Beyond Compliance: Getting Curious About Safer Care

Voices Shaping Safer Care is a blog series featuring reflections and experiences from people across health and social care in Canada. Through stories from patients, caregivers, healthcare providers, leaders and community partners, the series explores the everyday moments, relationships and systems that influence safety.

When routine becomes the risk

Have you ever driven to a place you go to often – only to realize you don’t remember anything about the drive? You know you were behind the wheel, stopped at all the red lights and used your turn signal. But you can’t recall the actual details of the journey?

For healthcare organizations, routine patient safety practices can slip into autopilot mode, too. And recognizing when that’s happening can be the difference between outcomes that stagnate and those that improve.

That’s exactly what Rochelle Currie saw at Nova Scotia Health. She was new in her role as Senior Director, Quality and Patient Safety, and she quickly saw the organization’s strong track record for implementing recommendations from patient safety incidents. Scorecard after scorecard showed implementation rates close to 100%.

But she noticed something else, too: a disconnect with lived reality. “It felt like we were ticking a lot of boxes, but we weren’t really getting the intended outcomes,” she says. “Rather than reporting on whether we have implemented 98% of the recommendations, we should be looking at whether our policies and procedures are achieving what we need them to, and whether our recommendations actually improve care.”

From checking boxes to driving change

The disconnect prompted Nova Scotia Health to launch a full review of its incident analysis work, including:

• a review of all incident analysis and patient safety processes. Conducted in partnership with the implementation science team, this review explored if the organization’s approach was driving the desired outcomes.

• Interviews and focus groups with staff throughout the province, including those who had been involved in patient safety incidents to identify gaps and opportunities to improve.

• a literature review of incident analysis research conducted in Canada, the US and the UK to find learnings and best practices.

Through the multi-step review, themes emerged that helped the organization to shape a plan for how to strengthen its approach to incident analysis and ultimately improve patient safety. Equipped with meaningful insights, a body of evidence, and a clear picture of the future state they wanted to create, Nova Scotia Health began the hard work of creating a plan to build a stronger approach.

What progress looks like

The introduction in 2026 of a standardized patient safety incident toolkit was a major milestone. It is a single source that identifies quality and patient safety responsibilities within the organization, documents clear processes that support related policies and procedures and provides an algorithm staff can reference to support them in navigating different scenarios. It’s now being used across the whole authority.

The toolkit’s introduction was supported by in-person education sessions with every management team at Nova Scotia Health. Currie emphasizes the value of this face time with employees, saying that “the discussion, dialogue and opportunity to ask questions” have been particularly powerful in helping staff feel supported to navigate safety incidents with confidence.

Expertise over enforcement

While Currie is hesitant to define the changes as a full transformation, she is seeing signals that the culture of safety is changing for the better.

Reframing the role of the quality improvement and safety team from the “safety police” to a resource with expertise has been part of that shift. “We try to be supportive of teams across the organization and work with them,” she explains. “As a result, I think people are coming to [the quality improvement and safety team] more often to have open conversations, rather than being scared when they see us calling.”

Aligning the approach with the need

The province’s response to sepsis is another example that things are changing. Rather than continuing to tackle sepsis safety incidents at the regional or hospital level, Nova Scotia Health prioritized a system-level response by creating a Sepsis Action Improvement Team that was recently recognized by the Canadian College of Health Leaders with the 2026 Excellence in Patient Safety Award.

“We’re trying to have the right solution and the right tools to respond to each problem – and that’s not always one size fits all,” says Currie. “For a large-scale issue like sepsis, that meant changing the way we approached the problem.”

Choose curiosity over judgement

Currie believes that a judgemental mindset and attitude is one of the biggest barriers to safer care, because it prevents meaningful and open discussion when things don’t go as they should. But she’s quick to admit that a curiosity mindset doesn’t always come naturally, even for her. Currie’s advice? Model what it looks like to lead with curiosity, even if you’re thinking of something entirely different. “The initial reaction when things go wrong is so important as it lays the foundation for how people are going to react now and in the future. Typically, one may respond with ‘Oh my goodness, how could that ever happen?’” says Currie. “And the minute you say that, you’ve laid the foundation to imply ‘This is something that is completely unacceptable and shouldn’t have happened, thus people will be less inclined to speak about it.” So, it’s important to change the script right away to something like: ‘Oh, that’s interesting. Tell me more.’”

Connect intention with outcomes

The top piece of advice that Currie has for quality and patient safety professionals is to think with intention about what it means to be safe, and whether the processes in place to support safety are actually doing that.

“You may have all of the policies and procedures you need,” she says, “but at the end of the day, you need to know they’re actually leading to safer care.”

That’s why Currie is comfortable with a safety scorecard that’s not entirely green. “That’s what the conversation needs to be about – not ‘oh my goodness, look at all the greens,’ but it’s about getting curious about the yellow and red dashboard items and understanding what’s really happening so we can improve.”