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Creating a Safe and High-Quality Health Care Environment


The sphere of health care is among the fastest-growing in the United States economy, which points to the need for recognizing its key problems and improving the quality of care provided to a large population of patients. In the assignment, the topic of safe and high-quality care environments was chosen for identifying best practices for safety improvements and learning about how to overcome common errors for reducing their adverse impact on patients’ health and well-being. The issue will be explored from the perspective of relevant standards as well as theories related to nurses’ care of self and nurses’ contributions to continuous quality improvement (CQI).

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Aspects of Safety and High Quality

When it comes to effective methods of creating a safe and high-quality care environment, establishing an effective organizational climate, balancing out turnover and job satisfaction, conducting a cost analysis, and involving effective leaders in the process of safety and quality management were identified as the most beneficial (Stone, Hughes, & Dailey, 2008). In order for these methods to work efficiently, relevant tools are needed. A bulk of such tools is associated with the effective measurement of nurses’ and patients’ satisfaction, workforce retention, and the identification of the impact care failures have on the quality of services. According to Stone et al. (2008), managers of healthcare facilities can use root-cause analysis, the Plan-Do-Study-Act framework, failure modes, and effects analysis, as well as patient and nurse satisfaction surveys.

Performance measures usually indicate how well a healthcare facility adheres to the established norms and practices associated with patient safety and quality improvement. As mentioned in the report by Smith, Mossialos, and Papanicolas (2008) for World Health Organization, there is a range of performance measures that can be used for assessment. They include composite measures (e.g., responsiveness, equity, efficiency, access, outcomes), information systems, incentives, targets, and professional improvement. The final goal of any of the mentioned performance measures is promoting the achievement of objectives set by specific health systems. For instance, when measuring the access to care by different patients, a healthcare facility can determine whether the quality of care that it provides is enough to cover patients with different access capabilities.

In the discussion about creating a safe and high-quality environment in a healthcare facility, culturally safe practices play an important role. The standard of cultural safety in public health nursing practice is gaining popularity due to the continuous diversification of society and the need for healthcare practitioners to address this trend. As found by Richardson, Yarwood, and Richardson (2016), the creation of a culturally safe environment requires the introduction of collaborative and educative projects that foster better communication between nurses and their patients from diverse backgrounds.

Standards related to quality and safety are diverse and usually cater to demands that patients have regarding receiving health care. In order to create a safe and high-quality environment in a healthcare setting, it has been recommended for the head management and licensing bodies to do the following:

  • Conduct reexaminations of healthcare providers to determine whether they are competent and knowledgeable of existing safety practices;
  • Develop a curriculum for patient safety to encourage practitioners to follow established rules and guidelines;
  • Share information on best quality and safety practices from other healthcare facilities;
  • Conduct regular surveys and interviews with patients and nurses to determine areas for improvement and identify practices that contributed to respondents’ satisfaction with healthcare services (Chang & Chang, 2013).

Nurses’ Roles in CQI

As standards related to safety and quality have been discussed, it is also important to focus on nurses’ accountability and contributions to CQI. Today, nursing professionals encounter such issues as the lack of systematic evaluations, inefficient healthcare systems, and insufficient staffing (Izumi, 2012). To address these challenges, CQI should be aligned with the professional values of nurses, which means that practitioners should have a “longstanding commitment to improve the quality of care they provide” (Izumi 2012, p. 265). Both as professionals and as individuals, nurses are accountable for increasing the interest in healthcare quality by revising the values that make them nurses and clarifying standards necessary for implementing high-quality care.

Nurses’ expertise and experience will also help in getting first-hand knowledge of how quality can be improved in a particular setting. For example, Transforming Care at the Bedside or the Magnet Recognition Program showed that nurses’ practical knowledge about patient care could be transferred into leadership initiatives for CQI. Both examples relate to educating nurses on how they can meet appropriate quality and safety expectations based on their experiences. This means that in order to promote nurses’ accountability within CQI, both financial and leadership resources are necessary.

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Theory of Care

Since continuous quality improvement relies on nurses’ competencies and the application of their professional knowledge, it is important to discuss a theory that can reinforce the nursing practice. Watson’s Theory of Human Caring focuses on relational processes in which healthcare practitioners engage with their patients, families, as well as each other. At the center of the theory, there are ideas that a caregiver should take care of herself or himself for being available to care for patients and that health care is delivered only when two people (i.e., a caregiver and a patient) have a strong connection that will positively influence health outcomes (Foss-Durant, 2014). Taking this into account, it can be suggested that ensuring quality and safety in a healthcare organization will also rely on how nurses care for themselves as well as whether they create meaningful connections with their patients to positively influence their well-being.

Being available in the facility to respond to patients’ needs means that nurses will have to address their workplace satisfaction, resist burnout, and be prepared to withstand stressful situations. In many cases, nurses’ satisfaction will depend on how well the environment in which they operate has been developed and improved (Al-Abri & Al-Balushi, 2014). This means that there is a full circle of creating a safe and high-quality environment in healthcare settings: in order for nurses to be capable of caring for themselves and contributing to quality and safety improvement, healthcare facilities in which they work should regard the well-being of their professionals as a central principle of success.


To conclude, creating a safe and high-quality health care environment in a hospital setting requires continuous monitoring and the measurement of a variety of factors. Ranging from measuring patient satisfaction rates to introducing programs developed on the basis of nurses’ experiences, the improvement of safety and quality of healthcare is a continuous process that will adapt based on the recent trends in the development of healthcare services as well as changing needs of patients and their families.


Al-Abri, R., & Al-Balushi, A. (2014). Patient satisfaction survey as a tool towards quality improvement. Oman Medical Journal, 29(1), 3-7.

Chang, W-J., & Chang, Y-H. (2013). Patient satisfaction analysis: Identifying key drivers and enhancing service quality of dental care. Journal of Dental Sciences, 8(3), 239-247.

Foss-Durant, A. M. (2014). Science of human caring. Global Advances in Health and Medicine, 3(1), 9-15.

Izumi, S. (2012). Quality improvement in nursing: Administrative mandate or professional responsibility? Nursing Forum, 47(4), 260–267.

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Richardson, A., Yarwood, J., & Richardson, S. (2016). Expressions of cultural safety in public health. Nursing Inquiry, 24(1), 121-171.

Smith, P., Mossialos, E., & Papanicolas, I. (2008). Performance measurement for health system improvement: Experiences, challenges and prospects. World Health Organization. Web.

Stone, P., Hughes, R., & Dailey, M. (2008). Creating a safe and high-quality health care environment. In R. Hughes (Ed.), Patient safety and quality: An evidence-based handbook for nurses (pp. 57-71). Rockville, MD: AHRQ.

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