Have you ever struggled to unite a team on an improvement project? Or have you ever been in a situation where lack of communication has hindered your improvement efforts?

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“YOU DID
WHAT?...HOW?”
A PANEL DISCUSSION
A PANEL DISCUSSION
JEREMY GRIMSHAW
SENIOR SCIENTIST AND PROFESSOR
22ND NOVEMBER 2016
jgrimshaw@ohri.ca
@GrimshawJeremy

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▶ Successful implementation of patient safety programs
needs key actors (patients, healthcare providers,
managers and policy makers) to change their
behaviours and/or decisions whilst working in the
complex (ordered chaos) of health care environments
▶ There is a substantial evidence base in behavioural
sciences that can support the development of patient
safety programs and increase the likelihood of success
BEHAVIOURAL PERSPECTIVE

3. DESIGNING CHANGE PROGRAMS

4. Who needs to do
what differently?
Using a theoretical framework,
which barriers and enablers need
to be addressed?
Which intervention components
could overcome the modifiable
barriers and enhance the enablers?
How will we measure
behaviour change?
DESIGNING CHANGE PROGRAMS

5. 5
COM-B MODEL OF BEHAVIOUR
Michie (2011) Imp Sci

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▶ Patient safety usually involved a series of interlinked actions by different
team members.
▶ Define behaviours and proposed responsibilities key first step.
▶ Identify team and individual barriers and facilitators
▶ Planning change
• Ensure that team members understand the rationale and plan for whole program
and their responsible behaviours (communicaton).
• Ensure that team members have capability, opportunity and motivation to enact
their behaviours (barrier assessment).
• Explore opportunities for simplify behaviours and related processes (can you
reduce total number of team members involved? do you need to build skills in
team members for specific behaviours? can you simplify work processes to
make it easier for team members to enact their behaviours?)
TEAM WORK
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▶ Need for communication plan about change processes in general
▶ Improving communication often a key element of change processes
▶ Many communication patterns are semi automatic, heuristic behaviours
that are socially influenced
▶ Communicating well is a specific behaviour that can be developed
• Do staff have confidence to speak out in pressured team environments?
• Do staff have the communication skills to clearly express their views and
concerns?
• Are their specific wordings or signals that should be promoted?
COMMUNICATION
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▶ Chicken or egg?
▶ Is patient safety culture something that can be developed to
improve patient safety practices?
▶ Is patient safety culture an emergent property that is developed by
teams successfully engaging in patient safety practices?
▶ Chicken or egg? – BOTH
▶ Need to spend at least as much time working on promoting
specific patient safety practices as working on patient safety
practices
PATIENT SAFETY CULTURE
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▶ Keep an eye on the goal!
▶ Teamwork, communication and patient safety culture
are all means to an end ‘to ensure that healthcare
systems and professionals engage in patient safety
practices to improve patient safety and outcomes’
▶ Focus on changing patient safety related behaviours
SUMMARY
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10. jgrimshaw@ohri.ca
@GrimshawJeremy