Personal safety ethic

At the core of the Safety Leadership Model is the leader s personal safety ethic. Culture receives and hosts the effects of a leader s values and behavioral standards— what he believes is important, what is acceptable, and what is not. Of course, what s important here is not what a leader says he values, but what he actually values—the ethics manifested in his personal behavior. 

So getting these most basic core elements right is the place to start. This tenet doesn t mean that you need to become the perfect safety leader before taking action. It just means that you need to understand how your personality drives your behavior, what your true personal values are, and how to act from a position of informed commitment. 

A leader s personal safety ethic is a blend of the leader s personality, values, and emotional commitment to safety. Let s explore each one. 

Personality refers to individual differences in how people tend to think, feel, and act. We are all different, but what tendencies or dispositions make us different Personality research addresses what is unique about the individual in terms of specific traits and attributes. 

Personality research took a giant step forward when factor analysis (a sophisticated statistical technique) revealed that the dozens of personality attributes and traits that had been studied over the years could be reduced to five core attributes that define individual differences. Known as the Big Five (Table 4-1), the attributes have been subjected to extensive research  

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Dr. Krause in his article derides the absence of a personal safety ethic on the part of too many CEOs. Safety management too often is engineered in fits and starts. Safety cannot be an on-again, off-again priority, he writes. Too frequently, he says, innovative safety ideas filter slowly to the top of organizations the result common delays or outright dismissal of the proposal. 

The model can be read two ways from the inside out, with the individual leader s personal safety ethic, leadership style, and practices emanating outward to the culture or from the outside in, with the culture of the organization affecting the individual leader. Since our interest is primarily in how leaders influence culture, we will approach the model from the inside out. From the inside, each ring leads to the next and ultimately to business results. Who the leader is (her personality and values) sets the foundation for how she influences (her style), and what she does (her practices). Leadership practices shape the organization s culture, which, in turn, shapes safety results. 

Who the leader is lies at the center of the model. The leader s personal safety ethic is at the core of safety leadership. No one can be an effective patient safety leader without genuinely valuing the safety of others. Personality, values, and emotional commitment are part of this ethic. Because our personalities are developed early in life and tend to change little in adulthood, a leader is more successful in achieving his desired ends when he understands how his personality affects his behavior and is experienced by other people. 

How the leader influences—the leader s style—encircles his personal safety ethic. Over the years, researchers and scholars have described a plethora of leadership styles—laissez-faire, autocratic, charismatic, participative, transactional, theories X, Y, and Z—to name just a few. One widely researched style, transformational leadership, stands out as consistently predictive of business outcomes. The transformational leader focuses on the future, and her approach is strongly oriented toward developing her people. By going beyond her own self-interest, such a leader inspires employees to go beyond their mere shortterm self-interest. The transactional leader, in contrast, focuses on current results and undertakes individual exchanges (of recognition, position, or money) to deliver expected results in the near term. We ll explore these two leadership styles, both of which have their merits and uses, later in this chapter. 

Organizational culture forms the fourth and outer ring. Culture is both the result of the personal safety ethic, leadership style, and best practices and the prerequisite for outstanding business success. As with the other rings of the leadership... 

These considerations bring us to the next aspect of the Safety Leadership Model s center—the values and emotional commitment to safety that are part of the leader s personal safety ethic. 

Valuing safety—part of the personal safety ethic at the center of the Safety Leadership Model (see Figure 4-1)—is necessary but not sufficient to create effective safety leadership. It is... 

Leaders build culture through their personal safety ethic (the core of the Safety Leadership Model), their leadership style, and their leadership practices. In this chapter we examined the best practices that outstanding safety leaders share. In the next chapter we introduce applied behavior analysis, a tool for systematically managing one s own behavior and the behavior of others. 

Ethically, the restriction of movement of a potentially infectious person is highly problematic. It violates the core of the ANA Code of Ethics, respect for the inherent dignity of individuals—the nurse s primary commitment to the patient (ANA, 2001). In the event of a public health emergency, a nurse may have a corresponding obligation to the community. The nurse should work to resolve the dilemma in such a way to ensure patient safety, guard the patient s best interests and preserve the professional integrity of the nurse (ANA, 2001, p. 10). 

