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Framework for Patient Safety, Part 1: Culture as an Imperative

Blouin, Ann Scott PhD, RN, FACHE; McDonagh, Kathryn J. PhD, RN, FACHE, FAAN

JONA: The Journal of Nursing Administration: October 2011 - Volume 41 - Issue 10 - p 397-400
doi: 10.1097/NNA.0b013e31822edb4d

Nurse leaders play a critical role in patient safety. They are essential in building a culture of safety and engineering resilience into workflows and patient care processes enabling healthcare organizations to progress toward high reliability. In part 1 of this 2-part series, the authors discuss the critical nature of a safety culture: why trust and respect lead to teamwork and collaboration in preventing serious safety events. Part 2 will introduce the emerging healthcare concept of high reliability, described through examples of health systems that have successfully adapted models from other industries. Use of technology and other advancements provides a context for advancing patient safety. Aligning culture and engineering technology for safety, when coupled with effective leadership, can provide a long-term approach for safe and effective care.

Author Affiliations: Executive Vice President (Dr Blouin), The Joint Commission, Oakbrook Terrace, Illinois; Vice President (Dr McDonagh), Executive Relations, Hospira Inc, Lake Forest, Illinois.

The authors declare no conflict of interest.

Correspondence: Dr Blouin, The Joint Commission, One Renaissance Blvd, Oakbrook Terrace, IL 60181 (

© 2011 Lippincott Williams & Wilkins, Inc.