The upward spiral – the benefits of kindness and safety culture
14 November 2023
The Clinical Excellence Commission (CEC) helps teams across NSW Health on journeys of safety culture improvement. Kindness and compassion are the focus of this week's Gathering of Kindness at NSW Health and are key elements in a positive safety culture. Kindness and compassion are free and can start an upward spiral, bringing meaning and purpose to work.
Empirical data has shown that the experience of kindness can improve patient outcomes, produce financial benefits and enhance staff satisfaction. Healthcare staff who work in supportive teams with clear goals and good team leadership have dramatically lower levels of stress (West et al 2015). Staff who experience compassion from their leaders are more engaged and satisfied, delivering better outcomes for organisations including improved financial performance (Dawson and West 2018).
The way teams and health services express their culture is through words, signs, symbols, and actions.
Brigitte Sigl is a member of CEC People Partners panel that amplifies the voice of patients, families, carers and loved ones in healthcare strategy and policy.
"When you feel you're seen as a whole person and not just as the issue you're presenting with, you feel safe, in good hands, well looked after and more importantly, willing to trust your medical team to find the best possible solution for you.
This, to me, encompasses true and meaningful partnership," she said.
Susan Sims in her role as the CEC Safety Culture Lead, engages with healthcare consumers and NSW Health teams to improve our safety culture. Kindness and compassionate are an important part of this work.
CEC Safety Culture Lead Susan Sims.
"It is the simple things that matter. Being present with someone. Listening. Acknowledging concerns. Showing human compassion. These are so important when interacting with patients as well as your team," said Susan.
"This is something that everyone can do. It's about leading by example, no matter your role."
Teams often find it hard to identify issues affecting team culture, let alone know where to start to fix them. While compassionate leadership is central, there are many interacting elements that are part of a positive safety culture.
The Clinical Excellence Commission has a Safety Culture Framework to help people understand what we mean by safety culture and what the important elements are. Team Stripes is a structured approach to improving safety culture. There is also a library of concrete activities, called Safety Fundamentals, that can help with specific culture issues.
"Improving safety culture doesn't always need to be a huge project," said Susan.
"Small things can make a big difference. If you are giving kindness and compassionate care, you get some of it back in return," she said.
Defining safety culture and the Safety Culture Framework
The culture of an organisation is 'the way we do things around here'. It is values, attitudes, perceptions and beliefs, and how everyone behaves towards each other.
A safety culture is one where people feel 'psychologically safe' and feel empowered to speak out without judgement to identify and address safety issues together. It is a culture based on compassion on all levels, led by a compassionate leadership.
The Safety Culture Framework defines a healthcare safety culture more precisely, listing seven key elements for a positive safety culture. This framework is valuable when assessing the safety culture of a team or organisation, when strengths and gaps are identified.
Safety culture improvement – a structured approach
Sometimes it's hard to know where to start to improve a team's safety culture. There are often so many interconnecting issues, it’s hard to see the bigger picture and know what to do.
Team Stripes is a structured approach to improving safety culture. The approach starts with a discovery phase using team reflection and data to give an overview of a how a team works and its safety culture. It identifies potential areas of improvement and how they may be interconnected. It then uses improvement science to identify and implement potential solutions. This is an ongoing process of improvement, continuously strengthening a team's safety culture.
A library of culture improvement actions
There are lots of concrete actions a person or a team can take to improve safety culture. These are called Safety Fundamentals. Some are easy and quick to do and can make a real difference.
The person-centred communication safety fundamentals are all about how we communicate to improve patient care. A change can be as simple as saying 'Hello, my name is ..' when talking with a patient.
A change can be as simple as saying 'Hello, my name is..' when talking with a patient.
The Safety Fundamentals for teams are practical tools, most of which can be implemented quickly and easily, and have the potential to bring quick measurable gains.
An example is the safety huddle. This is a short meeting with the whole team at the start of every shift. The team exchanges information about potential or existing safety risks for patients and staff.