Significant deficiencies in the security and control of samples have been well documented. " " In fact, it has been estimated that just over half of samples actually reach patients. Samples may be used by prescribers and staff, or they may be diverted. Personal use of drug samples by physicians and other healthcare providers raises ethical concerns and is not without risk." Limaye and Paauw described three medical residents who self-prescribed antimicrobials and were subsequently diagnosed with Clostridium difficile infection." Tong and Lien reported self-medication with samples and distribution of samples to nonphysicians by almost 60% of pharmaceutical representatives surveyed at a Canadian family practice office. A contributing factor to some of these issues is that institutional or facility sample policy and procedures are often absent, or compliance is poor. One institution found only 10% compliance when the inventory of samples was compared with the required written documentation. Even after an educational program in which the policy was explained to the house staff, a second audit found only 26% compliance. " Poor compliance with policy and procedure may jeopardize patient safety, as well as put the institution at risk for JCAHO recommendations or Board of Pharmacy penalties. 

The need for privacy when participating in research is based upon a subject s dignity and autonomy and thus warrants respect. As a result, all information regarding a research subject must be kept confidential. The researcher has a duty not to share any information without a subject s free and informed consent. Respect for privacy is an internationally recognized ethical standard and is reflected in Canadian law as a constitutional right. However, there are some circumstances where public health and safety require protection and such privacy may be lost, e.g., child abuse, sexually transmitted diseases. The REB can play an important role in assessing the balance between the need for research versus invasion of privacy, thus protecting individuals from harm as a result of unauthorized use of personal information. 

Another remotely activated device has been described by Groning et al. (57). They demonstrated in a model the remote control of a device to delivery insulin (Fig. 7). This possibility of external programming and monitoring of insulin pumps is possible for continuous subcutaneous infusion. The use of SMS allows immediate transfer of commands to the pump. There are many pitfalls to overcome the ethics of taking control away from the patients and their carer is but one, and there are safety issues, should the GPS system fad, and presumably if in error the pump is activated by the physician or indeed by individuals accidentally. But there is no doubt that telepharmacy wiU impact on future medicine, whether personalized or not. The personal element could come simply as a result of automated reminders to patients to take their medications also discussed above, but the more sophisticated systems described by Groning et al. wiU also have their place. 

Finally, it is apparent that requirements of federal regulatory agencies (OSHA, FDA) not primarily concerned with emergency response to low-frequency events like chemical or biological terrorism nevertheless have a substantial influence on response capabilities. The characteristics and rules for use of personal protective equipment, for example, fall under the jurisdiction of the Occupational Safety and Health Administration. The investigational (IND) status of some very specific treatments, present and future, will hamper their use in mass-casualty situations. Furthermore, in the case of many treatments, collection of the data on efficacy necessary for full FDA approval will not be possible for ethical reasons or economically attractive to a potential manufacturer because of limited market potential. 

Although values may vary among and between individnals and organizations, please consider generally the values of what it takes to be a successful cowboy (a person who herds cattle). In his book titled. Cowboy Ethics What Wall Street Can Learn from the Code of the West, author Jim Owens (summarized by Dr. Roy Burris) identifies the following personal principles to live by for cowboys. Please give some thought to the application of these cowboy principles in the safety and health arena. 

Create a culture throughout our organization where the importance of personal health, safety and environmental ethics, and decision making is clearly understood at all levels, both among employees and contract workers. 

It has to be emphasized that the willingness-to-pay principle differs eompletely from attempts to use the monetary value of a human life or even life years as a safety criterion. There will never be a reasonable and ethically indisputable answer to that question. Ten different people who would be willing to quantify the values of the lives of 10 different persons might give 100 different answers. But even people who would refuse to answer this question for ethical reasons will find it necessary to spend money to prevent people from becoming victims. But, with regard to the value and object of the dangerous activity as well as the limited funds, they would not spend an infinite amount and would want to realize the minimum risk with the money spent. 

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