Blog Post: A Safe Space to Talk: Collateral Benefits of Safety Culture debriefings

Susanne Smith is a Lecturer at Plymouth University Peninsula Schools of Medicine & Dentistry, where she is joint programme lead for the Simulation & Patient Safety MSc, she is also a member of Q.
Margaret Heffernan, businesswoman, entrepreneur and writer, gave a TED talk in 2015 about the importance of taking time to talk to colleagues and that time spent chatting around the water-cooler was not time wasted: in fact it  contributed to organisational effectiveness.  She’s visited corporations where coffee cups were banned at desks because these companies wanted their staff to mingle by the coffee machine.  In Sweden there is a word for this activity, fika, a break which is more about socialising than coffee.
In healthcare, there often isn’t the time do this, and in some services or teams there is never the time to do this.
However, we are all highly motivated to improve Patient Safety and, convinced of the importance of culture in achieving this, teams from both secondary and primary care across the SW region have had the vision to make time over the last two years to undertake the SCORE Safety Culture surveys.
Whilst it’s often good to take stock and measure aspects of quality performance, I have been repeatedly struck during the course of SCORE debriefings how the most valuable aspect for staff seems to be the opportunity to talk in a psychologically safe place.
I’ve seen amazingly honest conversations, real appreciation of the difficulties of other people’s roles, offers of support, and heard tales of how staff have battled austerity, chronic staff shortages, unsupportive systems, physical isolation from key teams/staff, problems with unhelpful professional hierarchies/boundaries, and burnout.
Whilst there was a lot of discussion about negative aspects of work and culture, the prevailing feelings at the end of debriefings were a positive energy to tackle difficult issues, make changes and an increased awareness of each other’s jobs demands.  There was evidence of problems being solved during the debriefings, e.g. problems with accessing equipment from other parts of the hospital, and rationalising appointment systems, all through face-to-face discussions that took place in the “debriefing space”.
This creation of space is critically important as a way of addressing staff issues and facilitating a learning and compassionate culture  – analogous to the benefits seen by those attending Schwartz Rounds, when time is made to consider the emotional impact of patient cases on the people who care for them.
Debriefings have shown the importance of a positive culture as the key to high performing, happy, resilient teams; and, indeed it’s one way of looking after teams and the people within them as per Eleanor Brown’s words, “You can’t pour from an empty cup”.
We need more of this in healthcare, no matter what the political landscape. We don’t have time for the water-cooler chat, but time spent on measuring and talking about Safety Culture is essential.  We might not quite manage fika in healthcare, but we can come pretty close when debriefing culture survey results.”
For anyone interested in becoming involved in SCORE, the next round of SCORE debriefing training is being hosted by the SW AHSN on 22nd June at Exeter Racecourse (click here: http://www.swahsn.com/event/debriefing-skills-score-culture-survey/).  The SW AHSN currently provides funding for the SCORE survey so it’s free for Trusts in our region.

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