247 Breaking barriers to speaking up for safety: a leadership toolkit to foster a culture of communication openness
Notice bibliographique
Résumé
Introduction Appropriate and timely communication between healthcare professionals is required to effectively respond to patient care concerns. Ineffective communication of care concerns can result in delayed diagnosis and treatment, or the inability to rescue a patient from a deteriorating condition (Johnston et al., 2015). Despite the recognition of its importance, there remains multiple barriers preventing communication openness between healthcare professionals. An organization’s safety culture is one large factor that can hinder or support effective communication. Further, healthcare leaders have a crucial role in influencing safety culture (Pozzobon et al., 2024).Aim At our large multi-site academic health sciences centre in Canada, we identified an opportunity to improve communication openness following a review of the results from an organization-wide safety culture survey (using the Agency for Healthcare Research & Quality (AHRQ 2021) safety culture survey) conducted in Fall 2023. We aimed to improve the scores on the communication openness domain of the survey. Recognizing leaders are key influencers in the development of a culture supportive of communication openness, we co-designated a toolkit reflective of best leadership practices to improve communication openness. This intervention aligns with our organization’s strategy and executive goals to deliver high quality care improving patient outcomes and experiences.Methods To develop the toolkit, a multi-disciplinary team was struck and was composed of leaders spanning the enterprise, a patient partner and experts in patient safety. The team decided to meet with those clinical leaders who have oversight of clinical areas that scored well on the communication openness domain of the safety culture survey, and those who have the greatest opportunity for improvement to inform the toolkit contents. Further, a review of the literature identified key leadership practices to support communication openness.Results The interviews and literature informed the development of a toolkit with three parts. Part one is a leadership self-assessment where leaders assess themselves on six domains using pre-determined questions. Part two provides resources and tools aligned with each of the six domains. Leaders are encouraged to select resources and tools aligned with the domain(s) where they have the greatest opportunity for improvement identified in part one. In part three, leaders are asked to develop an action plan using a template to improve communication openness and are encouraged to incorporate the tools and resources from part two. The toolkit was launched in Fall 2024. To support implementation, the organizations’ quality governance structures was leveraged. To evaluate the effectiveness of the toolkit, optional pulse surveys using the communication openness questions are underway and the organization wide safety culture survey will be repeated in 2025.References Agency for Healthcare Research. (2021). Hospital survey 2.0: 2021 user database report https://www.ahrq.gov/sites/default/files/wysiwyg/sops/surveys/hospital/2021-HSOPS2-Database-Report-Part-I-508.pdf Johnston M, Arora S, Anderson O, King D, Behar N, Darzi A. Escalation of care in surgery: A systematic risk assessment to prevent avoidable harm in hospitalized patients. Ann Surg. 2015;261(5):831–8.Pozzobon LD, Sears K, Zuk A. Leaders’ role in fostering a just culture. Nursing Leadership (Toronto, Ont.) 2024;36(3):44–55. https://doi.org/10.12927/cjnl.2024.27289
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Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,026 | 0,051 |
| Méta-épidémiologie (sens strict) | 0,001 | 0,001 |
| Méta-épidémiologie (sens large) | 0,000 | 0,001 |
| Bibliométrie | 0,002 | 0,001 |
| Études des sciences et des technologies | 0,010 | 0,006 |
| Communication savante | 0,012 | 0,007 |
| Science ouverte | 0,003 | 0,020 |
| Intégrité de la recherche | 0,003 | 0,008 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,009 | 0,003 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».