At Holland Bloorview, Caring Safely is a core commitment and an organizational priority in the hospital's HB2030 strategic plan. Over the past two years, safety coaches have played an essential role in bringing this commitment to life by strengthening a culture of safety, empowering staff and supporting safer outcomes for clients and families.

The safety coach program has now been running for more than two years, with 23 active coaches across the organization. These coaches observe work processes, model safe behaviours and reinforce the consistent use of error‑prevention tools. By encouraging open communication about risks and near misses, they help staff surface issues earlier and strengthen accountability.

Across health care, organizations have found that internal safety champions are essential in transforming how care teams think and act. These champions normalize safe practices, support consistent application of policies and help build high‑reliability habits that prevent harm.

As a member of the Solutions for Patient Safety (SPS) Network, Holland Bloorview collaborates with hospitals internationally, contributing to global communities of practice where teams learn from one another, analyze safety events more effectively and implement sustainable changes that save lives. This collaborative model has helped more than 100 hospitals strengthen data‑driven systems for identifying and correcting safety vulnerabilities.

Over the past year, the hospital celebrated the impact of safety coaches through monthly profiles highlighting their commitment to modelling safe behaviors, supporting their teams and advancing our vision for zero harm. Their contributions have led to meaningful, measurable progress.

Impact of the safety coach program

• Monthly safety coach profiles have boosted program visibility by highlighting the contributions of coaches across the hospital and reinforcing that safety is a shared responsibility amongst all staff.
• Transitioning to a digital Behavior Observation Tools (BOT) log has improved the reliability and accessibility of safety‑related data, enabling real-time submissions and faster safety trend identification across units. Safety coaches consistently exceeded targets by completing 13-14 BOTs monthly and achieving 100 per cent compliance.
• Strong participation in monthly safety coach meetings has enhanced shared learning across inpatient, outpatient and non‑clinical areas, with teams regularly exchanging practical strategies, such as communication approaches for at‑risk moments, which have been later adopted by other coaches.

“By being present across the organization, safety coaches reinforce error prevention tools in everyday work. Through their ongoing presence and support, they recognize their colleagues for noticing risk, speaking up and strengthening safety as work is happening.” - Laura Nicholson, manager, risk and safety

Upcoming priorities

As the program continues to evolve, the focus will shift toward deepen­ing its impact and embedding even greater reliability into everyday practice. A key priority is ensuring that all teams consistently apply a range of error‑prevention tools aligned with the three core behavioural expectations:

• Personal commitment to safety
• Maintaining a questioning attitude
• Communicating clearly

To support this, quarterly BOT analyses will play a central role. By reviewing BOT data regularly, teams will be able to identify which tools are underused and understand the reasons behind inconsistent application. As a result, these insights will aim to inform:

• targeted awareness‑building initiatives;
• team‑based opportunities to practice tools in real scenarios; and
• stronger integration of error‑prevention tools into safety stories and coaching discussions.

Ultimately, underused tools represent missed opportunities to prevent harm. By pinpointing these gaps and addressing them early, teams can reduce risk, strengthen reliability and continue advancing a culture where safety is embedded into every interaction.

Commitment to zero harm

Holland Bloorview’s commitment to zero harm is unwavering. Safety coaches make this commitment tangible by championing reliable behaviours, supporting safer processes and ensuring insights from BOTs and safety huddles translate into everyday practice. Their leadership, presence and encouragement are helping shape a stronger culture of caring safely where every team member plays an active role in keeping clients, families and colleagues safe.

Learn more about Holland Bloorview’s Caring Safely program

By Terry Mutuku