Patient Safety Leadership Walkrounds: Promoting a Safety Culture in Developing Countries

Document Type: Letter to the editor


1 Iranian Center of Excellence in Health Management, Student Research Committee. Department of Health Service Management, School of Health Services Management and Medical Informatics, Tabriz University of Medical Sciences, Tabriz, Iran

2 Road Traffic Injury Research Center- Shahid Mahallati Hospital, Quality improvement office

3 Professor of Nursing and Practice Development, University of Teesside, Middlesbrough, England, United Kingdom.


Patient safety is the cornerstone of health care quality and governance(1). Globally the emergence of what could be regarded as a ‘patient safety movement’can be attributed to the following: firstly, health care organizations were trailing to develop and promote a positive attitude and safety culture(2). Secondly, apositive patient safety culture is one in which every individual, providing the care, should have the necessaryknowledge, understanding and is competent in skills of risk evaluation and reduction. Thirdly, where safety is a potential issue individuals should be encouraged and supported to promote changes through education and training(3). Fourthly, promotion patient safety culture interventions need to be rooted in the principles of teamwork, hospital leadership and behavioural change(4). Finally, an effective way to translate clinical leadership into health care quality improvement and patient safety is to focus on promoting the principles aligned to a duty of candour into frontline practice (5).

Various interventions and strategies are available to improve safety culture(3). For example, Patient Safety Leadership Walkrounds (PSLW) is a strategy engaging directly hospital leadership with frontline staff(4, 6). A multidisciplinary team of hospital executives visit the patient care areas in hospital to observe and identify the current and potential risks and discuss with the frontline care providers to eliminate them. In a walkround, the team and staff discus about safety issues only and they plan to improve safety issues (such as safety culture, equipment, patient safety, building safety and etc).Walkrounds show the commitment of hospital leadership and foster trust and psychological support for frontline staff(7).

The way forward for hospitals, especially in developing countries with restricted resources, where urgent interventions are required like patient safety leadership walkrounds. The aim of this initiative is to improve safety culture, care effectiveness and patients’ outcomes. It brings leadership commitment to the front-line efforts to improve patient safety.