On the Ball Leadership for Patient Safety and Learning in Critical Care

Objective: To explore nursing leadership for patient safety in critical care and identify opportunities to improve leadership that promotes patient safety. Background: There is limited systematic evidence about how nurses lead the microsystem of critical care and to the creation of a culture of patient safety. Methods: Focus groups of multi disciplinary frontline providers and managers were used to gain insight into leadership that promotes patient safety and learning. Results: Gains in critical care patient safety require a skilled nursing leader who is mindful of bedside situations and has real-time decision-making authority. Patient safety is seen as management of the moment, rather than a function of organizational systems and processes. Conclusion: Leadership for improved patient safety resides primarily with nurses who provide direct patient care. These nurse leaders play 3 critical roles: they are the "go-to," they are "on the ball," and they "keep the ball rolling."