Hospital Errors Result From a Culture of Fear

To address hospital errors, the Parkland Hospital Board wants more transparency and accountability, as reported last Friday in the Dallas Morning News. Actually, if the board spent some time reading about the root cause of hospital errors, instead of shooting from the hip, they would have found out that more accountability, in the current culture of our hospitals, results in less transparency and more hospital errors. There’s a culture of fear that permeates our medical institutions: fear of litigation, blame, accusations of incompetence, and retaliation.  This creates unresolved conflict throughout the organization because mistakes are not openly dealt with. Fear effectively blocks transparency, open communication and collaboration, which are necessary to resolve workplace conflict and provide a safe working environment. Rather than learning from mistakes and resolving conflict, healthcare managers and leaders place blame (accountability) for errors squarely on doctors’ and nurses’ shoulders. With unresolved conflict, mistrust persists, anxiety grows, conflict and mistakes escalate, creating an unsafe, hostile environment.Unresolved conflict in the workplace is the root cause of hospital errors and pointing fingers does not resolve it. Instead, conflicts are swept under the rug.

To successfully address conflict in the workplace, change must start at the top of the organization. Healthcare managers and leaders (including the hospital board) must be willing to change their behavior and work collaboratively with all healthcare workers to minimize the effect conflict has in the workplace. In a new environment of trust, rather than fear, employees are empowered to openly communicate (transparency) and collaborate and to learn from mistakes, not sweep them under the rug. This results in a spiral of trust and, as a consequence, better patient care. Without change from the top of the organization, mistrust will persist and mistakes will continue to be made.

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