scholarly journals What has been the impact of Covid-19 on Safety Culture?

2020 ◽  
Author(s):  
Max Denning ◽  
Ee Teng Goh ◽  
Jonathan Clarke ◽  
Melanie Almonte ◽  
Swathikan Chidambaram ◽  
...  
Keyword(s):  
Safety Culture ◽  
Safety Climate ◽  
Female Gender ◽  
Incident Reporting ◽  
Safety Attitudes ◽  
White Ethnicity ◽  
Nursing Role ◽  
Professional Groups ◽  
Job Role ◽  
The Impact

ABSTRACTIntroductionCovid-19 has placed an unprecedented demand on healthcare systems worldwide. A positive safety culture is associated with improved patient safety and in turn patient outcomes. To date, no study has evaluated the impact of Covid-19 on safety culture.MethodsThe Safety Attitudes Questionnaire (SAQ) was used to investigate safety culture at a large UK teaching hospital during Covid-19. Findings were compared with baseline data from 2017. Incident reporting from the year preceding the pandemic was also examined.ResultsSignificant increases were seen in SAQ score for doctors (p<0.001) and other clinical staff (p<0.001) from baseline. A decrease in SAQ was found in the nursing group. Largely due to ‘perception of management’ and ‘safety climate’ subscales. During Covid-19, on univariate regression analysis, female gender (p<0.001), age 40-49 years (p<0.01), non-white ethnicity (p<0.001), nursing job role (p<0.001) were all associated with lower SAQ scores. Training (p<0.001) and support (p<0.001) for redeployment were associated with higher SAQ scores. On multivariate analysis, non-disclosed gender (−0.13), non-disclosed ethnicity (−0.11), nursing role (−0.15), and support (0.29) persisted to significance. A significant decrease (p<0.003) was seen in error reporting after the onset of the Covid-19 pandemic.DiscussionThis is the first study to report SAQ during Covid-19 and compare with baseline. Differences in SAQ scores were observed during Covid-19 between professional groups and compared to baseline. Reductions in incident reporting were also seen. These changes may reflect perception of risk, changes in volume or nature of work. High-quality support for redeployed staff may be associated with improved safety perception during future pandemics.

scholarly journals What Has Been the Impact of Covid-19 on Safety Culture? A Case Study from a Large Metropolitan Healthcare Trust

2020 ◽  
Vol 17 (19) ◽  
pp. 7034
Author(s):  
Max Denning ◽  
Ee Teng Goh ◽  
Alasdair Scott ◽  
Guy Martin ◽  
Sheraz Markar ◽  
...  
Keyword(s):  
Safety Culture ◽  
Female Gender ◽  
Incident Reporting ◽  
Safety Attitudes ◽  
White Ethnicity ◽  
Nursing Role ◽  
Level Of Significance ◽  
Training And Support ◽  
Job Role ◽  
The Impact

Covid-19 has placed an unprecedented demand on healthcare systems worldwide. A positive safety culture is associated with improved patient safety and, in turn, with patient outcomes. To date, no study has evaluated the impact of Covid-19 on safety culture. The Safety Attitudes Questionnaire (SAQ) was used to investigate safety culture at a large UK healthcare trust during Covid-19. Findings were compared with baseline data from 2017. Incident reporting from the year preceding the pandemic was also examined. SAQ scores of doctors and “other clinical staff”, were relatively higher than the nursing group. During Covid-19, on univariate regression analysis, female gender, age 40–49 years, non-White ethnicity, and nursing job role were all associated with lower SAQ scores. Training and support for redeployment were associated with higher SAQ scores. On multivariate analysis, non-disclosed gender (−0.13), non-disclosed ethnicity (−0.11), nursing role (−0.15), and support (0.29) persisted to a level of significance. A significant decrease (p < 0.003) was seen in error reporting after the onset of the Covid-19 pandemic. This is the first study to investigate SAQ during Covid-19. Differences in SAQ scores were observed during Covid-19 between professional groups when compared to baseline. Reductions in incident reporting were also seen. These changes may reflect perception of risk, changes in volume or nature of work. High-quality support for redeployed staff may be associated with improved safety perception during future pandemics.

scholarly journals Could low Safety Attitudes Questionnaire scores be indicative of an environment where it may be difficult to get new training practices established?

