Evidence-based Strategies to Advance a Safety Culture in ...Safety Culture in Child Welfare A safety...
26
Evidence - based Strategies to Advance a Safety Culture in Child Welfare
Transcript of Evidence-based Strategies to Advance a Safety Culture in ...Safety Culture in Child Welfare A safety...
Evidence-based Strategies to Advance a Safety Culture in Child Welfare
Safety Culture in Child Welfare
A safety culture is one in which organizational values, attitudes, and behaviors support an engaged workforce and reliable care delivery.
Leaders in a safety culture:– Strive to balance systems and individual accountability; and– Value open communication, transparency, and continuous learning
and improvement.
Teams in a safety culture– Monitor themselves, their colleagues, and their system for stress– Anticipate and respond to unexpected events
Cull, Rzepnicki, O’Day, & Epstein (2013)
Serenity Deal3
Choice?
ECONOMIC CONSTRAINTS
OPERATIONAL CONSTRAINTS
Budget Cuts
Limited Resources
Service Array
High Caseloads
Turnover Paperwork
Work as Prescribed
SAFE WORKBOUNDARY
Erro
r M
argi
n
Failure Point
Safety Culture
Cook & Rasmussen (2005)
Enhanced surveillance
Reliable systems
Better communication
Culture Carriers
Measuring Our Safety Culture
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
2013 2015
pe
rce
nt
po
siti
ve r
esp
on
se o
n 7
po
int
scal
e
Psychological Safety
Burnout
Safety Organizing
Stress Recognition
Year to Year Comparison – All Regions, All Staff
(n=1719) (n=1431)
0
10
20
30
40
50
60
70
80
90
100
Aviation Healthcare Child Welfare
pe
rce
nt
po
siti
ve r
esp
on
se
Stress Recognition Across Industries12
(Gaba et. al., 2003)
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
Stress Recognition Burnout Safety Organizing Psychological Safety
Larimer – TN Safety Culture Survey Comparison
Larimer Cnty Knox Cnty Tenn Statewide
Pe
rce
nt
Po
siti
ve R
esp
on
se
Three Levels of Stress Response
PositiveBrief increases in heart rate.
Mild elevations in stress hormone levels
TolerableSerious, temporary stress responses,
Buffered by supportive relationships.
ToxicProlonged activation of stress response systems
In the absence of protective relationships.
Harvard Center of the Developing Child
Interplay of Stress and Fatigue
16
Walker et. al., Current Biology, October 2014
"The emotional centers of the brain were over 60 percent more reactive under conditions of sleep deprivation than in subjects who had obtained a normal night of sleep,"
Debriefings348 Conducted625 Findings
0
20
40
60
80
100
120
CDR-2013 Systems Analysis
Do
cum
en
ted
Fin
din
gs
CDR 2013 Systems Analysis 2014
34
31
29
26 26
24
21
18
15
12
9
6
Freq
uen
cy o
f Sy
stem
ic F
ind
ing*
CY 2015 Child Death Review Systemic Findings
0 2 4 6 8 10 12 14 16 18
System Change
2014 Rate 2015 Rate
-29%
-5%
-10%
-40%
-5%
-49%Equipment/Technology
Stress
Demand-Resource Mismatch
Medical Records
Knowledge Deficits
Teamwork/Coordination
Enhanced surveillance
Reliable systems
Better communication
Predicting Problematic Prescribing Behavior
Thank you…
