I am a firm believer in explaining the big picture and the root of why people do certain things. I think that is especially important when it comes to medication safety initiatives and processes that have been put in place to improve safety. If we don’t explain the big picture of why, we risk staff viewing the processes as a waste of time and energy, and ultimately we risk those processes not being followed. How well does the why get disseminated out to staff? If you are a pharmacist, how well do you disseminate information to the pharmacy staff and do you take it to the next step and confirm nursing or physician staff understand? It is critical all disciplines involved in the process, even peripherally, understand the why. Sometimes the why seems so obvious! But I continue to be amazed at the number of times staff just don’t get it. This tells me just because it may be obvious to you, it is still worthy of messaging out the information and educating to the background of the process. Staff are more inclined to follow the safer process if they see the value and understand the history as opposed to seeing it as one more hoop you have given them to jump through. This premise also applies to the need for all staff within the facility to report medication errors. Does your facility have a true understanding of what is done with those reports? Are they aware of any changes that have been implemented as a result of an error? Do they understand the value of reporting near miss errors?
Reporting takes time. You are not likely to get the majority of staff to engage in reporting unless they understand the big picture and why it is important. Of course, having said that, their reporting needs to lead to improvements or else they are right in thinking it is a waste of time.
Explain the expectations for staff to follow policies and procedures and report errors, but also explain why that is important. This takes time, but it is well worth it. A the by product, if you can’t explain it, then perhaps the policy or procedure should be reevaluated!
If you can’t explain it simply, you don’t understand it well enough — Albert Einstein