2017 ◽  
Vol 3 (2) ◽  
pp. 54-59
Author(s):  
Sarah Channing ◽  
Neil Ryan ◽  
Sophie Barnes ◽  
Kate Collins ◽  
Helen van der Nelson ◽  
...  
Keyword(s):  
Safety Culture ◽  
Safety Climate ◽  
Training Session ◽  
Interrupted Time Series ◽  
Team Training ◽  
Multiprofessional Team ◽  
Safety Attitudes ◽  
Safety Attitudes Questionnaire ◽  
Significant Difference ◽  
The Impact

IntroductionSimulation-based, multiprofessional team training (SBMPTT) is used widely in healthcare, with evidence that it can improve clinical outcomes and be associated with a positive safety culture. Our aim was to explore the impact of introducing this type of training to a gynaecological team.MethodsIn this interrupted time-series study, ‘Safety Attitudes Questionnaire’ (SAQ) data was collected both before and after SBMPTT was introduced to a gynaecological team.ResultsLow baseline SAQ scores coincided with difficulty in establishing the training, meaning that at the end of our study period only a small proportion of staff had actually attended a training session. Despite trends towards improvement in scores for safety climate, teamwork climate and job satisfaction, no statistically significant difference was observed. There was however an improved perception of the level of collaboration between nursing staff and doctors after the introduction of training.Conclusions and DiscussionIn this paper we explore a hypothesis that low baseline SAQ scores may highlight that the multiprofessional teams most in need of training work in environments where it is more challenging to implement. There is evidence from other specialties that multiprofessional team training works, now we need to understand how to address the barriers to getting it started. In this paper we suggest how the SAQ could be used as a directive tool for improvement; using the detailed analysis of the local safety culture it provides to both inform future training design and also provide management with an objective marker of progress.

scholarly journals Fidelity and the Impact of Patient Safety Huddles on Teamwork and Safety Culture: An Evaluation of the Huddle Up for Safer Healthcare (HUSH) Project

2021 ◽  
Author(s):  
Laura Lamming ◽  
Kate Crosswaite ◽  
Muhammad Faisal ◽  
Eileen McDonach ◽  
Jane Montague ◽  
...  
Keyword(s):  
Patient Safety ◽  
Safety Culture ◽  
Safety Climate ◽  
Scale Up ◽  
Statistical Process ◽  
Frontline Staff ◽  
Role Based ◽  
Job Role ◽  
Future Work ◽  
The Impact

Abstract Background: The Patient Safety Huddle (PSH) is a brief multidisciplinary daily meeting held to discuss patient safety and action to mitigate risk. Despite growing interest and application of huddles as a mechanism for improving safety, evidence of their impact remains limited. There is also variation in how huddles are conceived and implemented with little focus on their fidelity (the extent to which delivered as planned) and potential ways in which they might influence outcomes. The Huddle Up for Safer Healthcare (HUSH) project attempted to scale up the implementation of patient safety huddles in five hospitals – 92 wards - across three UK NHS Trusts. This paper aims to assess their fidelity, time to embed, and impact on teamwork and safety culture. Methods: A multi-method Developmental Evaluation was conducted. The Stages of Implementation Checklist (SIC) was used to determine time taken to embed PSHs. Observations confirmed embedded status and fidelity of PSH. A Teamwork and Safety Climate survey (TSC) was administered at two time-points: pre- and post-embedding. Changes in TSC scores were calculated for Trusts, job role and clinical speciality.Results: Observations confirmed Patient Safety Huddles were embedded in 64 wards. Mean fidelity score was 4.9/9. PSHs frequently demonstrated a ‘fear free’ space while Statistical Process Control (SPC) charts and historical harms were routinely neglected. Analysis showed a positive change for the majority of TSC questions and the overall safety grade of the ward.Conclusions: PSHs are feasible and effective for improving teamwork and safety culture, especially for nurses. PSH fidelity criteria may need adjusting to include factors deemed most useful by frontline staff. Future work should examine inter-disciplinary and role-based differences in TSC outcomes.

