Research in nuclear energy, aviation and other innovative
industries indicates that these high-reliability industries place
a premium on safety as an integral part of the organization’s
culture, and the CEO occupies the leading role in fostering that
culture.CEO involvement takes two primary forms: high-visibility
leadership promoting organizational safety attitudes, behavior
and performance and participation in industry-driven initiatives
and activities whose results could be felt industry wide.These
industries rely on peer pressure created by open communication
and mutual accountability, which drives the development of safety
standards and best practices that yielded behavior change and
In the healthcare industry, there is an opportunity to develop a
robust patient safety culture. The vision and visibility needed
to drive a cultural transformation belongs to the CEO.
Organizations can focus on the needs of CEOs in this area by
supporting top executives’ efforts to enhance their patient
safety leadership skills and delivering this support in ways that
they would find most effective given their busy schedules.
A market research survey of hospitals and system CEOs indicated:
They feel a responsibility to highlight patient safety as
more than just another management challenge.
Most indicated no formal training or a clinical background in
safety issues and expressed a desire to develop knowledge and
skills in this area.
Examples of what different health systems have implemented to
improve CEO involvement in patient safety:
Offer a safe, confidential forum through which CEOs can
accelerate their patient safety leadership skills by exploring
ideas and sharing experiences with those whose professional
judgment they value most highly — other CEOs
Recognize that the culture of safety needs to come from the
top down and from the bottom up
Don’t talk about safety as a priority; think about it as a
Include safety goals in the strategic plans for every
Have the Board of Trustees review quality and safety updates
Place quality and safety before finance on the board agenda.
Start a senior leadership huddle.
Reinforce key behaviors as well as addressing system issues.
Believe in the power of story telling and the impact it has
Remove barriers between administrative and clinical staff by
Participate daily in rounds of selected clinical units to
see the problems and improvements.
Reinforce patient safety messages.
Commend units that have performed well and communicate
that commendation in person.
It is the responsibility of the CEOs and goes to the core
of what their jobs are all about: improving the healthcare of
the people in their communities.
Birk S. Creating a culture of safety: why CEOs hold the key to
improved outcomes. Healthcare executive. 24(2):14-6, 18,