Building a collaborative culture in cardiothoracic operating rooms: pre and postintervention study protocol for evaluation of the implementation of teamSTEPPS training and the impact on perceived psychological safety

IntroductionThe importance of effective communication, a key component of teamwork, is well recognised in the healthcare setting. Establishing a culture that encourages and empowers team members to speak openly in the cardiothoracic (CT) operating room (OR) is necessary to improve patient safety in this high-risk environment.Methods and analysisThis study will take place at Barnes-Jewish Hospital, an academic hospital in affiliation with Washington University School of Medicine located in the USA. All team members participating in cardiac and thoracic OR cases during this 17-month study period will be identified by the primary surgical staff attending on the OR schedule.TeamSTEPPS (Team Strategies and Tools to Enhance Performance and Patient Safety) training course will be taught to all CT OR staff. Before TeamSTEPPS training, staff will respond to a 39-item questionnaire that includes constructs from the Agency for Healthcare Research and Quality Hospital Survey on Patient Safety Culture, Edmondson’s ‘Measure of psychological safety’ questionnaire, and questionnaires on turnover intentions, job satisfaction and ‘burnout’. The questionnaires will be readministered at 6 and 12 months.The primary outcomes to be assessed include the perceived psychological safety of CT OR team members, the overall effect of TeamSTEPPS on burnout and job satisfaction, and observed turnover rate among the OR nurses. As secondary outcomes, we will be assessing self-reported rates of medical error and near misses in the ORs with a questionnaire at the end of each case.Ethics and disseminationEthics approval is not indicated as this project does not meet the federal definitions of research requiring the oversight of the Institutional Review Board (IRB). Patient health information (PHI) will not be generated during the implementation of this project. Results of the trial will be made accessible to the public when published in a peer-reviewed journal following the completion of the study.

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Evaluating Patient Safety Culture in Iraqi Community Pharmacies

Iraqi Journal of Pharmaceutical Sciences ( P-ISSN 1683 - 3597 E-ISSN 2521 - 3512) ◽

10.31351/vol30iss1pp154-162 ◽

2021 ◽

Vol 30 (1) ◽

pp. 154-162

Author(s):

Basma S. Jasim ◽

Mohammed Y. Jamal

Keyword(s):

Patient Safety ◽

Improve Patient Safety ◽

Health Care Organization ◽

Patient Safety Culture ◽

Healthcare Research ◽

Community Pharmacies ◽

Care Organization ◽

Patient Counseling ◽

Work Pressure ◽

Improve Patient

Patient safety is the main issue in health care organization, the Agency for Healthcare Research and Quality defines it as, “freedom from accidental or preventable injuries produced by medical care. Thus, practices or interventions that improve patient safety are those that reduce the occurrence of preventable adverse events”. The purpose of this study was to evaluate Iraqi pharmacist perception about the culture of patient safety. As well as estimate whether safety is a principal issue in their pharmaceutical practice this study was carried out on 435 pharmacists who are working in community pharmacies in various Iraqi provinces. A survey was distributed via the internet during the period from May to June 2020. A community pharmacy questionnaire was used to evaluate the awareness of pharmacists regarding the culture of patient safety. A result of this study shows that the patient counseling field was the most positive one among the studied domains with score 68.8% of positive awareness and 70.4% of the pharmacists indicated that they inform patients with needed information about their new prescriptions. In contrast, staffing and work pressure scored the lowest positive response (36.55%). Although 66.7% of the participants stated they have the appropriate number of staff in their pharmacies to deal with the workload.

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Interdisciplinary Differences in Patient Safety Culture within a Teaching Hospital in a South East Asia

10.22541/au.160578922.29497408/v1 ◽

2020 ◽

Author(s):

Karthikayini Krishnasamy ◽

Maw Pin Tan ◽

Mohd Idzwan Zakaria

Keyword(s):