scholarly journals Patient safety culture in Slovenian out-of-hours primary care clinics

2017 ◽  
Vol 56 (4) ◽  
pp. 203-210 ◽  
Author(s):  
Zalika Klemenc-Ketiš ◽  
Ellen Tveter Deilkås ◽  
Dag Hofoss ◽  
Gunnar Tschudi Bondevik
Keyword(s):  
Patient Safety ◽  
Safety Culture ◽  
Safety Climate ◽  
International Study ◽  
Patient Safety Culture ◽  
Cross Sectional Study ◽  
Full Time ◽  
Cross Sectional ◽  
Out Of Hours ◽  
Safety Attitudes

Abstract Introduction Patient safety culture is a concept which describes how leader and staff interaction, attitudes, routines and practices protect patients from adverse events in healthcare. We aimed to investigate patient safety culture in Slovenian out-of-hours health care (OOHC) clinics, and determine the possible factors that might be associated with it. Methods This was a cross-sectional study, which took place in Slovenian OOHC, as part of the international study entitled Patient Safety Culture in European Out-of-Hours Services (SAFE-EUR-OOH). All the OOHC clinics in Slovenia (N=60) were invited to participate, and 37 agreed to do so; 438 employees from these clinics were invited to participate. We used the Slovenian version of the Safety Attitudes Questionnaire – an ambulatory version (SAQAV) to measure the climate of safety. Results Out of 438 invited participants, 250 answered the questionnaire (57.1% response rate). The mean overall score ± standard deviation of the SAQ was 56.6±16.0 points, of Perceptions of Management 53.6±19.6 points, of Job Satisfaction 48.5±18.3 points, of Safety Climate 59.1±22.1 points, of Teamwork Climate 72.7±16.6, and of Communication 51.5±23.4 points. Employees working in the Ravne na Koroškem region, employees with variable work shifts, and those with full-time jobs scored significantly higher on the SAQ-AV. Conclusion The safety culture in Slovenian OOHC clinics needs improvement. The variations in the safety culture factor scores in Slovenian OOHC clinics point to the need to eliminate variations and improve working conditions in Slovenian OOHC clinics.

scholarly journals Application of Safety Attitudes Questionnaire (SAQ) in Adult Intensive Care Units: a cross-sectional study

2020 ◽  
Author(s):  
Abdullah S. Alqahtani ◽  
Rachel Evley
Keyword(s):  
Safety Culture ◽  
Safety Climate ◽  
Cross Sectional Study ◽  
Self Report ◽  
Sectional Study ◽  
Cross Sectional ◽  
Safety Attitudes ◽  
Safety Attitudes Questionnaire ◽  
Significant Difference ◽  
The Mean

