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Improving safety through changes to the practice culture
  1. Hannah C. Perrin, BSc, MA, PGCHE, PGDipHE, FHEA, PhD
  1. Royal Veterinary College, Hawkshead Lane, North Mymms, Hatfield, Hertfordshire AL9 7TA; e-mail:

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IF someone came to your practice for an interview, toured the building and met the staff, what would their impression be? Would they say that the place felt friendly? Professional? Patient-focussed? What would you want for your workplace?

‘Practice culture’ is tricky to pin down. Definitions generally include an organisation's values, habits, assumptions, interactions, working language, traditions, roles and responsibilities; its collective behaviours and the underlying beliefs that drive them. Workplace culture is significantly influenced by senior members in terms of guiding working practices, but is embodied by the entire staff. It is (partly unconsciously) taught to, and learned by, new members of staff by role modelling (particularly by senior members); and by identifying the behaviours and attitudes that are rewarded in the practice – whether explicitly or otherwise.

Harnessing workplace culture to improve safety originated with airlines, and has filtered into veterinary practice via our medical colleagues (Armitage-Chan 2014). One of the most widely implemented initiatives has been the introduction of presurgical checklists in hospital theatres. The major lesson learned from the World Health Organization's safe surgery guide is that success relies on the whole team being involved – from the senior surgeon to the porter that delivers the patient and reconfirms their name (WHO 2009). Clinical audit and analysis after the event, such as significant event audit (Mosedale 2017), are increasing in veterinary practice. But how can we …

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