scholarly journals Relationship among team dynamics, care coordination and perception of safety culture in primary care

2018 ◽  
Vol 35 (6) ◽  
pp. 718-723 ◽  
Author(s):  
Karen J Blumenthal ◽  
Alyna T Chien ◽  
Sara J Singer

Abstract Background There remains a need to improve patient safety in primary care settings. Studies have demonstrated that creating high-performing teams can improve patient safety and encourage a safety culture within hospital settings, but little is known about this relationship in primary care. Objective To examine how team dynamics relate to perceptions of safety culture in primary care and whether care coordination plays an intermediating role. Research Design This is a cross-sectional survey study with 63% response (n = 1082). Subjects The study participants were attending clinicians, resident physicians and other staff who interacted with patients from 19 primary care practices affiliated with Harvard Medical School. Main Measures Three domains corresponding with our main measures: team dynamics, care coordination and safety culture. All items were measured on a 5-point Likert scale. We used linear regression clustered by practice site to assess the relationship between team dynamics and perceptions of safety culture. We also performed a mediation analysis to determine the extent to which care coordination explains the relationship between perceptions of team dynamics and of safety culture. Results For every 1-point increase in overall team dynamics, there was a 0.76-point increase in perception of safety culture [95% confidence interval (CI) 0.70–0.82, P < 0.001]. Care coordination mediated the relationship between team dynamics and the perception of safety culture. Conclusion Our findings suggest there is a relationship between team dynamics, care coordination and perceptions of patient safety in a primary care setting. To make patients safer, we may need to pay more attention to how primary care providers work together to coordinate care.

2011 ◽  
Vol 12 (1) ◽  
Author(s):  
Clara González-Formoso ◽  
María Victoria Martín-Miguel ◽  
Ma José Fernández-Domínguez ◽  
Antonio Rial ◽  
Fernando Isidro Lago-Deibe ◽  
...  

2021 ◽  
Author(s):  
Maria J Serrano-Ripoll ◽  
Maria A. Fiol-DeRoque ◽  
José M. Valderas ◽  
Rocío Zamanillo-Campos ◽  
Joan Llobera ◽  
...  

BACKGROUND Developing new strategies to support the provision of safer primary care (PC) is a major priority both internationally and in Spain, where around 3 million adverse events occur each year in the PC setting. OBJECTIVE The primary aims of this mixed-methods feasibility study were to examine the feasibility and to explore the acceptability and perceived utility of the SinergiAPS intervention, a novel low-cost and scalable theory-based online intervention to improve patient safety in PC centres, based on the use of patient feedback. The secondary aim was to examine the potential impact of the intervention to improve patient safety culture and avoidable hospitalizations in PC centres. METHODS We conducted a three-month, one-arm, feasibility trial in ten PC centres in Spain. Centres were fed back information regarding patients' experiences of safety (collected through PREOS-PC questionnaire) and were instructed to plan safety improvement actions based on it. We measured recruitment and follow-up rates, and intervention uptake (number of centres registering improvement plans). We explored the impact of the intervention on patient safety culture (MOSPSC questionnaire), and avoidable hospital admissions rate. We conducted semi-structured interviews with nine professionals to explore the acceptability and perceived utility of the intervention. RESULTS Of 256 professionals invited, 120 (47%) accepted to participate and 97 completed baseline and post-intervention measures. Of 780 patients invited, 585 (77%) completed the PREOS-PC questionnaire. Five centres designed 27 improvement actions. Most of the actions addressed treatment-related safety problems and consisted in the provision of training to PC providers. Compared to baseline, post-intervention MOSPSC scores were significantly higher (indicating a higher level of culture) for the safety culture synthetic index (3.36/5 at baseline vs. 3.44/5 at post-intervention (2% increase); p=0.01). No differences (p=0.11) were observed in avoidable admissions rate before (median (IQR)=0.78 (0.7 to 0.9) vs. after the intervention (0.45 (0.33 to 0.83)). The interviews revealed that the intervention was perceived as a novel strategy that could produce long-term safety improvements by raising their awareness and improving their technical knowledge about patient safety. CONCLUSIONS The proposed intervention is feasible to deliver and perceived as acceptable and useful by PC professionals if the barriers identified are addressed. The effectiveness of the refined intervention will be assessed in a trial involving 59 centres. CLINICALTRIAL clinicaltrials.gov NCT03837912


2020 ◽  
Vol 2 (4) ◽  
Author(s):  
Titi Purwani ◽  
Fahmi Rahmy ◽  
Zifriyanthi Minanda Putri

Health service mistakes can result in thousands of people dying annually. One strategy to improve patient safety is to create the safety culture of patients with the satisfaction of nursing work. The dissatisfaction of nurses work can lead to a decline in hospital service quality. Objective: This study aims to know the relationship perception of nurse work satisfaction to patient safety culture. The studies used are descriptive-analytic with a cross-sectional approach. The sample number of 137 nurses taken at Padang in the 2020 period with total sampling techniques. There is a significant link between salary satisfaction, supervision, additional benefits, motivation, technical procedures, communication, and nursing work satisfaction with the safety culture of the patient. The most significant relationship is supervision with the safety culture of the patient.