Job Satisfaction ◽

Patient Safety ◽

Safety Culture ◽

Improve Patient Safety ◽

Patient Safety Culture ◽

University Hospital ◽

Percentage Agreement ◽

Allied Health Professionals ◽

Cross Sectional ◽

Stress Recognition

Background: Patient safety represents a global issue which leads to potentially avoidable morbidity and mortality. This study aimed to determine the inter-professional differences in patient safety culture in a tertiary university hospital. Method: A cross-sectional study using the Safety Attitude Questionnaire (SAQ) self-administered electronically in the English and Malay languages to evaluate safety culture domains. A positive percentage agreement score of 60% was considered satisfactory. Comparisons were made between clinicians, nurses, allied health professionals, ward attendants and support staff. Results: Of 6562 potential respondents, 5724 (80.4%) completed the questionnaire; 3930 (74.5%) women, 2263 (42.9%) nurses, and 1812 (34.2%) had 6-10 years of working experience. The mean overall positive percentage agreement scores were 66.2 (range=31.1 to 84.7%), with job satisfaction (72.3±21.9%) and stress recognition (58.3±25.6%) representing the highest and lowest mean domain scores respectively. Discussion: Differences were observed between all five job categories. Linear regression analyses revealed that the other four job categories scored lower in teamwork, safety culture, job satisfaction, and working conditions compared to nurses. Conclusions: The overall mean SAQ score was above the satisfactory level, with unsatisfactory percentage agreement scores in the stress recognition domain. Interventions to improve patient safety culture should be developed, focusing on stress management.

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Nurses’ perception of patient safety culture and its relationship with adverse events: a national questionnaire survey in Iran

BMC Nursing ◽

10.1186/s12912-021-00571-w ◽

2021 ◽

Vol 20 (1) ◽

Author(s):

Edris Kakemam ◽

Hojatolah Gharaee ◽

Mohamad Reza Rajabi ◽

Milad Nadernejad ◽

Zahra Khakdel ◽

...

Keyword(s):

Patient Safety ◽

Adverse Events ◽

Safety Culture ◽

Improve Patient Safety ◽

Patient Safety Culture ◽

Teaching Hospitals ◽

Management Support ◽

Cross Sectional Survey ◽

Nurses Perceptions ◽

The Impact

Abstract Background Patient safety culture is an important factor in determining hospitals’ ability to address and reduce the occurrence of adverse events (AEs). However, few studies have reported on the impact of nurses’ perceptions of patient safety culture on the occurrence of AEs. Our study aimed to assess the association between nurses’ perception of patient safety culture and their perceived proportion of adverse events. Methods A cross-sectional survey was carried out among 2295 nurses employed in thirty-two teaching hospitals in Iran. Nurses completed the Persian version of the hospital survey of patients’ safety culture between October 2018 and September 2019. Results Positive Response Rates of overall patient safety culture was 34.1% and dimensions of patient safety culture varied from 20.9 to 43.8%. Also, nurses estimated that the occurrence of six adverse events varied from 51.2–63.0% in the past year. The higher nurses’ perceptions of “Staffing”, “Hospital handoffs and transitions”, “Frequency of event reporting”, “Non-punitive response to error”, “Supervisor expectation and actions promoting safety”, “Communication openness”, “Organizational learning continuous improvement”, “Teamwork within units”, and “Hospital management support patient safety” were significantly related to lower the perceived occurrence at least two out of six AEs (OR = 0.69 to 1.46). Conclusions Our findings demonstrated that nurses’ perception regarding patient safety culture was low and the perceived occurrence of adverse events was high. The research has also shown that the higher level of nurses’ perception of patient safety culture was associated with lowered occurrence of AEs. Hence, managers could provide prerequisites to improve patient safety culture and reduce adverse events through different strategies, such as encouraging adverse events’ reporting and holding training courses for nurses. However, further research is needed to assess how interventions addressing patient safety culture might reduce the occurrence of adverse events.

