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 multidisciplinary 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.


CONCLUSIONS
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."
Tregunno
Deborah
D
York University School of Nursing, Toronto, Ontario, Canada. tregunno@yorku.ca
Jeffs
Lianne
L
Hall
Linda McGillis
LM
Baker
Ross
R
Doran
Diane
D
Bassett
Sue Bookey
SB
D002983:Clinical Competence; D003422:Critical Care / Q000458:organization & administration*; D005260:Female; D017144:Focus Groups; D006801:Humans; D007857:Leadership; D007858:Learning; D008297:Male; D017146:Models, Organizational; D009718:Nurse Administrators / Q000458:organization & administration*; D036301:Qualitative Research; D012449:Safety / Q000592:standards*; D012866:Skilled Nursing Facilities / Q000458:organization & administration*; D014481:United States