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Ensuring Medical Practice Safety Through Change


Adopting a safety culture in a medical practice is a difficult process that includes getting everyone on board with and willing to implement changes.

The issue of safety from disease and the tendency to be more prone to disease as a result of poor hygiene standards, has long been a great point of contention in the medical profession, and is often overlooked.

Most practitioners, according to Billie Blair, Ph.D., president and chief executive officer of Change Strategists, Inc., simply believe they won’t be affected, and therefore they don’t have to pay particular attention to safety issues in their practice.

“The medical profession has long held the belief that they are sort of invulnerable to risk from infection as a result of not washing one’s hands,” Blair says. “That’s been the toughest nut to crack in the work that we do with health care systems, is to get the medical professionals simply to embrace the practice of washing one’s hands between patients.”

Too busy to change

Blair explains that when it comes to implementing change, in this case the adoption of a safety culture and rules documentation within a medical practice, the person in charge of the practice needs to assume a leadership position.

Adopting a safety culture means understanding the need for safety and conveying that understanding to the practice staff. The problem, she explains, is that physicians are not necessarily the best managers.

“Physicians aren’t necessarily trained in the issue of management, and what we’re talking about is an issue of management; we’re talking about an issue of change,” Blair says. “Both of those concepts are beyond a physician’s training, and sometimes beyond their interest. They’re trained to listen to and treat the patient.”

Blair explains that every one of her corporate clients is the same — they’re busy. And everyone who is busy uses that as an excuse for not embracing change. In other words, they say that they don’t have the time to step back and take the necessary steps in a technical process to bring about change. The time that they do have needs to be spent treating patients.

“That’s what we typically hear from physicians,” Blair says. “They don’t want to engage in what they consider a fluffy area. And yes, by the time they’ve established their practice they are older, and so they don’t want to change their practice.”

The steps to change

Specific steps that medical practices can take to ensure a safer environment are not unusual. According to Blair, they include properly training staff — not once every two years, but continuous safety training on a regular basis.

“Safety procedures will not be put in place, nor will they remain functional, if that doesn’t happen.”

Next, formulate and document a safety plan for when accidents occur, including the preparation of a policy and procedures manual for the way the practice is run. Perhaps most important, make certain to get commitment from the entire staff. In order for changes to get instituted, the individuals have to want to change.

“And individuals won’t change unless they see what’s in it for them,” Blair says. “So, our role, when we’re there, is to give them the facts and figures, and implore them to engage in the change. And ultimately come around to the point of having them want to make the change.”


hose “facts and figures” include pointing out how staff is more at risk due to some risk practices. And therefore, the practice itself is at risk. Once staff has a better understanding and begins to recognize the need, it develops both an understanding and a willingness to institute change, says Blair.

Making headway?

Blair says that some headway is being made in the battle to convince medical practices to adopt a safety culture. But she also points out that change is not rapid, because it relies on human behavior and human preference. But increased awareness — having staff understand why there needs to be change — is all part of the process.

“It’s an education process, and the more that’s done, and the more it becomes the accepted practice of what needs to be done, the better we will be,” Blair says. “It’s about 30% willingness, 70% unwillingness, but that’s a large increase from where we were five years ago.”

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