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GESTÃO HOSPITALAR E CULTURA DE SEGURANÇA DO PACIENTE NA PERCEPÇÃO DA EQUIPE DE ENFERMAGEM

Revista Baiana Saúde Pública ◽

10.22278/2318-2660.2016.v40.n0.a2670 ◽

2017 ◽

Vol 40 ◽

Author(s):

Edenise Maria Santos da Silva-Batalha ◽

Marta Maria Melleiro

Keyword(s):

Patient Safety ◽

Safety Culture ◽

Patient Safety Culture ◽

Healthcare Research

O objetivo deste estudo foi avaliar a percepção de trabalhadores de enfermagem de um hospital de ensino acerca da cultura de segurança do paciente frente à gestão hospitalar. Trata-se de uma pesquisa quantitativa desenvolvida em um hospital de 900 leitos. A amostra foi composta por 301 profissionais de enfermagem. O instrumento de coleta foi o questionário da Agency for Healthcare Research and Quality, intitulado Hospital Survey on Patient Safety Culture, traduzido para o Português e adaptado da versão original em inglês. A análise deu-se por meio de estatísticas descritivas e testes específicos. Os resultados referentes à dimensão “Apoio da gestão hospitalar para segurança do paciente” evidenciaram que 53,6% dos participantes discordavam que a administração propiciava um clima de trabalho favorável à segurança do paciente, 46% discordavam que a segurança do paciente fosse uma prioridade da administração e 58,3% concordavam que a administração apenas se interessava pela segurança após a ocorrência de eventos adversos. Tais resultados demonstram a necessidade de envolvimento maior da gestão hospitalar para com a segurança dos pacientes, favorecendo o amadurecimento da cultura de segurança. Ainda, a relação entre a enfermagem e a gestão hospitalar deve ser fortalecida, baseando-se em relações mais próximas e lineares. Conclui-se que não é apenas uma parte da organização que é responsável pela cultura de segurança, há, portanto, a necessidade de envolver a gestão e todos os trabalhadores na criação, implementação e fortalecimento dos sentimentos, valores, comportamentos, atitudes e ações que irão fomentar essa cultura. Palavras-chave: Administração hospitalar. Segurança do paciente. Enfermagem.

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OR and ICU teams ‘running in parallel’ at the end of cardiothoracic surgery improves perceptions of handoff safety

BMJ Open Quality ◽

10.1136/bmjoq-2020-001001 ◽

2021 ◽

Vol 10 (1) ◽

pp. e001001

Author(s):

Safraz Hamid ◽

Frederic Joyce ◽

Aaliya Burza ◽

Billy Yang ◽

Alexander Le ◽

...

Keyword(s):

Patient Safety ◽

Cardiac Surgery ◽

Safety Culture ◽

Positive Response ◽

Improve Patient Safety ◽

Health Care Research ◽

Response Rates ◽

Patient Safety Culture ◽

Improvement Project ◽

Surgery Patient

The transfer of a cardiac surgery patient from the operating room (OR) to the intensive care unit (ICU) is both a challenging process and a critical period for outcomes. Information transferred between these two teams—known as the ‘handoff’—has been a focus of efforts to improve patient safety. At our institution, staff have poor perceptions of handoff safety, as measured by low positive response rates to questions found in the Agency for Health Care Research and Quality (AHRQ) Hospital Survey on Patient Safety Culture (HSOPS). In this quality improvement project, we developed a novel handoff protocol after cardiac surgery where we invited the ICU nurse and intensivist into the OR to receive a face-to-face handoff from the circulating nurse, observe the final 30 min of the case, and participate in the end-of-case debrief discussions. Our aim was to increase the positive response rates to handoff safety questions to meet or surpass the reported AHRQ national averages. We used plan, do, study, act cycles over the course of 123 surgical cases to test how our handoff protocol was leading to changes in perceptions of safety. After a 10-month period, we achieved our aim for four out of the five HSOPS questions assessing safety of handoff. Our results suggest that having an ICU team ‘run in parallel’ with the cardiac surgical team positively impacts safety culture.

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A comparative assessment of two tools designed to support patient safety culture in UK general practice

BMC Family Practice ◽

10.1186/s12875-021-01438-4 ◽

2021 ◽

Vol 22 (1) ◽

Author(s):

Ian Litchfield ◽

Kate Marsden ◽

Lucy Doos ◽

Katherine Perryman ◽

Anthony Avery ◽

...

