SNEAK PREVIEW Q&A with Safety and Quality Conference Keynote Speaker:

Prof Dianne Parker

Chair in Applied Social Psychology, University of Manchester

Much of Prof Parker’s research has been carried out in the domain of human error and safety, including the application of theoretical models of attitudes and behaviour to the understanding and improvement of safety behaviour.

In your experience, who are the most important ‘champions’ of safety in health care organisations, eg: clinicians, health care managers etc.

Clinicians, especially senior experienced people, because they set the tone for the whole organisation. Managers will always struggle if they do not have the backing of the senior clinicians.

What are the greatest challenges in getting experienced professionals to do things differently, ie: follow new guidelines?

Resistance to standardisation, in the name of professional judgment.

Lack of attention to risk management and patient safety in medical education (though this is now starting to be addressed).

How important is multidisciplinary team working to patient safety?

Very. No individual, however experienced, ever achieves error-free performance, and patients have the right to expect that every individual has their behaviour monitored by other professionals as a guard against error. This is not a criticism of clinicians – in other safety-critical professions (pilots,  drillers) it is standard procedure.

What are the biggest barriers to creating a culture of safety, ie: what elements of the culture have to change?

It is not possible to engineer cultural change because culture is an emergent property, that arises from the people, their values, beliefs and behaviour, the way they work and the organisational context they work in. 

Do you have a view as to whether ‘errors and lapses’ or ‘violations’ cause more serious outcomes and do different cultures breed different types of errors?

At the moment we have no reliable data to help answer this question. Many healthcare professionals are not aware of the difference between error and violation. In fact, violation only becomes meaningful when ‘rules’ are broken and ‘risks’ are taken intentionally. This can only happen in a context where there is general agreement about what the ‘rules’ are and what constitutes unaceptable risk. I am not sure that has yet been established in healthcare. The defining of best practice and standardisation around that practice is a crucial part of improving system safety, and i believe this poses one of the biggest challenges for healthcare for the next decade.

Any particular aspects of your trip to Australia that you’re looking forward to?

The people, the conference, the food, the holiday afterwards!

Conference registration available now:

http://www.sapmea.asn.au/conventions/sqhc2007/index.html