Managing improvements
To manage improvements, it is important to be able to measure and make sure the improvements last. Safeguards must be provided not only for the recommendations themselves, but also for patient safety policy as a whole. This is the most difficult aspect of a SMS.
UMC Utrecht has developed indicators to be added to the items on the Balanced Score Card, the instrument used by the Board of Directors and division management to assess performance. The number of IRC reports are shown in a graph, distributed over the three risk score categories. The aim is a rise in the total number of reports (an indication of a “culture of safety”) and a drop in the number of serious reports. In addition, the Board of Directors will actively investigate to what extent measures from RCA or HFMEA are being implemented. It is important that everybody understands that working on patient safety is not just another hype, but an integral part of daily routine within the whole organization.
Changes in organizational culture take years and as such, require repeated attention on all fronts.