Picture this: a healthcare world where patients are always treated with care, where healthcare workers feel supported and valued, and where safety isn’t just a set of rules, it is the foundation of a culture’s organization.
This vision isn’t just about preventing harm to patients, it’s about creating a workplace environment where everyone thrives. When healthcare workers feel safe and supported, they are able to do their best work, which ultimately leads to better care for patients and better outcomes for health systems.
It’s also the inspiration for Safer Together: A National Action Plan to Advance Patient Safety, born from the collaboration of members of the National Steering Committee (NSC) for Patient Safety that was convened by the Institute for Healthcare Improvement (IHI). Twenty-seven organizations, representing federal agencies, national associations, accreditors, regulators and patient and family advocates. This actionable initiative provides clear direction for making significant advances toward safer care and reduced harm across the continuum of care.
As IHI Board Members who advocated for the development of Safer Together, Don Berwick, MD, MPP, FRCP, president emeritus and senior fellow at IHI, and NSC Co-Chair Patricia McGaffigan, RN, MS, CPPS, Senior Advisor for Patient and Workforce Safety at IHI, offer valuable insights into how healthcare organizations can achieve these goals. Their work emphasizes a crucial truth: safety is everyone’s responsibility.
Safety begins with the workforce
For decades, healthcare has focused on keeping patients safe. But Safer Together reinforces a critical shift in perspective, demonstrating that workforce safety and well-being is inextricably linked to and is necessary for patient safety. When healthcare workers feel supported, respected, and safe, they’re empowered to provide the highest level of care.
“If we don’t have a safe workplace and a workforce that feels safe, good about themselves and has a sense of well-being, we can’t optimize care for patients,” McGaffigan said.
Berwick echoes, “You can’t have excellence of any form or safety or focus on patients from a workforce that feels vulnerable, unsafe, psychologically, or physically.”
For care to be great, the people delivering it need to be well-supported and secure. Creating an environment where healthcare workers thrive is the first step to creating a safe environment for everyone – patients and caregivers alike.
Moving from blame to systems improvement
One of the biggest obstacles to improving safety is a culture of blame. Too often, when something goes wrong, the focus shifts to assigning fault rather than improving the system. “Blame is toxic to safety,” Berwick said. If we really want safer care and safer workplaces, you have to do away with fear and do away with blame.”
Instead of pointing fingers, organizations should focus on system improvement and learn from mistakes. In a culture that fosters learning and growth and rewards speaking up, mistakes are treated as opportunities to improve, not opportunities for punishment.
“Care of patients is not an individual sport,” Berwick said. “We take care of our patients together – specialists, nurses, doctors, technicians, the infrastructure. And most of the time, when something goes wrong, it isn’t an error of an individual. It’s a breakdown in a complex series.”
Safer Together: a clear path forward
The Safer Together action plan offers a straightforward, yet powerful, vision for improving safety across the entire healthcare system by focusing on four key areas: culture, leadership and governance, workforce safety and well-being, and patient and family engagement.
“We need to design care so good people can do the job they want to do,” Berwick said. The plan isn’t just about preventing errors but making sure the systems are in place to reduce risks and provide support when things go wrong.
“Safety has to be the purpose of the organization,” McGaffigan said. “Traditionally, I think we’ve thought of it as, let’s make sure the people at the ‘sharp end of care’ are doing a perfect job every day. But safety is a system property.”
The role of leadership in fostering a culture of safety
Leadership is essential to making safety a foundation of a health system’s culture – when leaders prioritize safety as a core value and show it in their actions, everyone else follows.
“We need to design systems that support our workers and help them succeed,” McGaffigan said. “The leaders who are running the system have the utmost obligation to intentionally engineer safety into the daily work of the organization and make sure that the resources are there daily, not just if something goes wrong or after a crisis has occurred.”
McGaffigan emphasized that safety depends on open communication. Workers should feel empowered to raise concerns about risks and mistakes, knowing they will be heard and supported, not punished.
This level of trust creates a more resilient organization, as healthcare workers become part of a team where everyone is looking out for each other and working toward a common goal.
A systems-based approach to safety
The journey toward a safer healthcare system is a shared responsibility, and the Safer Together plan offers a roadmap for organizations to build a systemic foundation of support at every level, from the beside to the boardroom.
By focusing on leadership, communication, and continuous learning, organizations can build a safer, more resilient healthcare system. And the result, as Berwick and McGaffigan envision, is a world where patients and healthcare workers alike can thrive.
Learn more and download the Safer Together action plan here.
