scholarly journals Patient safety in chiropractic teaching programs: a mixed methods study

2020 ◽  
Vol 28 (1) ◽  
Author(s):  
Katherine A. Pohlman ◽  
Stacie A. Salsbury ◽  
Martha Funabashi ◽  
Michelle M. Holmes ◽  
Silvano Mior
Keyword(s):  
Patient Safety ◽  
Mixed Methods ◽  
Patient Safety Culture ◽  
Safety Attitudes ◽  
Work Pressure ◽  
Leadership Support ◽  
Academic Settings ◽  
Teaching Programs ◽  
Qualitative Responses ◽  
Teaching Clinics

Abstract Background Patient safety research has lagged within academic settings, including chiropractic teaching institutions. To develop a robust patient safety culture, the Institute of Medicine emphasized the need for employee’s attitudes to be understanding and positive. To initiate the assessment of the current culture and future needs, this study evaluated patient safety attitudes among chiropractic teaching clinic stakeholders (supervising clinicians, student interns, and administrative staff) and compared their standardized survey scores to established medical survey databases. Methods We conducted a cross-sectional, mixed methods survey design with quantitative analytic priority. Chiropractic interns, clinical faculty, and clinic staff of 5 international chiropractic educational programs completed a modified version of the Agency for Healthcare Research and Quality (AHRQ) Patient Safety Culture for Medical Offices Survey with open-ended comment fields between 2014 and 2016. Composite means of positive responses were calculated and compared to patient safety, quality of care, and overall self-ratings benchmarks from Canadian providers and academic settings in the AHRQ database. Qualitative responses were thematically categorized for a convergent analysis of quantitative results for the chiropractic sample. Results Chiropractic survey response rate was 45.3% (n = 645). Quantitative survey results indicated moderate scores and ranges (57–85%) on all patient safety dimensions for the chiropractic samples. Academic medicine and chiropractic providers’ benchmarks scored higher positive responses than chiropractic teaching clinics on most quantitative dimensions, except for work pressure/pace. Teamwork, organizational learning, and patient tracking/follow-up were the most positively endorsed quantitative dimensions, with communication, staff training, office standardization, and leadership support considered areas for improvement in both settings. Qualitative responses for the chiropractic clinics identified a need for open communication; additional staff training and student involvement in creating safety cultures; standardization of office processes including information exchange, scheduling, and equipment maintenance; and leadership support that focused on decreasing work pressure/pace and setting safety priorities. Conclusion As the first report of patient safety attitudes from stakeholders in chiropractic teaching clinics, specific areas of improvement were identified. Chiropractic teaching programs might consider incorporating these and related patient safety concepts into their formal curricula. Mixed methods approach offers teaching clinics opportunities to assess stakeholders’ insights and enhance safe delivery of chiropractic care.

scholarly journals Study and promotion of safety culture using mixed methods research

2021 ◽  
Vol 8 (2) ◽  
pp. 129-139
Author(s):  
Daiane Brigo Alves ◽  
Elisiane Lorenzini ◽  
Nelly Oelke ◽  
Anthony John Onwuegbuzie ◽  
Adriane Cristina Bernat Kolankiewicz
Keyword(s):  
Patient Safety ◽  
Mixed Methods ◽  
Knowledge Translation ◽  
Safety Culture ◽  
Multidisciplinary Team ◽  
Mixed Methods Research ◽  
Negative Impact ◽  
Patient Safety Culture ◽  
Research Approach ◽  
Safety Attitudes

Abstract Objective With a positive safety culture, institutions offer the best quality and safe care to their patients. The objective of this study was to analyze patient safety culture from the perspective of the multidisciplinary team, to identify factors that influence patient safety culture, and to create/promote—jointly with the study participants—strategies for improving processes of change. Methods The study design represented a mixed methods research approach, with a sequential explanatory design. A multidisciplinary team of workers at a general hospital was eligible for the study. To collect quantitative data, we administered the Safety Attitudes Questionnaire (SAQ). The qualitative phase was accomplished via focus groups (FGs), with participants from the first phase of the study using the principles of deliberative dialogue (DD) as a knowledge-translation strategy. The STROBE guideline was used to develop the study. Results The overall SAQ score was positive (75.1 ± 10.4). Negative scores were found in the fields of Safety Climate, Working Conditions, and Stress Recognition. Focus group discussions identified the aspects that create a negative impact on safety culture, such as ineffective communication, punitive approach in the event of errors, the lack of commitment and adherence to the protocols, and the non-recognition of the stress and the mistakes. Actions for the promotion of safety culture were developed and implemented during the study. Conclusions The use of the principles of DD as a strategy for knowledge translation (KT) made it possible to identify and plan for joint actions to generate improvements in safety culture.

scholarly journals Acute care nurses’ perceptions of leadership, teamwork, turnover intention and patient safety – a mixed methods study

