Offering the latest news in health care quality and safety, the ISQua blog also features guest posts from the best and brightest in the industry.

By BK Rana, ISQua Board Member Thursday. May 30, 2019

Improvement Culture vs Compliance Culture in Healthcare Featured


In the last 10 years, a lot has happened around the world as far as healthcare quality and patient safety is concerned.


This includes efforts from the World Health Organisation (WHO), the epitome of healthcare-related enterprise, to Ministries of Health, and down to single-doctor clinics.


These efforts cover the most developed nations as well as least developed. Huge praise should be given to leaders at all levels for driving the agenda.


However, the question I often ask myself and my colleagues is, is it making a change or just another exercise?


I see the existence of a voluntary system on one hand and a mandatory system on the other. I am yet to see the adaption of quality and safety as a culture to improve and not a race for mere compliance of standards.


It is interesting to witness special preparations just before a compliance audit and not witness a sustainable system which is always ready. All these initiatives to adopt the standard thinking in a way to improve quality and safety, and they get lost in the cracks. It makes me ask several questions.


Why don’t we follow an approach like a disaster management plan which is always ready to tackle any adverse situation, and include mock drills in between to ensure that ‘all is well’ without any special preparation?


Why do only a small group of few select people in the organisation ‘looks after’ quality and safety instead of encouraging everyone to engage in patient safety?


Why are we unable to convince healthcare providers that compliance culture only gives a one-time benefit but an improvement culture will continue to give benefits in terms of reducing avoidable errors/ harms/ risks, reducing waste, increasing efficiency and effectiveness, increase patient satisfaction, increase community confidence, and hence significant financial savings on a continuous basis.


Is patient safety just the patient’s business or everyone’s business?


What are we missing?



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We all have two vocations in health care – to do our job and to continually improve