Getting safety right means engaging and aligning the levels of the organization and all its constituencies in the right ways. Nurses and physicians have allegiances to their professions; and physicians, to their practices. Do these groups perceive the need for safety improvement? Both caregivers and non-professional staff are present at the point of exposure and their engagement and behavior are critical to safety improvement, but the scope of their organizational influence is limited. Organizational leaders can make decisions about resources and organizational direction, but they are limited in their ability to enact the particulars of work at the bedside. Supervisors and middle managers express the organizational culture and priorities to their reports while managing and representing that workforce to the larger organization.

When these groups work for a common purpose, their cooperation creates a platform on which safety, and other critical business performance, can be built. BST's Leading with Safety® approach, based on a validated model that defines the elements that influence safety outcomes, helps organizations connect employees at every level for world-class performance. Our focus and project management discipline ensure that our clients are set up for success at each step of the process.

The Blueprint for Safety Transformation is a conceptual model that shows the key elements needed for sustainable safety excellence:

The Working Interface • This is where exposure to injury occurs — where people come together with patients and their families, equipment, facilities, and the processes through which treatment is administered.

Safety Enabling Systems • These are the systems used to identify and eliminate or mitigate exposure.

Organizational Sustaining Systems • These systems or business processes help assure that safety enabling systems are used as intended; sustaining systems are not specific to safety.

Culture • Often described as “the way we do things in this organization”, culture influences the day-to-day effectiveness of both enabling and sustaining systems, and most importantly, the behavior of individuals.

Leadership • Placed at the top of the model, leadership drives culture and influences the design and use of enabling and sustaining systems.

While each of these elements is independently important, long-term success and stellar safety performance requires integration and alignment of the elements. When true integration happens, safety becomes a part of the fabric of the organization rather than a stand-alone activity.