3. Provide a framework to help staff succeed. Just
telling staff they need to speak up isn't enough; they also should be
given the tools they need to do so, says Ms. Fencl. Her organization's
C.U.S. model — short for "I have a Concern; I'm Uncomfortable; Stop,
this is a safety issue" — provides this guidance, complete with role-
modeled scenarios staff might see in the OR. The team also developed
protocols for dealing with what happens next. "Before, when we had
an event or a near miss, we would pull a couple of stakeholders aside
and talk about it so we could identify something that needed to
change," says Ms. Fencl. "That was all good, but now we say, 'Let's
step back and have a comprehensive evaluation of the practice we
have in place.'"
M A R C H 2 0 1 7 • O U T PA T I E N TS U R G E R Y. N E T • 1 0 1
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