WACEP President's Message, June 2019
Jeffrey Pothof, MD, FACEP
“If you see something, say something” has become common vernacular in post 9/11 America. I suspect most of us think of air travel when we hear that phrase, but the phrase is equally applicable to healthcare and the environments we work in.
One of the most important aspects of safety culture in healthcare is the ability of anyone on our teams to say something when they know or suspect that something is amiss. This includes everyone on our teams. From providers to nurses to techs to volunteers and other supporting staff. The more people who are being sensitive to how things are supposed to work the more likely we are to identify a problem before it ruins our day, or even worse, harms our patient.
Although this idea may seem intuitive and all of us would nod in agree that we as providers expect the rest of the team to speak up if they think a patient may be harmed, I’ve seen repeatedly in my work within patient safety that someone saw or knew something but didn’t say anything. Many will be quick to blame the person who said nothing however the problem is rarely the person. We hear things like “no one acknowledged my concerns before, why would I make the effort to say something this time”, or “the provider put me in my place the last time I raised a concern that turned out to be nothing, so now I just stay quiet because they know what they are doing”.
One of my mentors once told me that as physicians we don’t get a choice as to whether we want to be leaders or not. The only choice we get is whether we are going to be good leaders or not. Many on our teams in the ED look to us for guidance and tone setting whether we want that responsibility or not. When it comes to saying something when you see something, I don’t think as providers it’s enough to raise our hand or speak up when we see something that isn’t right. I think our role is also to communicate directly and with intention to our teams that we expect everyone on our teams to say something when they see something, and then have to foresight to identify when that is occurring and show respect to them while reaffirming that speaking up was the right thing to do--irrespective of whether they were right or wrong. This is how we can change culture, and this is how we can keep patients safer.