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 Andrea Christoff Wednesday. Dec 4, 2019

Leading a Culture of Safety

As a quality and safety champion within my organization, I am the clinical lead for an initiative to improve the safety culture within our critical care department. Creating psychological safety within a team empowers staff to speak up and promotes the delivery of safer care to patients.


A cohesive team that develops trust in each other is more likely to speak up for safety and deliver high quality care to patients. What are the safety attitudes of our critical care team? This is the question I wanted to explore.


Our team cares for critically ill patients and their families every day and we all come together as a team to provide the best quality care. However, in the past year there has been a shift in attitude and evidence of compassion fatigue. Learning about safety culture through the ISQua Fellowship, empowered me to evaluate our safety climate in order to develop strategies to improve our joy at work.


The Safety Attitudes Questionnaire (SAQ) is a validated tool that the Clinical Excellence Commission (CEC) provides to hospital- based teams. The goal of the survey is to assess the staff perceptions of safety culture. The results are de-identified, collated and shared using facilitated debriefs which are conducted to explain the results to all staff. The goal is to develop change ideas for improving the safety climate within our department based on the feedback from the survey.


I have learned that ongoing collaboration with stakeholders and emphasis on the importance of safety as a science enables the advancement of change ideas. We formed a safety culture group with the support of our senior staff and leadership team. Our motto- Team PICU Leading a Culture of Safety.


During the weeks prior to the launch of the survey we engaged all staff in the process by disseminating information in huddles and departmental meetings. The CEC facilitated safety and leadership workshops and we recruited safety culture champions. The survey was advertised widely with posters and badges to promote participation in the survey.


pic 1      pic 2


The surveys were available to all staff electronically with incentives for completion and weekly raffle prizes. One week after launching the SAQ we had an extraordinary 71% completion rate with positive feedback from both medical and nursing staff regarding the process. We ran the survey for 4 weeks and at the time of closing had an 87% staff completion rate.


pic 3


I noticed that during the 4-week survey completion period, there was a perception of increased staff engagement and participation in quality improvement learning opportunities. I have started to incorporate safety science into morbidity meetings with an emphasis on safety 2 and creating a safe container. The aim of morbidity improvement meetings is to create a learning environment that allows for safe reflection and feedback. Reframing the problem and discussing why events happened as they did by using a system thinking approach to improve process of care.


This process has developed my understanding of transformation concepts, and highlighted the leadership skills required for a team to create change in order to improve the safety climate. The results of the SAQ will be shared with staff and change ideas developed for implementation over the next few months.


Thank you to the CEC for their leadership and ongoing support.


For more information about how you can develop a culture of safety, please feel free to connect with Andrea Christoff on ISQua Community or by email:This email address is being protected from spambots. You need JavaScript enabled to view it.


If you're interested in finding out more about the ISQua Fellowship Programme, please email the ISQua education team: This email address is being protected from spambots. You need JavaScript enabled to view it.






Sign Up for our newsletter and receive a monthly digest of news!

Become A Member Today

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