scholarly journals Exploring patient safety in Swedish specialised home healthcare: an interview study with multidisciplinary teams and clinical managers

BMJ Open ◽  
2018 ◽  
Vol 8 (12) ◽  
pp. e024068 ◽  
Author(s):  
Marléne Lindblad ◽  
Maria Flink ◽  
Mirjam Ekstedt
Keyword(s):  
Patient Safety ◽  
Communication Systems ◽  
Qualitative Content Analysis ◽  
Patient Safety Culture ◽  
Home Healthcare ◽  
Multidisciplinary Teams ◽  
Team Members ◽  
Individual Interviews ◽  
Safety Research ◽  
Quality Assessments

ObjectiveHome healthcare is the fastest growing arena in the healthcare system but patient safety research in this context is limited. The aim was to explore how patient safety in Swedish specialised home healthcare is described and adressed from multidisciplinary teams’ and clinical managers’ perspectives.DesignAn explorative qualitative study.SettingMultidisciplinary teams and clinical managers were recruited from three specialised home healthcare organisations in Sweden.MethodsNine focus group interviews with multidisciplinary teams and six individual interviews with clinical managers were conducted, in total 51 participants. The data were transcribed verbatim and analysed using qualitative content analysis.ResultsPatient safety was inherent in the well-established care ideology which shaped a common mindset between members in the multidisciplinary teams and clinical managers. This patient safety culture was challenged by the emerging complexity in which priority had to be given to standardised guidelines, quality assessments and management of information in maladapted communication systems and demands for required competence and skills. The multiple guidelines and quality assessments that aimed to promote patient safety from a macro-perspective, constrained the freedom, on a meso-level and micro-level, to adapt to challenges based on the care ideology.ConclusionPatient safety in home healthcare is dependent on adaptability at the management level; the team members’ ability to adapt to the varying conditions and on patients being capable of adjusting their homes and behaviours to reduce safety risks. A strong culture related to a patient’s value as a person where patients’ and families’ active participation and preferences guide the decisions, could be both a facilitator and a barrier to patient safety, depending on which value is given highest priority.

scholarly journals Patients’ perceptions of safety in emergency medical services: an interview study

BMJ Open ◽  
2020 ◽  
Vol 10 (10) ◽  
pp. e037488
Author(s):  
Anu Venesoja ◽  
Maaret Castrén ◽  
Susanna Tella ◽  
Veronica Lindström
Keyword(s):  
Patient Safety ◽  
Emergency Medical Services ◽  
Professional Competence ◽  
Qualitative Content Analysis ◽  
Medical Services ◽  
Individual Interviews ◽  
Driving Skills ◽  
Emergency Medical ◽  
Perceptions Of Safety

BackgroundResearch on patient safety in emergency medical services (EMS) has mainly focused on the organisation’s and/or the EMS personnel’s perspective. Little is known about how patients perceive safety in EMS. This study aims to describe the patients’ experiences of their sense of safety in EMS.MethodsA qualitative design with individual interviews of EMS patients (n=21) and an inductive qualitative content analysis were used.ResultsPatients’ experiences of EMS personnel’s ability or inability to show or use their medical, technical and driving skills affected the patients’ sense of safety. When they perceived a lack of professionalism and knowledge among EMS personnel, they felt unsafe. Patients highlighted equality in the encounter, the quality of the information given by EMS personnel and the opportunity to participate in their care as important factors creating a sense of safety during the EMS encounter. Altogether, patients’ perceptions of safety in EMS were connected to their confidence in the EMS personnel.ConclusionsOverall, patients felt safe during their EMS encounter, but the EMS personnel’s professional competence alone is not enough for them to feel safe. Lack of communication or professionalism may compromise their sense of safety. Further work is needed to explore how patients’ perceptions of safety can be used in improving safety in EMS.

scholarly journals Exploring stakeholder perceptions around implementation of the Operating Room Black Box for patient safety research: a qualitative study using the theoretical domains framework

2019 ◽  
Vol 8 (3) ◽  
pp. e000686 ◽  
Author(s):  
Nicole Etherington ◽  
Aya Usama ◽  
Andrea M Patey ◽  
Chantal Trudel ◽  
Antoine Przybylak-Brouillard ◽  
...  
Keyword(s):  
Patient Safety ◽  
Operating Room ◽  
Video Recording ◽  
Theoretical Domains Framework ◽  
Black Box ◽  
Leadership Team ◽  
Senior Leadership ◽  
Team Members ◽  
Barriers And Enablers ◽  
Safety Research