AbstractPurposeTo achieve a positive safety culture, staff perception of safety must be frequently measured. There are several active and reactive methods to use to measure safety cultures such as near-miss occurrence, accidental data collection, measuring behavior, self-report method, and safety questionnaires. The safety attitudes questionnaire (SAQ) tool was used to measure safety culture. This tool is widely used in literature and among researchers and has been used and validated in middle eastern cultures. In addition, it has a validated Arabic version.MethodsA cross-sectional study was conducted using anonymous and random sampling. I surveyed all ICU staff working in all the adult ICUs in two of the major hospitals in the eastern province of Saudi Arabia. The short version of the Safety Attitudes Questionnaire was used to assess participants’ attitudes towards safety culture. The study involved all healthcare providers working in Adult ICU.ResultsThe study occurred over a three-week period in March 2019. A total of 82 completed questionnaires were returned which represented a response rate of 82%. On average, the domain that scored the highest number of positive responses was Job satisfaction with 68.5%, followed by teamwork climate 67.8%, then working conditions 60.1%, 57.1% safety climate, then preparation of management with 53.4%, and finally 46% in Stress recognition. A statistically significant difference was found between the mean SAQ score and the educational level of the participants. Participants with bachelor’s degrees scored a mean of 50.17 compared to participants hold diploma degrees who scored a mean of 68.81 (P=0.02). Moreover, a significant difference was found between the mean SAQ score and participants’ specialties. Attending/Staff Physician mean score was 36.40, Nurse Manager/Charge Nurse scored 39.78, and Respiratory therapist mean score was 47.88, compared to mean score of 62.27 for Registered Nurse, and Respiratory supervisor 67.0 (P=0.04). In addition, 79.2% of the respondents did not report any incidents in the last 12 months.ConclusionsThe result of the study shows an unsatisfying level of safety culture among healthcare staff in ICUs. The importance of this study is to establish a baseline for safety climate in these hospitals and specifically ICUs. In addition, by exposing the system weaknesses it helps the administration to strengthen and improve patient care. By decreasing workload and job stress, studies show they have a positive association with increasing job performance.

scholarly journals Do quality management systems influence clinical safety culture and leadership? A study in 32 Australian hospitals

2020 ◽  
Vol 32 (Supplement_1) ◽  
pp. 60-66
Author(s):  
Robyn Clay-Williams ◽  
Natalie Taylor ◽  
Hsuen P Ting ◽  
Gaston Arnolda ◽  
Teresa Winata ◽  
...  
Keyword(s):  
Hip Fracture ◽  
Quality Management ◽  
Safety Culture ◽  
Safety Climate ◽  
Public Hospitals ◽  
Management Systems ◽  
External Audit ◽  
Quality Management Systems ◽  
Safety Attitudes ◽  
Organization Level

Abstract Objective This study aimed to explore the associations between the organization-level quality arrangements, improvement and implementation and department-level safety culture and leadership measures across 32 large Australian hospitals. Design Quantitative observational study, using linear and multi-level modelling to identify relationships between quality management systems and clinician safety culture and leadership. Setting Thirty-two large Australian public hospitals. Participants Quality audit at organization level, senior quality manager at each participating hospital, 1382 clinicians (doctors, nurses and allied health professionals). Main outcome measures Associations between organization-level quality measures and department-level clinician measures of teamwork climate, safety climate and leadership for acute myocardial infarction (AMI), hip fracture and stroke treatment conditions. Results We received 1332 valid responses from participants. The quality management systems index (QMSI, a questionnaire-based measure of the hospitals’ quality management structures) was ‘positively’ associated with all three department-level scales in the stroke department, with safety culture and leadership in the emergency department, but with none of the three scales in the AMI and hip fracture departments. The quality management compliance index (QMCI, an external audit-based measure of the quality improvement activities) was ‘negatively’ associated with teamwork climate and safety climate in AMI departments, after controlling for QMSI, but not in other departments. There was no association between QMCI and leadership in any department, after controlling for QMSI, and there was no association between the clinical quality implementation index (CQII, an external audit-based measure of the level of implementation of quality activities) and any of the three department-level scales in any of the four departments, after controlling for both QMSI and QMCI. Conclusions The influence of organization-level quality management systems on clinician safety culture and leadership varied depending on the hospital department, suggesting that whilst there was some consistency on patient safety attitudes and behaviours throughout the organizations, there were also other factors at play.

