Mac’s Safety Space: The challenges of compliance may have never been as daunting as they are now!

As we enter the final moments of 2023 (we won’t be publishing the week of December 25, so I shan’t be pestering you about stuff and nonsense), I continue to reflect on the struggle (and, believe me, the struggle is real) of compliance versus human tendencies. (I was going to say human nature, but some of this stuff doesn’t feel “natural” to me.) We in the safety community are generally driven by the expectations outlined in various codes and regulations. Certainly, a great number of those codes and regulations are subject to interpretation, but our experience and knowledge facilitate our establishing practices within our own organizations that represent those expectations.

But it seems to be coming increasingly more common that we end up having to deal with what Jan Rutherford refers to in his LinkedIn session on Managing in Difficult Times as “undesirable default conditions” (my version of that term is unauthorized field modifications). What it comes down to is the result of folks “coloring outside of the lines” and creating compliance challenges. A couple of weeks back, we talked a bit about the aspects of compliance as a function of convenience (if compliance isn’t convenient, achieving it can be that much more difficult); in years past, one could make the case that convenience wasn’t necessarily the deciding factor (or at least not as often as appears to be the case now) and when it did make an appearance, corrective actions were fairly simple to actualize.

I guess it ultimately comes down to the general concept of teamwork as a function of the management of the physical environment (why do I suspect that if you were to look back at 15-plus years of blogs, function is one of the most used terms; maybe Conjunction Junction made that much of an impact); the whole “we before me” as an operational baseline.

As always, I remain hopeful that we can make some inroads in 2024 to an approach based on mutual trust and respect—in the process and its participants. Try to refrain from “gotcha” rounds, or, if you have to “get” folks, catch them doing things right and highlight their contributions to the overall safety of the organization. I suspect that this is going to take a fair modicum of positivity to make happen, but my challenge to you is to “bring the positivity” to your practice next year.

Initially, this post was setting up in my mind as more of a rant, so I’m glad that I found a less screedy way to talk about this—plenty of time next year for ranting about this, that, and the other thing …

That said, I wish you and yours a most joyous and restful holiday season—I’ll be waiting when you get back!

About the Author: Steve MacArthur is a safety consultant with Chartis Clinical Quality Solutions (formerly known as The Greeley Company) in Danvers, Mass. He brings more than 30 years of healthcare management and consulting experience to his work with hospitals, physician offices, and ambulatory care facilities across the country. He is the author of HCPro's Hospital Safety Director's Handbook and is contributing editor for Healthcare Safety Leader. Contact Steve at