PCSAO: Safety Culture Community of Practice

Abstract Public Children’s Services Association of Ohio (PCSAO): Safety Culture Community of Practice Purpose An assessment of fifteen Ohio counties public service agencies can identify highly actionable needs related to safety and system-level resilience. Safety Culture Surveys are used extensively in areas such as healthcare, aviation, and high-risk industrial settings to improve safety, effectiveness, and reliability. These assessments are also an often used first step toward system-level culture change efforts in high-risk work settings. This abstract outlines a draft strategy for administering and using a safety culture survey. An organization’s culture is made up of the artifacts and rituals that shape how members understand and participate in their work and environment (Schein, 2010). A safety culture is a facet of an organization’s broader organizational culture and is generally understood to be the product of the values, beliefs, and behaviors of its members. In a safety culture, those qualities orient the work toward safety as the prevailing priority for members, and there is a focus on team-based solutions that simultaneously improve practice and address workforce resilience (Commission to Eliminate Child Abuse and Neglect Fatalities, 2016; Cull, Rzepnicki, O''Day, & Epstein, 2013). Organizations with a strong safety culture create a space for learning and improvement, particularly following errors or mistakes, and they understand the importance of systems-thinking in problem solving efforts (Morath & Turnbull, 2005). Moreover, across industries these organizations achieve better outcomes and workforce stability (Vogus & Hilligoss, 2016). Qualifications Teams with a well-established safety culture monitor and plan for vulnerabilities in the system and work toward continuous improvement and accountability, which leads to decreased bias in decision making and improved practice at many levels (Sutcliffe, 2011). In order to build this culture of safety, teams first need to understand more about their existing team culture. Implementing a safety culture survey in Ohio’s counties would help to establish benchmarks of team culture components, like psychological safety. Looking at individual team cultures within the larger context of Impact teams would allow teams to identify their potential areas of improvement and areas of strength. For example, if Team A reports lower psychological safety scores than the Impact average but higher workplace connectedness scores than the Impact average, this team might conclude that psychological safety represents an area of improvement but that workplace connectedness represents a strength for this team. Subsequently, Team A could implement team-based strategies to build psychological safety in their team to address this targeted area of improvement. If workplace connectedness is identified as a strength, Team A might serve as a model or consultant for how to build strong workplace connectedness for other Teams that may be struggling in that area of safety culture. We have established strong relationships between these constructs measured in the safety culture survey in child welfare teams. Professionals with higher levels of workplace [Type here] connectedness are more psychologically safe. Psychologically safe professionals have higher retention rates, lower levels of emotional exhaustion, and better team work skills. The real strength of measurement lies in its ability to be used is for the purposes of communication and change. The use of a safety culture survey within the team may indeed have an interventional aspect in and of itself: assessing constructs like psychological safety, mindful organizing, and emotional exhaustion gives weight and importance to these aspects of a team culture. Furthermore, an assessment of this kind helps a system develop a language to talk about these issues; language itself can be an effective tool for culture change. The purpose of studying and shifting the culture of a team is not just to build a safety culture as the end goal: the purpose of building a safety culture is to help teams become more safe, effective and reliable in their operations in order to improve outcomes for the children, families, and communities that these teams serve. The collective capabilities that emerge from elements of safety culture, like mindful organizing, are thought to be effective at identifying and combating individual and team cognitive biases that impact decision-making, as multiple perspectives can be accessed before and during the decision (Gebauer, 2013). Teams that are more psychologically safe, organized, and resilient make better decisions. Understanding and enhancing the culture of these teams in order to support teamwork, decision-making, and communication is the first step in improving outcomes for this high- stress, high-consequence work. The Safety Culture Survey we use with organizations consists of three sections: 1) A set of workforce and demographic questions; 2) Scales measuring aspects of safety culture most relevant to your workforce; 3) Additional questions designed to measure agency-specific practices. Methods Scope of Work: • Safety Culture Survey Administration (15 counties) The survey will be anonymous. o 5 hours of Survey Design o 2 hours Survey Implementation o 15 hours of Survey Aggregation/Report Out Development o Total: 22 hours o Proposed Time: April-July 2022 • Post-evaluation: Safety Culture Survey o Administration and Data Collection with Report Out o Total: 20 hours o Proposed Time: : January 2024-February 2024 Length of Contract: 2 Years (April 2022 to April 2024). We will use REDCap, HIPAA compliant web-based software to administer both surveys electronically. [Type here] Qualifications of Key Staff Tiffany Lindsey, EdD Background and experience: Dr. Lindsey is an Assistant Professor and Safe Systems Practitioner at the Center for Innovation in Population Health at the University of Kentucky. Her work focuses on quality improvement and system reform efforts in child welfare jurisdictions. Lindsey has specific expertise in applying safety science to improve the safety, reliability, and effectiveness of organizations. Her approach leverages tools like organizational assessment, team-based behavioral strategies, and systemic analysis of critical incidents, including deaths and near deaths, to help organizations learn and improve. Lindsey has 10+ years experience in child welfare and is co-author of two tools within the Transformational Collaborative Outcomes Management (TCOM) framework—the Safe Systems Improvement Tool (SSIT) and TeamFirst: A Field Guide for Safe, Reliable, and Effective Child Welfare Teams. With the support of Casey Family Programs, Lindsey provides technical assistance and content expertise to the National Partnership for Child Safety—the first member-owned quality improvement collaborative in public child welfare. Before coming to the Center, Lindsey served as a quality improvement director within Tennessee’s Department of Children Services (DCS). During her time at DCS, she oversaw the Department’s nationally acclaimed child death review process and was foundational to its creation. She provided leadership to DCS’ safety culture survey, confidential safety reporting, and several other applications in safety science. She taught team-based casework strategies at DCS’ Child Protective Services Academy, held in partnership with Vanderbilt University and the Tennessee Bureau of Investigation. Lindsey also has a strong clinical background working with vulnerable populations. Lindsey is a licensed professional counselor with special designation as a mental health service provider. She holds a Master of Art in Marriage and Family Therapy/Professional Counseling from Johnson University and a Doctor of Education in Leadership and Professional Practice from Trevecca Nazarene University. Position Description: Safety Culture in Child Welfare Lead Elizabeth Riley, PhD Background and experience: Dr. Elizabeth Riley is a Clinical Psychologist and Assistant Professor at the Center for Innovation in Population Health at the University of Kentucky. Elizabeth has a research and clinical background in trauma and substance use among adults. She has a strong publication and external funding record, and she has worked predominantly in academic settings. Elizabeth also works as a clinician and has a passion for working with complex, high-need/high risk client populations. Elizabeth received her PhD in Clinical Psychology from the University of Kentucky in 2020. Position Description: Organizational Assessment and Data Lead [Type here]