**3. Managerial perspectives**

Hospital governance is increasingly encompassing 'improving performance on clinical outcomes'. Coordination of medicine and management across the levels of hospital/department is for quality-effective hospital governance [33]. The managers themselves seem to rely more on personal strength and medical knowledge than on management tools [34]. Medical expertise benefits management evidently. Doctors are increasingly involved in hospital management. This is likely to lead to better implemented quality management systems [35].

Among physicians, there is a growing sense of the responsibility as teachers of better habits of life and work, and hospitals in like manner are becoming more truly educational centers in preventive medicine [36]. Prevention for safety needs to be practiced by all.

#### **3.1 Money matters**

It has been shown that patients treated at financially distressed hospitals are more likely to have adverse patient safety events [37]. This suggests that hospitals should be financially sound, ensuring safety of patients. Cost-cutting efforts should be carefully designed and managed, without compromising quality and safety.

#### **3.2 Leadership**

With evolution of safety field, there is a growing recognition that organizational leadership plays a role in prioritizing safety [38]. Hospital boards have an important role of in overseeing patient quality and safety. It has been shown that high-performing hospitals have board members who were more skilled in quality and safety issues *Prevention Strategies for Patient Safety in Hospitals: Methodical Paradigm, Managerial… DOI: http://dx.doi.org/10.5772/intechopen.106836*

and who devoted more time to discussion of quality and safety [39]. Patient safety performance by hospitals adds to good reputation.

We suggest three-dimensional initiatives for Leaders:


## **3.3 Teamwork – a blueprint**

Teamwork is a powerful patient safety tool. The U.S. Department of Defense (DoD) Military Health System provided essential insight for Teamwork development [40]. Teamwork initiatives are effective with a clear blueprint defining the solid steps for building the desired culture. Characteristics for success of the blueprint are clear, detailed, and self-evident. All this should include the 'Five Es'


v.**E**nergetically align and integrate the behaviors [40].

#### **3.4 Organizational change for patient safety initiatives**

Patient safety accomplishment requires not only clinical efforts but also organizational. Widespread organizational change for betterment in patient safety is indispensable. The implementation of patient safety initiatives should be done utilizing change management principles, namely the 'Five Cs'

