APPLYING EI TO CHANGE THE CULTURE OF PATIENT SAFETY

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Changing a culture prone to medical error is one of the most difficult obstacles to improving patient safety. In the traditional safety culture, blame and judgment undermine reporting and systems improvement. A “fix-the-problem-not-the-blame” approach is at least articulated if not operationalized in most healthcare organizations.

However, simply identifying risk management and quality improvement as a no-blame system is not enough to change a culture deeply ingrained in healthcare providers. The EIPS model may offer a way to change the blame culture (see Figure 13.5). For example, in the story presented, several clinical culture issues predisposed the unit to the error. Using Reason’s model, the culture created holes that made the flow from error to patient harm more likely, especially with the new employee orientation to the clinical unit.
EI/Patient Safety (EIPS) Model.

In this model, good communication skills improve EI skills and good EI skills improve communication. These two skill sets are in a positive feedback loop. If communication skills are poor, EI abilities can improve them. If communication is poor, safety is compromised, but as EI ability improves communication, this negative influence is mitigated via EI abilities.

 

Using the EIPS Model, diagram a patient safety procedure on your unit [in other words- YOUR CURRENT PLACE OF WORK] that has an emotional or interpersonal “hole” in it.

Describe how one EI ability could be used to ameliorate that hole.

Sample Solution

Scenario: Medication Administration

Emotional/Interpersonal Hole:

During shift change, nurses are often pressed for time and may rush to hand off medications to oncoming staff. This can lead to incomplete or unclear information being relayed, increasing the risk of medication errors.

EI Ability to Ameliorate the Hole: Empathy

How it Works:

The outgoing nurse utilizes empathy to understand the potential stress and time constraints of the incoming nurse. Here’s how:

  1. Preparation: The outgoing nurse gathers all relevant medication information beforehand, including medication names, dosages, frequencies, and any special administration instructions.
  2. Active Listening: During handover, the outgoing nurse actively listens to the oncoming nurse’s questions and clarifies any potential ambiguities.
  3. Double-Checking: Both nurses double-check medication details together at the point of handover, ensuring clear communication and reducing the risk of errors.

By employing empathy, the outgoing nurse demonstrates a willingness to collaborate and share the workload, mitigating the pressure on the incoming nurse. This fosters a more positive and supportive team environment, improving communication and reducing the likelihood of medication errors due to rushed handoffs.

Additional Considerations:

  • Standardized Procedures: Implementing standardized medication administration procedures can further streamline the process and reduce reliance on individual communication styles.
  • Technology Integration: Utilizing electronic medication administration records (eMAR) can improve accuracy and reduce the risk of miscommunication during handoffs.

Remember, this is just an example. You can adapt the EIPS Model to any patient safety procedure in your workplace that has an emotional or interpersonal “hole” by identifying a relevant EI ability that can help bridge the gap and improve communication and collaboration.

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