March 17, 2021
In recognition of Patient Safety Awareness Week, we asked Dr. Jeremy Souder to tell us what patient safety means to him. Dr. Souder is Pennsylvania Hospital’s Patient Safety Officer & Medical Director of Palliative Care. He joined HCIF’s Clinical Advisory Committee in 2017 and served as Vice Chair for 2 years (2018-2020) before taking the position of Chair in 2020.
I was recently asked “What does patient safety mean to you?” After a decade in the field, it means the same thing to me now as it did when I started: advancing toward a world in which everyone is safe and feels safe when they access health care. However, being safe and feeling safe are not the same thing, of course. People often feel safer driving cars than flying in airplanes, though their lifetime odds of dying in a car crash are hundreds of times higher, or worse! So how do we advance toward this vision of making people safe both physically and psychologically when they seek medical attention?
It requires a mixture of things, all of which must be present in healthcare organizations to achieve the aim. Leaders need to set the foundational expectations that we can and will achieve our goal of not causing harm. A robust process improvement structure, with components such as reporting systems and analysis methods, are usually what people think of next–and they are necessary elements, to be sure. Without this infrastructure, organizations can’t learn about their vulnerabilities and opportunities for improvement. But those things alone are not sufficient!
Only when we make it feel safe for people to open up do those improvement systems get the inputs they need to drive learning and change. This is what is meant by the term “psychological safety.” It develops when everyone in the organization feels accountable not just for the work we do together, but also to support one another through trusting relationships. So in addition to building infrastructure for organizational analysis and learning, those of us in patient safety advocate for clear behavioral expectations, such as to be respectful, fair, and compassionate with one another regardless of the situation at hand. People need to know that their behaviors will be evaluated fairly whether a clinical outcome was as anticipated or not. Only then can we feel that it’s ok to look deeply at our work and talk about what needs to improve so that we don’t cause unnecessary suffering for the patients we serve. This compassion, fairness, and trust with one another sets the stage for us as caregivers to demonstrate those same virtues to the people for whom we care—making patients feel safe.
Although, I could have answered this question in another very personal way. Working with others to advance patient safety is what makes me feel like I’m doing my best to help people – that simple goal that pretty much every kid, who wants to be a doctor or nurse or clinician, voices when asked why they want to enter the medical profession. And that means the world to me.