Leveraging a culture of safety and facilitative leadership skills for medical practice excellence

Healthcare organizations still face significant obstacles as they return to normal operations, requiring a radical reorientation of their employee investments to create a thriving workplace.

By combining existing safety culture elements with new processes and protocols formed during the COVID-19 pandemic, healthcare organizations can chart an effective path forward that achieves this goal. 

For instance, medical groups developed comprehensive safety protocols related to testing, vaccination and patient care to navigate the pandemic without compromising employee health or patient care. They also redesigned care delivery models to provide services via telehealth, reallocated staff to manage testing and accommodated extensive vaccination campaigns.

As healthcare providers begin resuming normal operations, sustaining these safety measures can help leaders build trust and enhance collaboration in a post-pandemic environment, which will be crucial for ensuring employee well-being, maintaining patient outcomes and optimizing functionality as public health conditions evolve. 

Safety culture in a post-COVID-19 healthcare sector

Rebuilding resilience in medical practices requires leaders who create conditions in which clinicians and staff feel valued and integral to operational effectiveness. Practice leaders at each level have an important challenge in creating a culture that positively impacts employee well-being and patient care. Culture of safety principles provide a road map for helping with this transition.

First, highly effective leaders are especially proficient in creating cultures of trust, including making it safe to raise concerns, valuing individual contributions and acting on employee feedback. Evaluate leaders’ performance by noting how intentionally they engage with team members in planning and decision-making. 

At the same time, leaders need to be active. Leadership walkarounds during which managers connect with personnel, assess the professional climate, and diagnose potential problems are a tangible and practical element of safety culture. Many organizations have embraced virtual walkarounds during the pandemic, and a hybrid model will be needed going forward as the walkaround is a key tactic for building and sustaining culture. Similarly, involving team members in decisions and asking questions are essential behaviors for effective leaders. Utilizing both inquiry and advocacy techniques, especially during leadership walkarounds, is particularly effective in building trust and organizational resilience.  

Creating and nurturing a sense of collaboration and an autonomous ethos — in which people are comfortable and empowered to make individualized decisions — improves holistic outcomes. Specifically, leaders need to cultivate a culture of transparency and familiarity in which workers feel comfortable reporting safety concerns, reflecting employee safety as a priority across the organization. 

Finally, a strong mission and vision will help healthcare organizations embrace a post-pandemic operational landscape. Take time to revisit the mission and vision, considering the implications of the past year and providing team members an opportunity to put that experience into perspective. Provide an opportunity to help team members identify actions and ways of thinking that encourage looking forward. 

The importance of facilitative medical practice leaders

Regaining equilibrium after the impact of the pandemic will take time. It requires intentional steps and continual assessment of priorities. It especially requires a facilitative leader — one who focuses on actions that build connection and engagement among team members. To reestablish this equilibrium, support key facilitative leadership behaviors, including coaching, increasing engagement through inquiry and advocacy, and maximizing collaboration and working together. Here are three steps to achieving these critical results: 

1. Invite and train physician leaders in collaborative best practices 

The pandemic drastically disrupted the realities of working together and created conditions in which collaboration and decision-making processes shifted continually. As we return to more stable conditions, establishing and renewing collaboration and shared decision-making practices will be needed as clinicians and staff move forward.     

Helping leaders build new capabilities that develop and encourage teamwork and openness to others’ ideas will define healthy healthcare organizations in a post-pandemic environment. As healthcare leaders become facilitative leaders, they prioritize and develop trust at every level. They become managers of the decision-making process rather than makers of all decisions. They find opportunities to include team members appropriately, reinforcing the shared responsibility for a culture of safety.

2. Reflect on existing practices and embrace change 

Organizations need to take time to stop and process what happened over the past year. 

Many healthcare workers are exhausted and burned out, overwhelmed from pandemic trauma. According to one survey, two-thirds of doctors felt “intense burnout” during the pandemic.1 At the same time, despite surging patient loads during the pandemic, healthcare systems lost significant revenue as increased safety costs and declining revenue from elective procedures and decreased primary care interactions decimated their bottom lines, costing millions of healthcare workers their jobs, and causing others to take on new responsibilities while their incomes were reduced.2

Leaders, especially those in healthcare, should take the necessary time to identify the dramatic effects of the pandemic on their people and the ways they have been working together. Facilitative leaders use skills including inquiry, consensus building and systematic approaches to planning and action that are essential in transitioning to new ways of working together. A critical skill of a facilitative leader is to provide a deliberate and well-designed process to reflect on the events of the past year and encourage team members to consider what they have learned. These actions help reset the culture and are essential for successful transition to post-pandemic healthcare. 

3. Evaluate success

One of the most important insights from the past year has been understanding that measures of success must be multi-dimensional. With results-driven, quality healthcare as the cornerstone, facilitative leaders know that evaluating staff and clinician engagement is also important. Accounting for and measuring the way work gets done (process) as well as the connection among those who do the work (relationship) is especially important as the practice moves forward.  

Facilitative leaders know that process and relationship are generally leading indicators of success, while results-driven outcomes are, by definition, lagging indicators. Managing the three dimensions of results, processes and relationships is necessary to transform culture so that sustainable success can occur. 

Conclusion 

As healthcare providers move into the future, it’s important to review and rethink the impact of the past year on their leaders and on the new leadership capabilities necessary for future success. They will need to invest in their teams to maintain a thriving work environment that delivers outstanding patient care and supports employee well-being. By harnessing the safety culture, healthcare providers can effectively meet the moment. Supporting clinicians and staff can help produce better patient outcomes. Facilitative leaders make this possible by empowering everyone to be impactful contributors in this unique and important moment of possibility. 

Notes:

1. Jacobs A. “A Parallel Pandemic Hits Health Care Workers: Trauma and Exhaustion.” The New York Times. Feb. 4, 2021. Available from: nyti.ms/3mrcfW4.
2. Fadel L, et al. “As Hospitals Lose Revenue, More Than a Million Health Care Workers Lose Jobs.” NPR. May 8, 2020. Available from: n.pr/3muQ1Tq.