Developing A Culture of Safety

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Developing A Culture of Safety

• Return to the Cabin
• March, 2009
• Deborah M. Galvin, Ph.D.
• SAMHSA/CSAP

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Culture

• Culture is overall social and work themes within
  an organization made of written and un-written
  policy, rules, knowledge, belief, custom,
  behavior and actions.
• Culture can be crystal clear or implied
  intentional or unintentional.
• Unintended outcomes of policy or procedures in
  the organization can be in conflict with stated
  goals and values.
• Culture is not necessarily uniform within a
  single organization. There can be variations
  between different disciplines, management/non-mana
  gement management/union, etc.
• When organizations attempt to change their
  culture, there may be cultural lag between the
  old and the new.
• Variations in culture can lead to cultural
  conflict resulting in communication difficulties
  and lost productivity.

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Workplace Culture of Safety

• Workplace culture of safety influences reporting
  of safety events, issues, and near misses.
• Remove barriers to Communication
• Errors are opportunities to learn improve.
• Errors exist are a part of a healthy
  workplace.
• To improve there is a need to continuously
  measure where you are.

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Culture of Safety Elements

• Teamwork Awareness
• Management Union Involvement
• Operational Systems of Safety Training
• Openness/Transparency
• Accountability Measurability

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Measures of Safety Survey

• Please indicate your agreement or disagreement
  with the following statements about your work
  area/unit.
• We have enough staff to handle the workload.
• When a lot of work needs to be done quickly, we
  work together as a team to get the work done.
• In this unit, people treat each other with
  respect.
• Staff in this unit work longer hours than is
  best.
• We are actively doing things to improve safety.
• We use more agency/temporary staff than is best.
• Staff feel like their mistakes are held against
  them.
• Mistakes have led to positive changes here.
• It is just by chance that more serious mistakes
  dont happen around here.
• When one area in this unit gets really busy,
  others help out.
• When an event is reported, it feels like the
  person is being written up, not the problem.
• Adopted from the AHRQ Hospital Survey on Patient
  Safety Culture (www.ahrq.gov/qual/hospculture/hosp
  form.pdf ).

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Health/Wellness in Culture of Safety

• Physical and Behavioral Health works best in
  integrated health/wellness environment.
  Workplaces provide excellent opportunities for
  addressing a wide range of health issues and
  behaviors.
• Workplaces that emphasize team-building and
  mutual support can also help people learn about
  health and safety, and foster the development of
  attitudes and behaviors that improve health and
  safety.
• All this can be good for business, employees
  (supervisory and nonsupervisory), their families,
  and their communities.

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Drug-Free Health/Wellness Workplace

• Management/union relationship workplace safety
  culture is key to the success of a drug-free
  workplace policy and program.
• Sets the tone and provide the vision and the
  force to initiate, shape, and sustain the
  health/wellness and drug-free policy program.
• According to process evaluation of PeerCare, a
  successful workplace substance abuse prevention
  and intervention program Leadership begins at
  the top. The vision and dedication of corporate
  champions propelled the program into prominence.

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Health Care Assessment

• Health risk assessment tools scores a persons
  health status, calculates risk levels, and
  provides recommendations for health improvement
  and behavior change on certain diseases acute
  and chronic (including substance abuse mental
  health)
• Primary care and behavioral health clinicians
  frequently fail to detect substance-related
  problems among their patients, thereby leading to
  increased morbidity and mortality and health care
  costs.

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Health Risk Assessments Measuring Need for
Substance Abuse Intervention

• Max Heirich, Ph.D. GM heart health

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GM Health Risk Assessment

• Health Risk Assessment was beneficial!

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Drink Wise
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Peer to Peer Programs

• Peer to peer programs in prevention utilize the
  credibility that colleagues and fellow employees
  (peers) have with each other (their peers).
• These programs are designed to provide effective
  communications and early interventions to reach a
  diverse employees within the workplace culture
  with substance abuse prevention information
  along with related issues such as HIV/STD, TB,
  etc.
• Frequently programs are both peer-developed and
  peer-delivered with resources provided by both
  management/unions. EAPs, and other outside
  professionals have assisted over time with their
  development. Peer educators participate in
  program planning and development to increase the
  effectiveness of interventions.

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WMC Cross-Site Findings

• Operation Redblock
• A 15 year study indicated that the program works!
  One reason - Management and Unions work
  together.
• Operation Redblock prevents substance abuse.
• The program pays for itself!

Return on Investment 26 to 1
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WMC Cross Site Finding

• In a Manufacturing peer-based program, findings
  were not as positive
• Management unions did not work together
• CEO changed did not support peer program

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Early Findings

• Operation Redblock continues to be an excellent
  peer-to-peer program for all employees including
  youth.
• The majority of participants in the pilot program
  said that the most helpful part of the PREVENT
  class was the discussion of personal values.
• Most participants in the pilot program said that
  the PREVENT class made them think about making
  changes in their lives.

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Workplace Challenges Opportunities

• Believing we dont need to invest in prevention
• Believing management can do it alone without the
  unions participation or unions can do it alone
  without management participation
• Youth Multi-generations in the workplace
• New use patterns, changing drugs, prescription
  drugs
• The economy, jobs, benefits, and the future