BackgroundSystematically observing clinical performance in the operating room (OR) to support patient safety initiatives faces numerous logistical and methodological challenges. These may be solved by new audio-video recording technologies like the OR Black Box, which is a tool similar to black boxes in aviation. This study aimed to identify barriers and enablers that may influence patients’, clinicians’ and senior leadership team members’ support of the OR Black Box in order to guide its future implementation.MethodsPatients, clinicians and senior leadership team members were recruited to participate in semistructured interviews informed by the theoretical domains framework (TDF) to identify factors relevant to planning OR Black Box implementation. Deidentified interview transcripts were analysed in duplicate following a TDF coding structure.ResultsData saturation was achieved at 15 patients, 17 clinicians and 9 senior leadership team members. Seven domains were relevant for patients, nine for clinicians and four for senior leadership. Knowledge and Beliefs about consequences were barriers and enablers for all three groups. Memory, attention and decision processes and Social influences were enablers for both clinicians and senior leadership. Environmental context and resources, Emotion and Behavioural regulation were found to be barriers and enablers for both clinicians and patients. Social/professional role and identity and Reinforcement were enablers for patients only and Optimism and Intentions were barriers and enablers to clinicians.ConclusionsWhile most stakeholders were supportive of the OR Black Box, we identified many key areas that need to be addressed during its implementation. It is critical to ensure all stakeholders have adequate and accurate information about the OR Black Box system and research goals, and that the OR Black Box is positioned as a patient safety initiative for learning from and improving practice.

scholarly journals Patient Safety Culture and Spiritual Health in the Operating Room: A Qualitative Study

2020 ◽  
Author(s):  
Elahe mousavi ◽  
Behzad Imani
Keyword(s):  
Health Care ◽  
Patient Safety ◽  
Content Analysis ◽  
Health Care Providers ◽  
Safety Culture ◽  
Qualitative Content Analysis ◽  
Patient Safety Culture ◽  
Spiritual Health ◽  
Care Providers ◽  
Safety Skills

Abstract Background The concept of patient safety is an essential component of health care systems and is one of the key pillars of quality in health care organizations. One of the most important factors related to the safety of patients is the spiritual health of staff and patients. Accordingly, this study strived to explain the status of patient safety culture and its relationship with spiritual health from the perspective of health care providers in teaching hospitals of Hamadan.Methods This study was a qualitative content analysis study with a conventional approach using semi-structured open-ended interviews with samples selected by purposeful sampling technique to achieve data saturation. The proposed method of Granheim and Landman (2004) was also used for the qualitative content analysis of the data.Results In this study, 5 themes and 11 sub-themes were obtained from the participants' experiences. These included: continuous and dynamic training and upgrading of safety skills, attention to spirituality and conscientiousness and work commitment, effective communication and teamwork, equipping human and logistical resources based on the principle of care, accurate recognition of instructions, and error control.Conclusions The evaluation of safety culture clarifies the perceptions of safety participants in the organization and the attitude of managers and employees towards safety issue which can lead to the development of safety culture and quality improvement.

scholarly journals Perspectives on Patient Safety Education in the Kenyan Preregistration Nursing Curriculum

2018 ◽  
Vol 20 (2) ◽  
Author(s):  
Nickcy Nyaruai Mbuthia ◽  
Mary M Moleki
Keyword(s):  
Patient Safety ◽  
Content Analysis ◽  
Safety Culture ◽  
Nursing Faculty ◽  
Qualitative Content Analysis ◽  
Patient Safety Culture ◽  
Nursing Curriculum ◽  
Safety Education ◽  
Clinical Nurses ◽  
Patient Safety Education