Applying importance-performance analysis to patient safety culture

2015 ◽  
Vol 28 (8) ◽  
pp. 826-840 ◽  
Author(s):  
Yii-Ching Lee ◽  
Hsin-Hung Wu ◽  
Wan-Lin Hsieh ◽  
Shao-Jen Weng ◽  
Liang-Po Hsieh ◽  
...  
Keyword(s):  
Patient Safety ◽  
Performance Analysis ◽  
Safety Culture ◽  
Safety Climate ◽  
Patient Safety Culture ◽  
Hospital Staff ◽  
Healthcare Organizations ◽  
Content Type ◽  
Safety Attitudes ◽  
Upper Management

Purpose – The Sexton et al.’s (2006) safety attitudes questionnaire (SAQ) has been widely used to assess staff’s attitudes towards patient safety in healthcare organizations. However, to date there have been few studies that discuss the perceptions of patient safety both from hospital staff and upper management. The purpose of this paper is to improve and to develop better strategies regarding patient safety in healthcare organizations. Design/methodology/approach – The Chinese version of SAQ based on the Taiwan Joint Commission on Hospital Accreditation is used to evaluate the perceptions of hospital staff. The current study then lies in applying importance-performance analysis technique to identify the major strengths and weaknesses of the safety culture. Findings – The results show that teamwork climate, safety climate, job satisfaction, stress recognition and working conditions are major strengths and should be maintained in order to provide a better patient safety culture. On the contrary, perceptions of management and hospital handoffs and transitions are important weaknesses and should be improved immediately. Research limitations/implications – The research is restricted in generalizability. The assessment of hospital staff in patient safety culture is physicians and registered nurses. It would be interesting to further evaluate other staff’s (e.g. technicians, pharmacists and others) opinions regarding patient safety culture in the hospital. Originality/value – Few studies have clearly evaluated the perceptions of healthcare organization management regarding patient safety culture. Healthcare managers enable to take more effective actions to improve the level of patient safety by investigating key characteristics (either strengths or weaknesses) that healthcare organizations should focus on.

scholarly journals The Association between the Participation of Quality Control Circle and Patient Safety Culture

2020 ◽  
Vol 17 (23) ◽  
pp. 8872
Author(s):  
Ni-Hu Tang ◽  
Shang-Feng Tsai ◽  
Jaw-Horng Liou ◽  
Yuan-Hui Lai ◽  
Shih-An Liu ◽  
...  
Keyword(s):  
Job Satisfaction ◽  
Quality Control ◽  
Patient Safety ◽  
Working Conditions ◽  
Safety Culture ◽  
Work Experience ◽  
Safety Climate ◽  
Patient Safety Culture ◽  
Safety Attitudes ◽  
Stress Recognition

Promoting patient safety culture (PSC) is a critical issue for healthcare providers. Quality control circles program (QCCP) can be used as an effective tool to foster long-lasting improvements on the quality of medical institution. The effect of QCCP on PSC is still unknown. This was a retrospective study conducted with matching data. A safety attitudes questionnaire (SAQ) was used for the evaluation of PSC. The association between all scores of six subscales of SAQ and the participation QCCP were analyzed with both the Mann–Whitney and Kruskal–Wallis tests. A total of 2718 valid questionnaires were collected. Most participants of QCCP were females (78.9%), nurses (52.6%), non-supervisors (92.2%), aged <40 years old (64.8%), degree of specialist or university graduates (78%), and with work experience of <10 years (61.6%). Of all participants, the highest scores were in the dimension of safety climate (74.11 ± 17.91) and the lowest scores in the dimension of working conditions (68.90 ± 18.84). The participation of QCCP was associated with higher scores in four dimensions, namely: teamwork climate (p = 0.006), safety climate (p = 0.037), perception of management (p = 0.009), and working conditions (p = 0.015). The participation or not of QCCP had similar results in the dimension of job satisfaction and stress recognition. QCCP was associated with SAQ in subjects with the following characteristics: female, nurse, non-supervisor, aged >50 years old, higher education degrees and with longer working experiences in the hospital. In this first study on the association between each dimension of SAQ and the implementation of QCCP, we found that QCCP interventions were associated with better PSC. QCCP had no benefits in the dimensions of job satisfaction and stress recognition.

