WBB's Thought Leadership

Successfully Implementing Safety Rounds

May 2

Implementation of senior executive Safety Rounds contributes to improved patient safety culture, higher employee engagement, and lower burnout in healthcare organizations.

WBB Take:  In today’s healthcare industry, senior executives rarely interact with front-line staff or experience the care environment. As a result, executives may lack a clear understanding of the risks, issues, and missed opportunities related to the work environment, and front-line staff may be unclear how their daily work relates to organizational goals. Contact between various levels of the organization is important to ensure delivery of quality care that aligns with organizational goals.

Implementing Safety Rounds, in which senior executives spend time on the frontlines of care, provides an opportunity for clear communication and collaboration. Interacting with senior executives allows front-line staff to be more connected to the organization and feel comfortable voicing recommendations and concerns. Similarly, by spending time in the care environment, senior executives have an opportunity to connect with their staff and see firsthand how policy decisions, technology deployments, and the built environment result in day-to-day risks, issues, and opportunities of which they may otherwise not be aware.
When implementing a management innovation such as Safety Rounds it is important that the individuals involved approach it with authenticity and sincerity. By creating a more collaborative work force, healthcare organizations can provide higher quality care, solve problems more efficiently, and establish an environment of learning and collaboration.

Cited by Matthew Loxton, Julia Davis, and Stephanie Owusu

Excerpt: “Implementing management innovations to improve safety of healthcare delivery is a critically important, yet often elusive, goal for healthcare organisations. Safety rounds, in which senior executives spend time on the frontlines of care, talking with staff and observing work, aim to improve safety of healthcare delivery by providing a systematic approach for engaging senior executives with the work system challenges faced by front-line staff and ensuring follow-up and accountability for addressing these challenges.”

“They resemble ‘Management by Walking Around’, which originated at Hewlett-Packard1 and ‘gemba walks’, which are considered a key component of the Toyota Production System.2 However, descriptions of these precursor interventions emphasise engagement of senior executives with front-line workers and not follow-up and feedback about ideas generated through observation and discussion. Perhaps unlike in healthcare delivery, 3 follow up and feedback in technology and manufacturing companies can be assume”

“Sexton and colleagues found inconsistent provision of feedback and that ‘providing feedback following Leadership WalkRounds is associated with better patient safety culture, higher employee engagement and lower burnout.’4 Their research represents a welcome advance over typical intervention studies that simply assess whether an intervention is or is not effective, in that the authors identify a key component of the WalkRounds intervention that differentiates more and less effective forms of intervening.”

“First, two key features that go hand in hand are leader attitudes and actions. Senior executives (ie, those who will be conducting safety rounds) must publicly demonstrate clear and authentic support for the objectives of safety rounds. For instance, when someone raises a concern during safety rounds, the senior executive should thank the staff member for their willingness to speak up on behalf of safety and do so within earshot of as many coworkers as possible. Executives conducting safety rounds must clearly and publicly promote communication and shared understanding with front-line personnel about safety risks and priorities.”

“Second, attitudes and actions of senior executives must be institutionalised through strong project management and problem-solving infrastructure. There is nothing worse for front-line morale—understandably so—than earnestly contributing thoughts and suggestions and then feeling like your recommendations have been ignored.”

“Third, rounds should be conducted with awareness of social and contextual factors. For example, one important question that arises when senior managers engage front-line workers is the appropriate role of middle managers. If middle managers feel their role is ignored when senior executives engage front-line workers, safety rounds risk igniting middle managers’ fears and negative repercussions.”
“Like any management intervention, the success of an intervention like safety rounds depends on many more factors than simply closing communication loops, important though this may be. The findings of Sexton and colleagues4 demonstrate a strong and almost certainly real association between feedback and the organisational impact of safety rounds.”
Source: British Medical Journal




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