Patient safety education is recognised as a key ingredient in the development of safety competencies in healthcare professionals. To ensure that patient safety is emphasised in the preregistration education, it is important that it be integrated explicitly in the curriculum. This study aimed at identifying explicit patient safety concepts in the Kenyan nursing curriculum and exploring the perspectives of the nursing faculty members and clinical nurses on the integration of patient safety in the curriculum. A qualitative content analysis was conducted on the relevant curriculum documents from two universities. In-depth, semi-structured interviews were conducted on a purposive sample of 13 staff members of the nursing faculty from the university and 14 clinical nurses from the hospitals where the students undergo clinical instruction. A thematic analysis was carried out on the transcribed interviews from which four themes and subthemes emerged. The curriculum content analysis did not identify any explicit patient safety content but the content was rather implicit within the curriculum as a series of statements and inferences to patient safety. The themes included curriculum issues, student characteristics, a patient safety culture, clinical education issues, and the academic-clinical relationship. To ensure training of a nurse who is competent in patient safety, the concepts must be integrated in the curriculum, the academic and clinical faculties need to be well equipped to teach and assess these concepts, the patient safety culture in clinical placement sites should be conducive to allow for learning about patient safety, and better collaboration between the academic and clinical settings for integration of patient safety in nursing education should be realised.

Strategies for handling ethical problems in sudden and unexpected death

2013 ◽  
Vol 20 (6) ◽  
pp. 708-722 ◽  
Author(s):  
Åsa Rejnö ◽  
Ella Danielson ◽  
Linda Berg
Keyword(s):  
Content Analysis ◽  
Qualitative Content Analysis ◽  
Unexpected Death ◽  
Ethical Problems ◽  
Team Members ◽  
Individual Interviews ◽  
Follow Up Study ◽  
Stroke Team

How ethical praxis is shaped by different contexts and situations has not been widely studied. We performed a follow-up study on stroke team members’ experiences of ethical problems and how the teams managed the situation when caring for patients faced with sudden and unexpected death from stroke. A number of ways for handling ethical problems emerged, which we have now explored further. Data were collected through a three-part form used as base for individual interviews with 15 stroke team members and analyzed using both quantitative and qualitative content analysis. In the analysis, the approaches in the form were condensed into strategies, and the two different ways those strategies were preferred and used by the team members were shown. Hindrances perceived by the team members to impede them from working the preferred way were also revealed and grouped into eight categories.

Assessing the Patient Safety Culture in Dentistry

2020 ◽  
Vol 5 (4) ◽  
pp. 399-408
Author(s):  
A. Yansane ◽  
J.H. Lee ◽  
N. Hebballi ◽  
E. Obadan-Udoh ◽  
J. White ◽  
...  
Keyword(s):  
Patient Safety ◽  
Safety Culture ◽  
Patient Safety Culture ◽  
The United States ◽  
Cross Sectional Study ◽  
Primary Objective ◽  
Cross Sectional ◽  
Team Members ◽  
Average Percentage ◽  
Medical Office

Objectives: Medical errors are among the leading causes of death within the United States. Studies have shown that patients can be harmed while receiving care, sometimes resulting in permanent injury or, in extreme cases, death. To reduce the risk of patient safety incidents, it is imperative that a robust culture of safety be established. The primary objective of this study was to evaluate the patient safety culture among providers at 4 US dental institutions, comparing the results with their medical counterparts in 2016. Methods: This cross-sectional study uses the Medical Office Survey on Patient Safety Culture that was modified for dentistry and administered at 4 US dental institutions during the 2016 calendar year. All dental team members were invited to complete electronic or paper-based versions of the questionnaire. Results: Among 1,615 invited participants, 656 providers responded (rate, 40.6%). Medical institutions outperformed the dental institutions on 9 of the 10 safety culture dimensions, 6 of the 6 overall quality items, and 8 of the 9 patient safety and quality issues. The surveyed dental institutions reported the strongest average percentage positive scores in organizational learning (85%) and teamwork (79%). Conclusion: These findings suggest that the patient safety culture progressed over time. However, there is still heterogeneity within safety culture among academic dental, private (nonacademic), and medical clinics. Knowledge Transfer Statement: Patient safety is the first dimension of quality improvement. Administering the Medical Office Survey on Patient Safety Culture within dental clinics represents a key measure to understand where improvements can be made with respect to patient care safety.

scholarly journals 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

BMJ Open ◽  
2017 ◽  
Vol 7 (9) ◽  
pp. e017389 ◽  
Author(s):  
Aaron Benjamin Dahl ◽  
Arbi Ben Abdallah ◽  
Hersh Maniar ◽  
Michael Simon Avidan ◽  
Mara L Bollini ◽  
...  
Keyword(s):  
Job Satisfaction ◽  
Patient Safety ◽  
Turnover Intentions ◽  
Improve Patient Safety ◽  
Psychological Safety ◽  
Patient Safety Culture ◽  
Healthcare Research ◽  
Risk Environment ◽  
Team Members ◽  
The Impact

