“This programme is already paying dividends. We can see our culture is improving and we’re getting better clinical outcomes

Chief Risk Officer (Australia), Ramsay Health Care
Chanelle McEnallay

Discover how Ramsay Health Care improved clinical outcomes and patient care

Ramsay Health Care is a global private hospital group with more than 77,000 employees and a large footprint across 11 countries. Promoting a strong professional accountability culture is an important part of Ramsay’s continuous improvement agenda to deliver safe care for their patients. Starting with an Australian implementation, their aim was to integrate an evidence-based accountability framework that would scale across their organisation and fit with their existing human factors programme.

We wanted a programme with strong integrity we could implement globally

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The challenge

As a large healthcare provider, with 480 hospitals, day surgeries, treatment facilities, rehabilitation and psychiatric units around the world, Ramsay is aware of the professional accountability challenges facing healthcare organisations. Their focus is to address staff behaviours that do not align to the values of The Ramsay Way; a set of principles defining their workplace culture.

They undertook extensive research to find an evidence-based accountability framework to fit with their existing human factors programme, which focusses on speaking up in the moment. It was also important the programme could scale, to be implemented internationally across their entire organisation.

The solution

The Promoting Professional Accountability programme was ideal for Ramsay’s needs. The programme’s sustainable, organisation-wide framework proven to address unprofessional behaviour is helping Ramsay to achieve the highest levels of safety and reliability.

Built on the work of Vanderbilt University Medical Centre in the United States of America, the programme is being implemented to help Ramsay identify and address behaviours that do not align with The Ramsay Way. The programme is assisting to contextualise unsafe behaviours and provide the tools and mechanisms to address it.

  • 73 Australian facilities
  • 35,000+ staff
  • 18 month timeframe

The programme in practice – Ramsay’s approach

Ramsay adopted a two-stage approach to rollout the Promoting Professional Accountability programme in Australia. The first stage was a large pilot encompassing 10,000 staff, implemented over nine months.

They cited the benefit of the pilot stage was the opportunity to develop a high level of understanding about the programme nuances, and align it to The Ramsay Way. Once the pilot was complete, Ramsay systematically implemented the programme across their other Australian facilities.

Systematic communication at every stage of the programme was critical for its success. Ramsay discovered it was important to engage all levels of staff on programme delivery and timelines, and celebrate milestones through the implementation.

The results

Anecdotal feedback has confirmed favourable clinical outcomes post-implementation. Ramsay believe the programme helps define behaviours undermining safety. They discovered staff did not realise the impact certain behaviours had on patient safety. For example not being available for clinical handover or calls and being late for theatre or meetings.

The Ramsay Research Foundation commenced researching the programme framework implementation, and results will follow completion. Due to the successful Australian implementation, Ramsay Health Care has commenced the programme across their facilities in Malaysia, Indonesia and the United Kingdom.


The feedback from doctors and clinicians has been extremely positive. They are encouraged by the programme, and feel supported to speak up

Ramsay’s top 5 key learnings – download the full report

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Discover how Ramsay Health Care improved clinical outcomes and patient care
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