Safety is Important, But

Added on May 22, 2015


Patient Safety

Butts are cute – especially on babies. Just don’t put them in the same sentence with safety. Once you have said “safety” and “but” in the same sentence – there is no way to put safety first.

Safety does not do well in a tie for first place with quality or satisfaction or cost.

Events – events of patient harm or personal injury – usually do not happen. Other pressures, such as schedule demands or provider needs or patient needs, stare us in the face every minute of every day. Putting safety in a tie with quality, satisfaction, and cost makes it too easy for us to borrow from safety. And when we borrow from safety – we allow for harm and injury.

“But” is the anti-safety statement. To be Safety First there can be no if’s, and’s, or but’s.

As another poor word choice – “at least” is the anti-empathetic statement. According to Dr. Brene Brown, a teacher, speaker, and a researcher at the University of Houston, once you have said “at least” there is no way to show empathy.

Safety includes empathy. Empathy connects communicators and creates trust. Trust keeps patients on treatment plans, resulting in better outcomes, and keeps patients and families observing precautions, which prevents harm.

Theresa Wiseman, a nursing scholar in the UK, defines four attributes of empathy:

  • 1. Perspective taking (taking the perspective of the other person as truth)
  • 2. Avoiding judgment (perceiving, not judging)
  • 3. Recognizing emotion in other people
  • 4. Communicating your understanding of those emotions


Use your Tones and Tools to show empathy and thereby reduce power distance among caregivers and between caregivers and patients. Reducing power distance keeps patients safe. And those very same Tones also improve quality and satisfaction as part of the broader patient experience. (Yes, they also improve patient satisfaction.)

One more word choice to avoid: please do not say “just” when diagnosing and assessing. Inherited knowledge is trouble enough (see Croskerry’s work in debiasing diagnosis). Do not minimize patients by labeling them with “just.” Here is a case of patient harm as a delay diagnosis from this week. Mom brings her little boy to the ED with just a sore throat. The little boy – sitting in the waiting room – eventually could not breathe or swallow. He had severe epiglottitis, and he nearly died. There was no “just” to it.