Organizational Climate and Patient Safety

According to the National Institutes of Health (NIH), a growing number of studies in healthcare show that members of organizations are more satisfied when they work in climates that have more supportive and empowering leadership and organizational arrangements, along with more helpful and collaborative group environments. A satisfied provider is often one who has more compassion for their patients and contributes to an overall climate of safety.

A leading cause of occupational injury for prehospital providers involves patient movement. Shoulder, back and neck injuries are common in our field. Proper lifting, patient transfer and attention to the task at hand are all forgotten when a provider becomes complacent and the job becomes routine; this increases your risk of occupational injury.

Some of the leading causes of prehospital emergency medical malpractice relate to patient handling. Have you had patients who reached for something to brace themselves as you began to move them on a long backboard or raise a stretcher? Did you tell them, “We’ve got you—you’re OK,” or maybe use one of my personal favorites, “I’ve been doing this for many years and never dropped anyone!”?

Too often the basics of patient handling are taken for granted. Whether it be distractions, complacency, arrogance, disregard or just plain laziness, having a preventable injury happen to those to whom you’ve sworn to do no harm is a tragedy. It’s a risk not only to your organization but to you personally.

With an estimated 42,000 patient drops annually, this is a leading cause of claims of negligence. Drops are attributed to a few general areas:

  • Improper selection and use of equipment;
  • Improper balance/strength of crew;
  • Improper evaluation of scene hazards;
  • Improper maintenance of equipment;
  • Equipment failure/malfunction.

As most of these areas involve human behavior, a climate of safety would certainly help minimize risk.

According to the NIH, here are some strategies that may help your organization:

  • Create a safe and supportive climate;
  • Work for continuous improvement of communication practices;
  • Provide frequent safety feedback to providers;
  • Ensure access to and use of quality personal protective equipment;
  • Create an environment of minimal conflict;
  • Ensure the cleanliness of the worksite; and
  • Educate providers on proper lifting, knowing their abilities, selection of proper lifting devices, scene hazards, limitations and proper use of stretchers.