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A case for safety leadership team training of hospital managers

Singer, Sara J.; Hayes, Jennifer; Cooper, Jeffrey B.; Vogt, Jay W.; Sales, Michael; Aristidou, Angela; Gray, Garry C.; Kiang, Mathew V.; Meyer, Gregg S.

doi: 10.1097/HMR.0b013e318208cd1d

Background: Delivering safe patient care remains an elusive goal. Resolving problems in complex organizations like hospitals requires managers to work together. Safety leadership training that encourages managers to exercise learning-oriented, team-based leadership behaviors could promote systemic problem solving and enhance patient safety. Despite the need for such training, few programs teach multidisciplinary groups of managers about specific behaviors that can enhance their role as leadership teams in the realm of patient safety.

Purpose: The aims of this study were to describe a learning-oriented, team-based, safety leadership training program composed of reinforcing exercises and to provide evidence confirming the need for such training and demonstrating behavior change among management groups after training.

Methods: Twelve groups of managers from an academic medical center based in the Northeast United States were randomly selected to participate in the program and exposed to its customized, experience-based, integrated, multimodal curriculum. We extracted data from transcripts of four training sessions over 15 months with groups of managers about the need for the training in these groups and change in participants' awareness, professional behaviors, and group activity.

Findings: Training transcripts confirmed the need for safety leadership team training and provided evidence of the potential for training to increase targeted behaviors. The training increased awareness and use of leadership behaviors among many managers and led to new routines and coordinated effort among most management groups. Enhanced learning-oriented leadership often helped promote a learning orientation in managers' work areas.

Practice Implications: Team-based training that promotes specific learning-oriented leader behaviors can promote behavioral change among multidisciplinary groups of hospital managers.

Sara J. Singer, MBA, PhD, is Assistant Professor of Health Care Policy and Management, Harvard School of Public Health and Harvard Medical School/Massachusetts General Hospital, Boston, Massachusetts. E-mail:

Jennifer Hayes, EdM, is Qualitative Research Analyst, Massachusetts General Hospital, Boston.

Jeffrey B. Cooper, PhD, is Professor of Anaesthesia, Harvard Medical School, Massachusetts General Hospital, Boston; Executive Director, Center for Medical Simulation, Cambridge, Massachusetts.

Jay W. Vogt, MEd, is Principal, Peoplesworth, Concord, Massachussets.

Michael Sales, EdD, is Principal, Art of the Future, Newburyport, Massachusetts.

Angela Aristidou, MEd, is PhD Candidate, Judge Business School, University of Cambridge, Cambdridge, England.

Garry C. Gray, PhD, is Postdoctoral Fellow, Department of Health Policy and Management, Harvard School of Public Health, Boston, Massachusetts.

Mathew V. Kiang, MPH, is Research Assistant, Department of Health Policy and Management, Harvard School of Public Health, Boston, Massachusetts.

Gregg S. Meyer, MD, MSc, is Senior Vice President, Center for Quality and Safety, Massachusetts General Hospital/Massachusetts General Physicians Organization, Boston.

The intervention in this project was developed by some of the coauthors under their association with the Center for Medical Simulation, a not-for-profit educational organization. The name of the program, Healthcare Adventures, is trademarked, but the description of it given here can be replicated by others, with the exception of the project planning tool, which is copyrighted. Those authors who developed the program were also involved in the design of this study.

© 2011 Lippincott Williams & Wilkins, Inc.