Keyword(s):

General Practice ◽

Patient Safety ◽

Focus Group ◽

Safety Culture ◽

Improve Patient Safety ◽

Patient Safety Culture ◽

Focus Group Discussions ◽

Group Discussions ◽

Staff Members ◽

Practice Team

Abstract Background The NHS has recognised the importance of a high quality patient safety culture in the delivery of primary health care in the rapidly evolving environment of general practice. Two tools, PC-SafeQuest and MapSaf, were developed with the intention of assessing and improving patient safety culture in this setting. Both have been made widely available through their inclusion in the Royal College of General Practitioners’ Patient Safety Toolkit and our work offerss a timely exploration of the tools to inform practice staff as to how each might be usefully applied and in which circumstances. Here we present a comparative analysis of their content, and describe the perspectives of staff on their design, outputs and the feasibility of their sustained use. Methods We have used a content analysis to provide the context for the qualitative study of staff experiences of using the tools at a representative range of practices recruited from across the Midlands (UK). Data was collected through moderated focus groups using an identical topic guide. Results A total of nine practices used the PC-SafeQuest tool and four the MapSaf tool. A total of 159 staff completed the PC-SafeQuest tool 52 of whom took part in the subsequent focus group discussions, and 25 staff completed the MapSaf tool all of whom contributed to the focus group discussions. PC-SafeQuest was perceived as quick and easy to use with direct questions pertinent to the work of GP practices providing useful quantitative insight into important areas of safety culture. Though MaPSaF was more logistically challenging, it created a forum for synchronous cross- practice discussions raising awareness of perceptions of safety culture across the practice team. Conclusions Both tools were able to promote reflective and reflexive practice either in individual staff members or across the broader practice team and the oversight they granted provided useful direction for senior staff looking to improve patient safety. Because PC SafeQuest can be easily disseminated and independently completed it is logistically suited to larger practice organisations, whereas the MapSaf tool lends itself to smaller practices where assembling staff in a single workshop is more readily achieved.

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Broadening the concept of patient safety culture through value-based healthcare

Journal of Health Organization and Management ◽

10.1108/jhom-07-2020-0287 ◽

2021 ◽

Vol ahead-of-print (ahead-of-print) ◽

Author(s):

Viktor Dombrádi ◽

Klára Bíró ◽

Guenther Jonitz ◽

Muir Gray ◽

Anant Jani

Keyword(s):

Patient Safety ◽

Patient Experience ◽

Safety Culture ◽

Improve Patient Safety ◽

Cost Benefit ◽

Population Level ◽

Patient Safety Culture ◽

Content Type ◽

Experience Of Care ◽

Improve Patient

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.

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A study on the relationship between intragroup conflict and turnover intentions, and the mediating effect of job satisfaction

The Korean Journal of Industrial and Organizational Psychology ◽

10.24230/kjiop.v24i1.75-102 ◽

2011 ◽

Vol 24 (1) ◽

pp. 75-102

Author(s):

Junho Lee ◽

Jihwan Park

Keyword(s):

Job Satisfaction ◽

Turnover Intentions ◽

Mediating Effect ◽

Task Conflict ◽

Mediating Effects ◽

Intragroup Conflict ◽

Chinese Workers ◽

The Impact ◽

The Relationship ◽

And Task

The study delved into the impact of intragroup conflict on turnover intentions and cultural commonalities and differences in job satisfaction that mediates the relationship. To identify correlations among intragroup conflict, job satisfaction and turnover intentions for each Korean and Chinese employee, the study analyzed questionnaires used to survey Korean employees working at Korean companies and Chinese workers in Korean companies based in China. The study divided intragroup conflict into two types - relation conflict and task conflict - and looked into the impact of each conflict on turnover intentions, and found that both types of conflict heightened turnover intentions of both Korean and Chinese workers. The study also attempted to prove the mediating effects of job satisfaction on the relationship between relation conflict and task conflict, and turnover intentions. As a result, mediating effects were found only in the relationship between relation conflict and turnover intentions among Chinese employees, while Korean workers saw the same effects only in the relationship between task conflict and turnover intentions. The above-mentioned results indicate the following implications. Firstly, there were common effects of intragroup conflict on turnover intentions for both Korean and Chinese employees. Such effect can be understood from culture universal perspective. Secondly, differences emerged in the mediating effects of job satisfaction in the relationship between turnover intentions and intra-group conflicts. That is understandable from culture specific perspective. Thirdly, the result that can be inferred from the aforementioned findings is that when it comes to cross-cultural research on methods of management, it is important to consider two types of approaches - culture universal and culture specific approaches. Lastly, the study also indicated that companies operating overseas should seek both localized and global management.

