People-Based Patient Safety: A New Approach to Eliminating Medical Errors


Coastal Training Technologies’ People-Based Patient Safety® program provides the newest training paradigm for the healthcare industry. The goal remains the same – preventing medical errors – with an estimated 98,000 American patients dying as a result of medical error each year, patient safety is healthcare’s No. 1 priority. 

Transcending conventional patient safety awareness training programs, People-Based Patient Safety® involves a deeper understanding of human nature, including why we make mistakes and take calculated risks. Its foundation rests on the holistic ACTS framework: Acting, Coaching, Thinking and Seeing. Together, these four skills motivate safe behavior, elicit staff cooperation, eliminate medical errors and enhance patient care.

Through an activator-behavior-consequence framework, the first skill, ACTING, uncovers systemic and personal factors that impede safety initiatives. For instance, the distance to the nearest hygiene facility can and does keep healthcare staff from washing their hands. 

The second skill, COACHING, demonstrates how safety can become an interdependent enterprise. It creates a culture where team members watch out for each other’s safety. By redefining communication parameters -- the role of hierarchy, leadership, listening skills, etc., it facilitates constant and constructive feedback within a group.

The third skill, THINKING, touches on the mental and psychological dimensions of safety. Distractions, automatic thinking and routine tasks can cause errors. People-Based Patient Safety® trains workers to focus, be mindful and concentrate on their tasks.

Developing the fourth skill, SEEING, sheds light on how attitudes and beliefs can blind healthcare staff to unsafe behavior. It sharpens their eye for danger and helps them resolve potential errors before they can cause harm.

Developed by Coastal and E. Scott Geller, PhD, People-Based Patient Safety® has initiated a practical and philosophical shift from compliance to commitment; from failure-avoidance to success-seeking; from outcome-focused to behavior-focused; from quick fix to ongoing improvement; and from safety as priority to safety as value. 

People-Based Patient Safety® breaks down common cultural barriers to safety and busts patient-safety myths. It redefines the roles of both leaders and workers and offers a more ‘democratic’ method of safety management. Most importantly, it presents a global, system-based and comprehensive examination of factors affecting safety: the working environment, logistics, leadership, communication, employee feelings, beliefs, and attitudes.

The principles of People-Based Patient Safety® have been applied in many hospitals around the country – with great success. Anita Brennan, MS, RN, CFNP, chronicles how Veteran Affairs’ University Drive acute-care hospital eliminated MRSA infections in its post-surgical unit. 

The unit removed the obstacles that kept staff from washing their hands.  Among other measures, it placed facilities nearer workstations, since the workers found them too far and therefore inconvenient. Once the corrective engineering controls were set up, the unit systematically measured behavior and reported the results: handwashing increased by 30 percent and MRSA cases declined accordingly. 

In their analysis, the unit also revealed that workers washed their hands more often when they knew the consequences of not doing so. Both cases show why behavior has to be tracked and accounted for. Once workers realize that a particular practice causes harm, they will be more likely to alter the practice.  

The principles of People-Based Patient Safety® are discussed in Dr. E. Scott Geller and Dave Johnson’s book, People-Based Patient Safety®: Enriching Your Culture to Prevent Medical Error. The book illustrates the practical philosophy of the paradigm and provides case studies to illustrate its success. For more details, visit

Source: Coastal Training Technologies Corp.

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