Articles  |   April 2019
Patient Safety Culture: A Real-Life Story of Why Culture Matters
Author Affiliations
  • John W. Allyn, M.D
    Committee on Quality Management & Departmental Administration
Article Information
Patient Safety / Articles
Articles   |   April 2019
Patient Safety Culture: A Real-Life Story of Why Culture Matters
ASA Monitor 4 2019, Vol.83, 24-27.
ASA Monitor 4 2019, Vol.83, 24-27.
Disclosure: Dr. Allyn and Dr. Curry both work for Spectrum Healthcare Partners, which markets FIDES, a QI product. There are no other disclosures.
“Culture of safety” is the latest jargon for what we’ve always wanted in the O.R.: a cohesive and respectful team focused on the well-being of the patient. For years, we thought culture was a fuzzy and undefinable topic, even though we were immersed in it every day. At times, we experienced and tolerated a toxic culture in O.R.s, not fully understanding that when sustained and unchecked, this toxic culture affected both patient safety and provider wellness. At the start of 2015, our department felt solid: we were focused on managing steadily increasing clinical demands, and our CRNA and anesthesiologist groups continued to have excellent recruiting success. All seemed well until a disruption demonstrated that it wasn’t. The disruption quickly and painfully fractured our culture. In responding, we learned there were aspects of our culture that needed attention before the disruption – we weren’t as good as we thought we were. With everyone’s help, we gained an understanding of steps to improve our culture, a process that continues today, stumbles at times and always needs attention. We are writing about our experience in the hope that we can help other anesthesia groups learn, improve and avoid the kind of disruption that forced us to deal with issues we had ignored. Even trying to tell this story for a large group of anesthesia providers is challenging; the experience remains different for each of us. Our narratives and assessments of our successes or failures are not all the same. Reliving a painful experience might put our own culture at risk, and we thank our colleagues for supporting our efforts to tell this story. One important thing we learned is that a strong culture is a journey, not a destination.1 
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