How Good Is Your Reporting Culture?

Are your staff members comfortable speaking up and do you have an action plan in place to respond to concerns? Test your reporting culture against these Joint Commission recommendations.

Encouraging a culture of safety in which staff are encouraged to speak up without fear of retribution or non-action has become more widespread, but how is it working in your setting? This is a question Lisa DiBlasi Moorehead, EdD, MSN, RN, CENP, associate nurse executive for The Joint Commission’s Department of Accreditation and Certification Operations asks perioperative nurse leaders across the country. 

“A preoccupation with failure is a key tenet of high reliability science. Instilling this preoccupation with failure among your frontline staff is fundamental to a reporting culture,” Moorehead stresses. “Systems will fail and you want staff to report potential failures before harm reaches a patient.”

She says getting your team to share these potential failures with you is the key, and that’s where an effective reporting culture really comes into play.

Take a Closer Look

To evaluate how effective your reporting culture is, Moorehead says it can be valuable to compare the number and type of staff concerns reported over a period of time to assess how these reports are increasing, because the stronger the reporting culture the more reports you will see—at least initially.”

Even for those organizations with strong reporting, Moorehead says nurse leaders can benefit from asking themselves these three questions to test how strong their reporting culture is:

Do you have established trust?

Every staff member should feel comfortable calling out issues or concerns directly to you without fear of retribution but also with the confidence that they will see you act to produce a resolution.

Are you rounding and asking about concerns?

Leaders who make a visible and regular presence among staff to ask about concerns will instill a stronger culture where reporting is expected, sought out, and welcomed.

Do you recognize reporting?

Recognizing team members who do speak up has shown to be an effective method in instilling an expectation of reporting among your entire staff.

“Make sure your daily rounding is purposeful, vocal and routine,” Moorehead suggests. Questions such as, “what issues are concerning you today?,” can give staff an open forum to share with you and it can also set an expectation that when they see you, you expect to hear any issues, she adds.  

She has seen some organizations establish a “Good Catch” Award shared in a department meeting or safety huddle to recognize staff who have the courage to call out a concern and as a way to share steps to resolve the issue.

Huddle boards are another way to promote a culture of sharing concerns that create a visual way for a leader to demonstrate progress with resolving an issue and demonstrating data on resolution statistics.

Reinforce Reporting Culture Musts

Based on how you grade yourself on the strength of your reporting culture, you may want to think about implementing these suggestions from Moorehead:

• Make sure you have a zero-tolerance policy for intimidating behavior.
• Act on results from any feedback related to your reporting culture, including the results from culture of safety surveys.
• Make it easy to report. [Sticky notes on a huddle board may be easier than an electronic system if the process to report is too cumbersome.]

Sharing more general statistics on adverse events can also be powerful with your staff, Moorehead suggests.

She points to The Joint Commission sentinel event statistics in which two of the top adverse events commonly reported—wrong site surgery and unintended retention of foreign objects—occur in perioperative care. “Zero harm should be the number one priority for every team member; identifying and then mitigating risks are what make this goal achievable.”

Free Resources for Members

Guideline Essentials: Create a patient safety culture among your team members with ready-to-use templates and tool for the guideline on Team Communication, such as policy and procedure templates, gap analysis tools, and an implementation road map.

Webinar

New AORN Guideline on Team Communication Replay (1 CH)

AORN Journal CNE Article

Guideline Implementation: Team Communication (1.8 CHs)