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.

scholarly journals Studi Fenomenologi Budaya Keselamatan Pasien Dari Perspektif Kepala Ruang Instalasi Rawat Inap di RSUD Raden Mattaher Jambi

2020 ◽  
Vol 20 (1) ◽  
pp. 334
Author(s):  
Afridawati MJ ◽  
Meri Neherta ◽  
Fitra Yeni
Keyword(s):  
Patient Safety ◽  
Data Analysis ◽  
Data Collection ◽  
Safety Culture ◽  
Design Research ◽  
Safety Management ◽  
Patient Safety Culture ◽  
Sampling Techniques ◽  
Descriptive Phenomenology ◽  
Safety Research

Patient safety culture is the key to support the achievement of improvement in the safety of the patient's head of the room as the operational manager responsible for delivering quality services to manage all the resources in Care unit, especially in the management of patient safety. Research aims to delve deeply into the safety of cultural patients from a room head perspective. Design research is a method of descriptive phenomenology, data collection with interviews Postamand field records. Participants in this study were taken with purposive sampling techniques with seven participants. Data analysis using Collaizi method. The results of this study identified seven themes, namely (1) Experience the culture of patient safety, (2) Dimension of patient safety culture, (based on results obtained by the head of the room need to understand the function of management in safety management Patients and improve supervision.

A Likert-Type scale for evaluating the “bottom line” of patient safety

2020 ◽  
pp. 251604352097286
Author(s):  
Sarit Rashkovits
Keyword(s):  
Patient Safety ◽  
Adverse Events ◽  
Reliability And Validity ◽  
Patient Safety Culture ◽  
Safety Behavior ◽  
Bottom Line ◽  
Safety Research ◽  
Two Samples ◽  
Reporting Systems ◽  
Significant Direct Effect

The formally reported number of adverse events may be open to ambivalent interpretation – actual higher prevalence of adverse events versus a patient safety culture supporting reporting and learning. Many methods appearing in the literature that are not based on reporting systems struggle for adequately assess the precise level of prevalence of adverse events. Confronting this challenge in patient safety research, we suggest evaluating the perceived state of “almost no adverse events” in the ward, by using a short Likert- type scale we developed for this purpose. Some evidence for its reliability and validity are presented using two samples (99 head nurses, and 383 nurses). As was expected, leadership had a significant direct effect on the measured state of “almost no adverse events” as well as an indirect effect mediated successively by psychological safety, and safety behavior.

scholarly journals Acting between Checklists and Reality. Managers’ Balancing between Standardization and Adaptive Behaviour in Patient Safety Work- an Interview Study

2020 ◽  
Author(s):  
Mats Hedsköld ◽  
Magna Andreen Sachs ◽  
Thorleif Rosander ◽  
Mia von Knorring ◽  
Karin Pukk Harenstam
Keyword(s):  
Patient Safety ◽  
Safety Culture ◽  
Role Models ◽  
Qualitative Content Analysis ◽  
Patient Safety Culture ◽  
Interview Study ◽  
Adaptive Behaviour ◽  
First Line ◽  
Line Managers ◽  
Everyday Work

Abstract Background Safety culture can be described and understood through its manifestations in the organisation as artefacts, espoused values and basic underlying assumptions and is strongly related to leadership-yet it remains elusive as a concept. Even if the literature points to leadership as an important factor for creating and sustaining a mature safety culture, little is known about how first line managers’ balance the different and often conflicting organizational goals in everyday practice. The purpose of this study was to explore how health care first line managers perceive their role and how they promote patient safety and patient safety culture in their units.Methods Interview study with first line managers in intensive care units in in eight different hospitals located in the middle of Sweden. An inductive qualitative content analysis approach was used.Results We present how first line managers view their role in patient safety and exemplify concrete strategies by which managers promote safety culture by acting as role models, designing everyday work and promoting psychological safety and a learning environment.Conclusions Our study shows the central role of front-line managers in designing the everyday work in the ICU. In our study both of Safety − 1 and Safety − 2 aspects emerged in the analysis. Although promoted widely in Swedish healthcare at the time for the interviews, the HSOPSC was not mentioned by the managers as a central source of information on the unit’s safety culture.

Sign in / Sign up

Export Citation Format

Share Document