Creating a culture of safety within operative neurosurgery: the design and implementation of a perioperative safety video

2012 ◽  
Vol 33 (5) ◽  
pp. E3 ◽  
Author(s):  
Catherine Y. Lau ◽  
S. Ryan Greysen ◽  
Rita I. Mistry ◽  
Seunggu J. Han ◽  
Praveen V. Mummaneni ◽  
...  
Keyword(s):  
Safety Culture ◽  
Video Production ◽  
Ongoing Research ◽  
Safety Practices ◽  
Safety Attitudes ◽  
Provider Behavior ◽  
Communication Processes ◽  
Perioperative Safety ◽  
Operative Neurosurgery ◽  
The Impact

Object Surgical and medical errors result from failures in communication and handoffs as well as lack of standardization in clinical protocols and safety practices. Checklists, simulation training, and teamwork training have been shown to decrease adverse patient events and increase the safety culture of surgical teams. The goal of this project was to simplify and standardize perioperative patient safety practices and team communication processes within operative neurosurgery through the creation of an educational safety video targeted at a neurosurgical provider audience. Methods A multidisciplinary group consisting of neurosurgeons, anesthesiologists, nurses, neuromonitoring specialists, quality champions, and a professional video production company met over several months in an iterative process to 1) determine the overall objectives of the video, 2) decide on the content and format of the video, 3) modify the proposed content and format based on stakeholder feedback, and 4) record the video and complete final revisions during postproduction. Results The video was launched within the authors' institution in July 2012 in conjunction with ongoing research projects to study the effects of the video on 1) multidisciplinary providers' knowledge of perioperative safety practices, 2) provider safety attitudes and safety culture in the operating room, and 3) provider behavior in performing predetermined elements of the preoperative timeout and postoperative debrief. Conclusions The neurosurgical perioperative safety video can serve as a national model for how quality champions can drive changes in safety culture and provider behavior among multidisciplinary perioperative patient care teams. Ongoing research is being performed to assess the impact of the video on provider knowledge, behavior, and safety attitudes and culture.

scholarly journals Causal Relationship Analysis of the Patient Safety Culture Based on Safety Attitudes Questionnaire in Taiwan

2018 ◽  
Vol 2018 ◽  
pp. 1-8 ◽  
Author(s):  
Yii-Ching Lee ◽  
Pei-Shan Zeng ◽  
Chih-Hsuan Huang ◽  
Hsin-Hung Wu
Keyword(s):  
Job Satisfaction ◽  
Patient Safety ◽  
Safety Culture ◽  
Safety Climate ◽  
Patient Safety Culture ◽  
Laboratory Method ◽  
Critical Dimensions ◽  
Safety Attitudes ◽  
Safety Attitudes Questionnaire ◽  
Relationship Analysis

This study uses the decision-making trial and evaluation laboratory method to identify critical dimensions of the safety attitudes questionnaire in Taiwan in order to improve the patient safety culture from experts’ viewpoints. Teamwork climate, stress recognition, and perceptions of management are three causal dimensions, while safety climate, job satisfaction, and working conditions are receiving dimensions. In practice, improvements on effect-based dimensions might receive little effects when a great amount of efforts have been invested. In contrast, improving a causal dimension not only improves itself but also results in better performance of other dimension(s) directly affected by this particular dimension. Teamwork climate and perceptions of management are found to be the most critical dimensions because they are both causal dimensions and have significant influences on four dimensions apiece. It is worth to note that job satisfaction is the only dimension affected by the other dimensions. In order to effectively enhance the patient safety culture for healthcare organizations, teamwork climate, and perceptions of management should be closely monitored.

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