General Introduction

Our primary commitment is the safety of our patients. This may sound like a bland statement that any company might make. However, we try hard to fulfil that promise. We know that healthcare is a high-risk industry, just like aviation or mining. All our staff need to be well trained, but also vigilant to potential problems.

Aside from the investments that we make in technology and clinical training, we also know from research that the most important element underpinning patient safety is the culture of the organization. We have therefore taken an unusual approach for a healthcare organisation, and decided to address the issue of patient safety culture head-on.

We call this the STEP-up programme.

STEP-up promotes four behaviours that are essential to patient safety

Culture of Reporting

Spotting problems and reporting them.

Culture of Openness

Talking about safety problems whenever they occur.

Culture of Justice

Examining the context which creates problems, rather than blaming individuals.

Culture of Improvement

Preventing problems from recurring by improving working practices and workflows.

These four behaviours which underpin our safety culture, are based on a published international model.[1]

Programme Training and Measurements

In this programme, the Vice President of Medical Affairs has personally provided a one-hour introduction to these behaviours to 2,500 members (85%) of staff, both clinical and non-clinical. He has also personally undertaken a half-day training session on patient safety leadership with all our 300 leaders and supervisors.

We also have incorporated safety-elements to inter-team situational training, which we make available to all our staff. Finally, to make this STEP-up programme sustainable, we have appointed Safety Ambassadors to each of our hospitals and facilities who are responsible for maintaining the STEP-up initiatives.

Our measure of success is based on international standards. Every year, we measure our safety culture using the US Agency for Healthcare Research (AHRQ) Quality Surveys on Patient Safety Culture (SOPS).[2]

In 2018, we posted the following results:



Average (US)

Response rate 72% 56%
Overall patient safety grading (staff opinions of safety) 80% 76%
Teamwork within units 91% 82%
Supervisor/Manager expectations and Actions promoting patient safety 80% 72%
Management support for patient safety 80% 72›%

In 2020, we hope to improve on these figures and also to begin measuring more accurately the number of patient safety incidents that result in harm.

We know that, in common with all healthcare organisations, we need to do more in order to continuously improve our approach to safety and our safety culture.

At UFH, we are actively doing this through our STEP-up programme.


[1] Hamblin-Brown, D. and Ingram, J. (2018) ‘The STEP-up programme: Engaging all staff in patient safety’, Journal of Patient Safety and Risk Management, 23(5), pp. 221–226. doi: 10.1177/2516043518792180 .