Do rules and guidelines really make healthcare safer? For sure, their presence does give the idea that we have controlled the environment and made it safe, which is a comfortable thought in a high-risk environment such as healthcare. However, what happens if an unexpected event arises that we did not account for? We could of course make another guideline and fix the hole in our otherwise completely air-tight rulebook.

Opportunity for resilience, adaptability, and craftmanship

Managing a healthcare organization this way is like playing a whack-a-mole game: every time one emergent issue is treated by a changing guidelines and rules, another one appears to take its place. Continuing to treat immediate causes of incidents this way is an unfruitful endeavor. In an increasingly complex healthcare system, relying only on guidelines has become an outdated thought.

Guidelines can certainly provide support in high-stress environments, but the concept of a one-size-fits-all guideline that deals with all possible events is an elusive ideal that is not realistic. In facing uncertainties, it is precisely the adaptability and resilience of care providers, the craftsmanship, that often, but not always, ensures that good care is provided. However, how, when and under what circumstances this is allowed is rarely made explicit. The amount of freedom is strongly dependent on the expertise of the healthcare professionals, context, and dynamics of the team, as well as the organization.

Team success through active safety leadership

In these team dynamics, active safety leaders play an important role. They set up a team for success by driving change, promoting safety behavior, creating an open climate for discussion of issues, and establishing a culture of mutual accountability of team members. Such leaders cultivate teams of healthcare professionals that possess the required adaptability and resilience. This supports effective remedying of unforeseen unsafe situations, and establishes an intrinsic team motivation to learn from incidents.

Such team dynamics can perhaps be compared to rowing. The leader steers the boat and makes sure that all team members work harmoniously to reach the finish line as fast as possible. Harmonious rowing determines the speed, and speed determines the winner in the next race. Resilient teams that meet operational and safety goals work together like the harmonious strokes of the oars.

To conclude, rules and guidelines can certainly provide support, but the added value of individual craftsmanship on top of these protocols and procedures should not be underestimated. Active safety leaders help create the conditions in a team to operate safely and effectively at times when rules and guidelines fall short.

Would you like to learn more about how leadership goes hand in hand with safety and team performance? Don’t hesitate to reach out to me on [email protected]. For more information about what I do in my work, please have a look at our website!