Featured Article: Why Civility is a Matter of Safety

As a psychologist who helps businesses improve their safety and quality outcomes, I often find myself talking about the importance of respectful interactions. People working in industrial companies often think I’m referring to touch-feely, full-and-puff stuff that doesn’t really matter. So I’m happy to see research that provides evidence to which every man and woman can relate.

What New Research Says About Polite Communication

This week JAMA Surgery published a study showing that respectful interactions between doctors and patients impacted surgical outcomes. The more polite the doctors, the less likely their patients were to suffer complications and medical errors. The study authors concluded, “Efforts to promote patient safety and address risk of malpractice claims should continue to focus on surgeons’ ability to communicate respectfully and effectively with patients and other medical professionals.”

True, though the importance of respectful communication applies to all healthcare professionals, not just surgeons. And, this lesson extends beyond the healthcare industry. Let’s hope we don’t need to wait for comparable research to be conducted for every specific industry before company leaders will take head. It makes sense and one thing I’ve learned is that business leaders appreciate common sense solutions.

Examples That Resonate with Everyone

Concrete examples might help drive the point home. Consider this tragic chemotherapy mix-up that was expressed by a participant in a roundtable discussion hosted by the National Patient Safety Foundation.

The mother said, “That doesn’t look like the chemo she has gotten previously. Are you sure it’s right?” She asked again a bit later. And she asked a third time. She was right and her child—who had a curable cancer—died of a chemotherapy mixture error. The nurse confirmed each time that the label on the bag was accurate. And each time, the nurse assured the mother it was the right medication. And she was right—the label said the right thing. But that wasn’t what was in the bag.

Or what about the widely publicized story of 18-month old Josie King recounted in Sorrel King’s memoir, Josie’s Story? As recounted by Josie’s mother, her daughter died because healthcare providers failed to communicate appropriately. Although one doctor listened to the mother’s concerns about Josie’s signs of dehydration from opiate painkillers and changed her care accordingly, another doctor failed to honor the change without discussing it with Sorrel King despite awareness of her concerns. Then a nurse rudely rebuffed Sorrel’s repeatedly expressed concern about the medication’s affect on Josie and her stated objection to another dose of the powerful painkiller. It turned out mother knew best—Sorrel King had observed the sort of behavioral changes in her daughter to which medical professionals and lab results are often not equally attuned. The last dose killed Josie.

Reviewing Your Workplace Incidents and Culture

Now think about your company’s last ten major rework and safety incidents. Did they involve breakdowns in communication? Would the incidents have been less likely to occur if people used a standard process for handing off a project, repeated back essential elements of the handoff before proceeding, or were encouraged to ask clarifying questions?

Listen to exchanges between people where you work. Do employees consistently seek to understand before they attempt to be understood? Do they express appreciation when others ask questions? Is the use of repeat backs a standard operating practice? You will be well on your way to creating a culture of safety when you can answer yes to these questions.

About the Author

Gretchen LeFever Watson, Ph.D. is a clinical psychologist and President of Safety & Leadership Solutions—an organizational change management firm that is a SWaM-certified business. Her work has drawn international scholar and media attention with appearances on national TV and radio programs. She consults with diverse industries. Her book entitle Your Patient Safety Guide: How to Protect Yourself and Others From Medical Mistakes will be published in 2017. In addition to providing valuable information for healthcare professionals and the public, her book contains important lessons for anyone seeking to improve their company’s culture or safety record. 

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