The patient safety culture: a systematic review by characteristics of Hospital Survey on Patient Safety Culture dimensions

ObjectivesThis study aimed to investigate staff’s perceptions of patient safety culture (PSC) in two Danish hospitals before and after an in situ simulation intervention.DesignA repeated cross-sectional intervention study.SettingTwo Danish hospitals. Hospital 1 performs emergency functions, whereas hospital 2 performs elective functions.ParticipantsA total of 967 healthcare professionals were invited to participate in this study. 516 were employed in hospital 1 and 451 in hospital 2. Of these, 39 were trained as simulation instructors.InterventionA 4-day simulation instructor course was applied. Emphasis was put on team training, communication and leadership. After the course, instructors performed simulation in the hospital environment. No systematic simulation was performed prior to the intervention.Main outcome measuresThe Safety Attitude Questionnaire investigating PSC was applied prior to the intervention and again 4 and 8 weeks after intervention. The proportion of participants with a positive attitude and mean scale scores were measured as main outcomes.ResultsThe response rate varied from 63.6% to 72.0% across surveys and hospitals. Baseline scores were generally lower for hospital 1. The proportion of staff with positive attitudes in hospital 1 improved by ≥5% in five of six safety culture dimensions, whereas only two dimensions improved by ≥5% in hospital 2. The mean scale scores improved significantly in five of six safety culture dimensions in hospital 1, while only one dimension improved significantly in hospital 2.ConclusionsSafety attitude outcomes indicate an improvement in PSC from before to after the in situ simulation intervention period. However, it is possible that an effect is more profound in an acute care hospital versus an elective setting.

Download Full-text

Impact of the Norwegian National Patient Safety Program on implementation of the WHO Surgical Safety Checklist and on perioperative safety culture

BMJ Open Quality ◽

10.1136/bmjoq-2020-000966 ◽

2020 ◽

Vol 9 (3) ◽

pp. e000966

Author(s):

Arvid Steinar Haugen ◽

Eirik Søfteland ◽

Nick Sevdalis ◽

Geir Egil Eide ◽

Monica Wammen Nortvedt ◽

...

Keyword(s):

Patient Safety ◽

Safety Culture ◽

Patient Safety Culture ◽

Operating Theatre ◽

Secondary Outcome ◽

Safety Program ◽

Surgical Safety ◽

Hospital Managers ◽

Culture Dimensions ◽

National Patient

ObjectivesOur primary objective was to study the impact of the Norwegian National Patient Safety Campaign and Program on Surgical Safety Checklist (SSC) implementation and on safety culture. Secondary objective was associations between SSC fidelity and safety culture. We hypothesised that the programme influenced on SSC use and operating theatre personnel’s safety culture perceptions.SettingA longitudinal cross-sectional study was conducted in a large Norwegian tertiary teaching hospital.ParticipantsWe invited 1754 operating theatre personnel to participate in the study, of which 920 responded to the surveys at three time points in 2009, 2010 and 2017.Primary and secondary outcome measuresPrimary outcome was the results of the patient safety culture measured by the culturally adapted Norwegian version of the Hospital Survey on Patient Safety Culture. Our previously published results from 2009/2010 were compared with new data collected in 2017. Secondary outcome was correlation between SSC fidelity and safety culture. Fidelity was electronically recorded.ResultsSurvey response rates were 61% (349/575), 51% (292/569) and 46% (279/610) in 2009, 2010 and 2017, respectively. Eight of the 12 safety culture dimensions significantly improved over time with the largest increase being ‘Hospital managers’ support to patient safety’ from a mean score of 2.82 at baseline in 2009 to 3.15 in 2017 (mean change: 0.33, 95% CI 0.21 to 0.44). Fidelity in use of the SSC averaged 88% (26 741/30 426) in 2017. Perceptions of safety culture dimensions in 2009 and in 2017 correlated significantly though weakly with fidelity (r=0.07–0.21).ConclusionThe National Patient Safety Program, fostering engagement from trust boards, hospital managers and frontline operating theatre personnel enabled effective implementation of the SSC. As part of a wider strategic safety initiative, implementation of SSC coincided with an improved safety culture.

Download Full-text

Front-line staff's perspective on patient safety culture in Iranian medical centers: A systematic review and meta-analysis

International Journal of Risk & Safety in Medicine ◽

10.3233/jrs-191021 ◽

2020 ◽

Vol 31 (4) ◽

pp. 193-207

Author(s):

Omid Khosravizadeh ◽

Mohammad Mohseni ◽

Najmeh Baghian ◽

Aisa Maleki ◽

Ailar Hashtroodi ◽

...

Keyword(s):

Systematic Review ◽

Patient Safety ◽

Safety Culture ◽

Medical Center ◽

Meta Analysis ◽

Random Effect ◽

Random Effect Model ◽

Computer Software ◽

Patient Safety Culture ◽

Forest Plot

BACKGROUND: The prerequisite for promoting safety culture is to assess the existing safety culture level of institutes, because safety precautions without appropriate evaluation increase costs and unforeseen risks. OBJECTIVE: This study aimed to systematically review the status of patient safety culture from the perspective of clinical personnel at Iranian hospitals through a meta-analysis of studies using the Hospital Survey on Patient Safety Culture (HSOPSC) questionnaire. METHODS: The present systematic review and meta-analysis was conducted in 2018. Data were gathered by searching Google Scholar, Scopus, PubMed, and Web of Science databases up to November 2018. Search keywords were “patient”, “safety”, “culture”, “healthcare”, “hospital”, “medical center”, “HSOPSC tool”, and “Iran”. The search protocol was limited to 10 years. To estimate the PSC score, computer software CMA:2 (Comprehensive Meta-Analysis) was used. The presence of heterogeneity across the studies was assessed with the I2 statistic. A forest plot was used to report the results. Publication bias was assessed through a funnel plot. RESULTS: The meta-analysis of studies showed that the PSC score based on the random effect model was 52.7% (95% CI: 50.2%–55.2%), (Q = 522.3, df = 54, P < 0.05, I2 = 89.6). A mean of 12 dimensions of HSOPSC showed that the “Teamwork within units” dimension had the highest PSC score (67.2%) and “Non-punitive response to error” had the lowest score (40.4%). CONCLUSIONS: Managers and policymakers should be directed towards non-punitive responses to errors and persuade staff to report errors and execute the approach to learn from mistakes. Also, a periodic government evaluation of the patient safety culture will help further its sustainable development.

Download Full-text