2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Viktor Dombrádi ◽  
Klára Bíró ◽  
Guenther Jonitz ◽  
Muir Gray ◽  
Anant Jani

PurposeDecision-makers are looking for innovative approaches to improve patient experience and outcomes with the finite resources available in healthcare. The concept of value-based healthcare has been proposed as one such approach. Since unsafe care hinders patient experience and contributes to waste, the purpose of this paper is to investigate how the value-based approach can help broaden the existing concept of patient safety culture and thus, improve patient safety and healthcare value.Design/methodology/approachIn the arguments, the authors use the triple value model which consists of personal, technical and allocative value. These three aspects together promote healthcare in which the experience of care is improved through the involvement of patients, while also considering the optimal utilisation and allocation of finite healthcare resources.FindingsWhile the idea that patient involvement should be integrated into patient safety culture has already been suggested, there is a lack of emphasis that economic considerations can play an important role as well. Patient safety should be perceived as an investment, thus, relevant questions need to be addressed such as how much resources should be invested into patient safety, how the finite resources should be allocated to maximise health benefits at a population level and how resources should be utilised to get the best cost-benefit ratio.Originality/valueThus far, both the importance of patient safety culture and value-based healthcare have been advocated; this paper emphasizes the need to consider these two approaches together.


Author(s):  
Yodang Yodang ◽  
Nuridah Nuridah

Background: Nurse leader has an important role in encouraging patient’s safety culture among nurses in the healthcare system. This literature review aims to identify the nursing leadership model and to promote and improve patient safety culture to improve patient outcomes in health care facilities including hospitals, primary health care, and nursing home settings. Methods: Searching appropriate journals through some journal databases were applied including DOAJ, GARUDA, Google Scholar, MDPI, Proquest, Pubmed, Sage Journals, ScienceDirect, and Wiley Online Library, which were published from 2015 to 2020. Results: Fourteen articles meet the criteria and are included in this review. The majority of these articles were retrieved from western countries, the US, Canada, and Finland. This review identifies three nursing leadership models that seem useful to promote and improve patient safety culture in health care facilities which are transformational, authentic, and ethical leadership models. Conclusion: The patient safety influences health care outcomes. The evidence shows the leadership has positive relation to patient satisfaction and patient safety outcomes improvement. The transformational, authentic, and ethical leadership models seem to be more useful in promoting, maintaining, and improving patient safety culture in health care facilities.  


2020 ◽  
Author(s):  
Katarzyna Kosiek ◽  
Iwona Staniec ◽  
Maciej Godycki-Cwirko ◽  
Adam Depta ◽  
Anna Kowalczyk

Abstract Background:. Patient safety is defined as an activity that minimizes and removes possible errors and injuries to patients. A number of factors have been found to influence patient safety management, including the facilities available in the practice, communication and collaboration, education regarding patient safety and generic conditions. This study tested a theoretical model of patient safety interventions based on safety antecedents. Methods: Medical professionals were surveyed using a questionnaire developed by Gaal et al. The results were analyzed with SPSS 20 and AMOS. A hypothetical model of direct and indirect effects on patient safety in a primary care environment was created and analyzed using structural equation modeling (SEM). Results: SEM proved to be an effective tool to analyse safety in primary care. The facilities in the practice appear to have no significant influence on patient safety management in the case of female respondents, those below mean age, those who are not GPs (general practitioner) and respondents not working in counselling centres.Conclusions: The integrated safety model described in the study can improve patient safety management.


2020 ◽  
pp. 106286062090805
Author(s):  
Alexis Wickersham ◽  
Jillian Zavodnick ◽  
Andrew Thum ◽  
Bonnie Robertson ◽  
Lily Ackermann

Interdisciplinary rounding has been shown to improve patient safety and provider engagement. Many models for interdisciplinary rounding have been proposed but few focus on preserving bedside medical education. The authors changed the interdisciplinary bedside rounding model to accommodate more time for medical education. The objective was to assess perceptions of communication, care coordination, and teamwork surrounding this change. Resident and attending physicians and unit-based nursing staff completed an anonymous online survey prior to and following the rounding intervention. Length of stay on medical units also was monitored prior to and following the rounding intervention. Following the intervention, there were perceived improvements in interdisciplinary communication, care coordination, and teamwork, and there were no significant changes in length of stay.


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