Team safety and innovation by learning from errors in long-term care settings.
BACKGROUND
Team safety and team innovation are underexplored in the context of long-term care. Understanding the issues requires attention to how teams cope with error. Team managers could have an important role in developing a team's error orientation and managing team membership instabilities.


OBJECTIVE
The aim of this study was to examine the impact of team member stability, team coaching, and a team's error orientation on team safety and innovation.


METHODS
A cross-sectional survey method was employed within 2 long-term care organizations. Team members and team managers received a survey that measured safety and innovation. Team members assessed member stability, team coaching, and team error orientation (i.e., problem-solving and blaming approach). The final sample included 933 respondents from 152 teams.


RESULTS
Stable teams and teams with managers who take on the role of coach are more likely to adopt a problem-solving approach and less likely to adopt a blaming approach toward errors. Both error orientations are related to team member ratings of safety and innovation, but only the blaming approach is (negatively) related to manager ratings of innovation. Differences between members' and managers' ratings of safety are greater in teams with relatively high scores for the blaming approach and relatively low scores for the problem-solving approach. Team coaching was found to be positively related to innovation, especially in unstable teams.


CONCLUSIONS
Long-term care organizations that wish to enhance team safety and innovation should encourage a problem-solving approach and discourage a blaming approach. Team managers can play a crucial role in this by coaching team members to see errors as sources of learning and improvement and ensuring that individuals will not be blamed for errors.
Department of Health Policy Management (iBMG), Erasmus University Rotterdam, PO Box 1738, The Netherlands. buljac@bmg.eur.nl
Martina
M
Buljac-Samardžić
Marianne
M
van Woerkom
Jaap
J
Paauwe
D000223:Adaptation, Psychological; D000288:Administrative Personnel / Q000523:psychology / Q000706:statistics & numerical data; D000328:Adult; D001291:Attitude of Health Personnel; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007318:Inservice Training; D007857:Leadership; D008134:Long-Term Care / Q000379:methods; D008297:Male; D019300:Medical Errors / Q000517:prevention & control / Q000523:psychology; D008503:Medical Staff / Q000523:psychology / Q000706:statistics & numerical data; D009426:Netherlands; D009936:Organizational Innovation; D010348:Patient Care Team / Q000706:statistics & numerical data; D061214:Patient Safety; D018794:Problem-Based Learning / Q000379:methods / Q000706:statistics & numerical data; D011361:Professional Competence; D024382:Professional Role; D011795:Surveys and Questionnaires; D000078329:Workforce