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Job Satisfaction and Organizational Commitment: Valid Predictors of Turnover Intentions

Review of Economics and Development Studies ◽

10.47067/reads.v6i4.292 ◽

2020 ◽

Vol 6 (4) ◽

pp. 931-939

Author(s):

Uzma Ashiq ◽

Nargis Abbas ◽

Syed Salman Hassan ◽

Usman Riaz Mir

Keyword(s):

Job Satisfaction ◽

Organizational Commitment ◽

Banking Sector ◽

Turnover Intentions ◽

Economic Condition ◽

Critical Issue ◽

Influential Factors ◽

Conventional Banks ◽

The Impact ◽

Survey Questionnaires

Human resource capital is the most strategic part of any organization. Retention of human resources is a critical issue these days. Keeping in view the importance of human capital and its retention, present study aimed to explore the impact of two strong predictors, job satisfaction and organizational commitment, on turnover intentions of employees in banking sector of Pakistan. 250 Survey questionnaires are distributed in Islamic and Conventional banks to elicit responses of professionals among which 207 questionnaires are returned and used for analysis. Findings reveal surprisingly contradictory results from previous studies. Job Satisfaction and organizational commitment are having very negligible impact on turnover intentions. Although employees are not much satisfied as well as committed with the organization but still they have minimal intention towards leaving the organization. Results indicated that turnover intentions of employees in banking sector of Pakistan depend on various other factors. Results are surprising but the paradox can be understood by keeping in view few demographics of respondents as well as the economic condition of the country. The study has significant decision-making implications for banks and called for an urgently inquiry about those influential factors that largely affect the turnover intentions of their employees. In addition, banks also need to apply measures to enhance the job satisfaction and organizational commitment as empirical results indicate very less satisfaction and commitment of employees.

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Assessment of patient safety culture in intensive care units and factors affecting it

European Journal of Public Health ◽

10.1093/eurpub/ckaa166.530 ◽

2020 ◽

Vol 30 (Supplement_5) ◽

Author(s):

M A Tlili ◽

W Aouicha ◽

H Lamine ◽

E Taghouti ◽

M B e n Dhiab ◽

...

Keyword(s):

Patient Safety ◽

Intensive Care ◽

Adverse Events ◽

Intensive Care Units ◽

Safety Culture ◽

Improve Patient Safety ◽

Healthcare Quality ◽

Patient Safety Culture ◽

Cross Sectional ◽

Learning From Errors

Abstract Background The intensive care units are a high-risk environments for the occurrence of adverse events with serious consequences. The development of patient safety culture is a strategic focus to prevent these adverse events and improve patient safety and healthcare quality. This study aimed to assess patient safety culture in Tunisian intensive care units and to determine its associated factors. Methods It is a multicenter, descriptive cross-sectional study, among healthcare professionals of the intensive care units in the Tunisian center. The data collection was spread over a period of 2 months (October-November 2017). The measuring instrument used is the validated French version of the Hospital Survey On Patient Safety Culture questionnaire. Data entry and analysis was carried out by the Statistical Package for Social Sciences (SPSS 20.0) and Epi Info 6.04. Chi-square test was used to explore factors associated with patient safety culture. Results A total of 404 professionals participated in the study with a participation rate of 81.94%, spread over 10 hospitals and 18 units. All dimensions were to be improved. The overall perception of safety was 32.35%. The most developed dimension was teamwork within units with a score of 47.87% and the least developed dimension was the non-punitive response to error (18.6%). The patient safety culture was significantly more developed in private hospitals in seven of the 10 dimensions. Participants working in small units had a significantly higher patient safety culture. It has been shown that when workload is reduced the patient safety culture was significantly increased. Conclusions This study has shown that the patient safety culture still needs to be improved and allowed a clearer view of the safety aspects requiring special attention. Thus, improving patient safety culture. by implementing the quality management and error reporting systems could contribute to enhance the quality of healthcare provided to patients. Key messages The culture of culpability is the main weakness in the study. Encouraging event reporting and learning from errors s should be priorities in hospitals to enhance patient safety and healthcare quality.

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