A Caring Work Environment
The leadership team’s ability to develop and
demonstrate caring will support building this type of clinical
environment. The leaders in the
organization are responsible for creating a caring environment that supports
respect among peers leading to the development of a culture of quality care
and clinical excellence. Nursing care is
increasingly complex and requires all team members to be aligned with
prioritizing patient safety while providing a high level of quality care. The objective is to integrate the conceptual
framework created by to build caring into the nursing practice that will foster
collaborate relationships among the healthcare team. The development of collaborative
relationships will lead to decreased adverse events for patient and the creation
of a culture of safety and caring[i].
The Joint Commission emphasizes the
requirement of leadership to serve as the role model and change agents to
promote safe patient environments[ii]. Leadership makes a major difference in the
quality and safety of patient care. The
first priority is to understand how we can improve the clinical environment to
decrease possibility of doing harm. We
must create an environment that encourages reporting of adverse events and
design a responsive planning strategy to modify policies and processes to
support patient safety5. The Swiss cheese model of safety by Reason
and Hobbs describes the processes and systems that must be implemented in
organizations to eliminate human error from leading to patient harm[iii]. Kohn described the impact medical errors had
on leading to 98,000 deaths adverse patient events have continued to increase
since 1999[iv]. There continues to be challenges with
hospitals eliminating human error when delivering care. Although there have been many evidence based
practices identified and implemented to decrease patient harm, deaths from
human error continues to increase[v]. It is sometimes challenging for healthcare
environments to fully implement safety strategies that decrease risk for human
error, such as checklist, protocols, read-backs, and timeouts. There continues to be much discussion about
what is best practice and disagreements about requirements from The Joint
Commission related to laterality site-marking and consent questions, despite
the fact that thousands of lives are lost due to medical errors7.
Patient outcomes are directly
impacted by the manager's ability to lead their department in a manner that
prioritizes safe patient care5. When the manager demonstrates caring staff
will feel more comfortable with discussing clinical issues and everyone is able
to work towards improving patient care. Managers
that are engaged with their staff are perceived as being an advocate for
quality nursing care. When staff feel
supported in their clinical practice they become advocates for providing safe
patient care and improving patient outcomes.
When employees believe they have been heard by a manager, they are more
committed and focused on great patient outcomes. There is a sense of team and focus on patient
care. The development of a caring work
environment for employees is a place where they can feel valued and provide a
high level of quality care to patients leading to exceptional outcomes.
[i]
Watson J. Caring science and human caring theory: transforming personal and professional
practices of nursing and health care. JHHSA.
2009; 31(4), 466-482.
[ii]
The Joint Commission. Sentinel Event Alert, Issue 43. Available at http://www.jointcommission.org/SentinelEvents/SentinelEventAlert/sea_43.htm.
Cited August 27, 2009.
[iii]
Reason J Hobbs A. Safety Culture,
Managing Maintenance Error: A Practical Guide. Hampshire, England: Ashgate
Publishing company; 2003.
[iv]Kohn
LT Corrigan JM Donaldson MS. To err is
human: building a safer health system. Washington, DC: National Academy
Press; 2000.
[v]
Nance JJ. Why hospital should fly: the
ultimate flight plan to patient safety and quality care. Bozeman, Montana:
Second River Healthcare Press; 2008.
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