CEO Holds key to Improved Outcomes

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 impressive results.

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 core value.
  • Include safety goals in the strategic plans for every executive.
  • Have the Board of Trustees review quality and safety updates every meeting.
  • 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 on behavior.
  • Remove barriers between administrative and clinical staff by having CEOs:
    • 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, 20 passim.