Ideas That Work: S Is for Safety

Practical pearls from your colleagues

An acronym is a great way to remember something important. It can also make the process of speaking up when you are concerned about a potential safety issue a little less daunting. That’s why the safety committee at Kaiser Permanente in San Jose, Calif., regularly reminds staff to use two catchy acronyms to promote a speak-up culture that fosters safety, respect and error prevention. The first acronym is CUSS, which stands for:

• I’m Concerned.
• I’m Uncomfortable.
• This is a Safety concern.
• Stop for safety.

The second acronym is ARCC, which stands for:

• Ask a question.
• Request a change.
• Voice a Concern.
• Use the chain of Command.

Janelle Casanave, RN, circulating nurse at Kaiser Permanente, says these tools allow staff to address their concerns, especially during times of conflict or opposing views. “They force all parties involved to set aside the hierarchy of ‘doctor over nurse’ so that we are all on a level playing field when making decisions. We have found this to be the most effective way to promote a speak-up culture, and we also feel that doctors and staff respond well to it,” she says. OSM