Despite decades of effort and innovation since the groundbreaking To Err is Human) report over 25 years ago, preventable harm in healthcare persists, and violence against healthcare workers continues to rise. With record understaffing, burnout, mandatory overtime, and mounting documentation demands, the pressure to provide safe care has never been higher nor the stakes more urgent.
In this first episode of our new series focusing on safety in healthcare, we explore a bold shift toward "total systems safety" with two leaders at the forefront of this movement who know these challenges all too well. Patricia McGaffigan), RN, MS, CPPS, Senior Advisor for Patient and Workforce Safety at the Institute for Healthcare Improvement, and President of the Certification Board for Professionals in Patient Safety, and Donald Berwick), MD, MPP, FRCP, President Emeritus and Senior Fellow at the Institute for Healthcare Improvement, and former Administrator of the Centers for Medicare and Medicaid Services.
Together, they continue to shape national safety efforts including IHI’s Safer Together: National Action Plan to Advance Patient Safety) the first public-private collaboration of its kind. Spearheaded by McGaffigan and bringing together 27 major organizations that had never collaborated before. The plan aims to restructure the very foundation of healthcare, building safety into every level of the system around four interlocking pillars.
Leadership & Governance: Strong, visible leadership and policies that make safety a strategic priority.
Workforce Safety & Well-Being: Protecting nurses and healthcare workers – physically and mentally – so they can care safely for others.
Patient & Family Engagement: Partnering with patients and family caregivers as co-designers of safe care.
Learning Systems: Creating feedback loops and continuous improvement so lessons from one hospital spread everywhere.
At the heart of this movement is a truth long understood by nurses: safety is not a checklist or a policy, it’s a culture, a commitment, and a collective responsibility. As Patricia McGaffigan reminds us, “You can’t have patient safety if you don’t have a safe workforce.” And as Don Berwick warns, “The illusion that safety is a matter of individual effort is one of the most toxic notions in the whole safety enterprise. It is we, not me.”
Nurses have always led by example, holding space for healing while navigating broken systems. Now, their leadership is essential in building the future of healthcare safety: one that protects not only patients, but the people who care for them. Where healthcare is not only safer, but also is a culture that ensures we’re all Safer Together.