BMC Nursing ◽  
2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Shahram Zaheer ◽  
Liane Ginsburg ◽  
Hannah J. Wong ◽  
Kelly Thomson ◽  
Lorna Bain ◽  
...  
Keyword(s):  
Patient Safety ◽  
Mixed Methods ◽  
Turnover Intention ◽  
Interactive Effect ◽  
Mixed Methods Study ◽  
Senior Leadership ◽  
Healthcare Organizations ◽  
Staff Perceptions ◽  
Leadership Support ◽  
The Impact

Abstract Background This study contributes to a small but growing body of literature on how context influences perceptions of patient safety in healthcare settings. We examine the impact of senior leadership support for safety, supervisory leadership support for safety, teamwork, and turnover intention on overall patient safety grade. Interaction effects of predictors on perceptions of patient safety are also examined. Methods In this mixed methods study, cross-sectional survey data (N = 185) were collected from nurses and non-physician healthcare professionals. Semi-structured interview data (N = 15) were collected from nurses. The study participants worked in intensive care, general medicine, mental health, or the emergency department of a large community hospital in Southern Ontario. Results Hierarchical regression analyses showed that staff perceptions of senior leadership (p < 0.001), teamwork (p < 0.01), and turnover intention (p < 0.01) were significantly associated with overall patient safety grade. The interactive effect of teamwork and turnover intention on overall patient safety grade was also found to be significant (p < 0.05). The qualitative findings corroborated the survey results but also helped expand the characteristics of the study’s key concepts (e.g., teamwork within and across professional boundaries) and why certain statistical relationships were found to be non-significant (e.g., nurse interviewees perceived the safety specific responsibilities of frontline supervisors much more broadly compared to the narrower conceptualization of the construct in the survey). Conclusions The results of the current study suggest that senior leadership, teamwork, and turnover intention significantly impact nursing staff perceptions of patient safety. Leadership is a modifiable contextual factor and resources should be dedicated to strengthen relational competencies of healthcare leaders. Healthcare organizations must also proactively foster inter and intra-professional collaboration by providing teamwork educational workshops or other on-site learning opportunities (e.g., simulation training). Healthcare organizations would benefit by considering the interactive effect of contextual factors as another lever for patient safety improvement, e.g., lowering staff turnover intentions would maximize the positive impact of teamwork improvement initiatives on patient safety.

Assessment of patient safety culture during COVID-19: a cross-sectional study in a tertiary a-level hospital in China

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Chih-Hsuan Huang ◽  
Ying Wang ◽  
Hsin-Hung Wu ◽  
Lee Yii-Ching
Keyword(s):  
Patient Safety ◽  
Working Conditions ◽  
Emotional Exhaustion ◽  
Safety Culture ◽  
Team Building ◽  
Reliability And Validity ◽  
Patient Safety Culture ◽  
Cross Sectional ◽  
Content Type ◽  
Safety Attitudes

PurposeThe aims of this study are to (1) evaluate physicians and nurses' perspectives on patient safety culture amid the COVID-19 pandemic and (2) integrate the emotional exhaustion of physicians and nurses into an evaluation of patient safety culture to provide insights into appropriate implications for medical care.Design/methodology/approachPatient safety culture was assessed with the Chinese version of the Safety Attitudes Questionnaire. Confirmatory factor analysis was conducted to validate the structure of the data (i.e. reliability and validity), and Pearson's correlation analysis was performed to identify relationships between safety-related dimensions.FindingsSafety climate was strongly associated with working conditions and teamwork climate. In addition, working conditions was highly correlated with perceptions of management and job satisfaction, respectively. It is worth noting that the stress and emotional exhaustion of the physicians and nurses during this epidemic were high and needed attention.Practical implicationsFor healthcare managers and practitioners, team-building activities, power of public opinions, IoT-focused service, and Employee Assistance Programs are important implications for inspiring the patient safety-oriented culture during the period of the COVID-19 pandemic.Originality/valueThis paper considers the role of emotional state into patient safety instrument, a much less understood but equally important dimension in the field of patient safety.

scholarly journals Instrument for Measuring Patient Safety Culture: Literature Review

2021 ◽  
Vol 10 (2) ◽  
pp. 158-176
Author(s):  
Yumna Nur Millati Hanifa ◽  
Inge Dhamanti
Keyword(s):  
Patient Safety ◽  
Literature Review ◽  
Safety Culture ◽  
Quality Care ◽  
Patient Safety Culture ◽  
Health Facilities ◽  
Healthcare Organizations ◽  
Just Culture ◽  
Safety Attitudes ◽  
Four Dimensions

The implementation of safe and quality care with attention to patient safety, requires organization’s effort to create and cultivating patient safety culture. The purpose of this article was to map the instruments used in measuring patient safety culture in healthcare organizations. The method used integrated literature review from various sources of research articles published from 2015 to 2020. The article included if it was available in full text and open access as well as articles described the instruments of patient safety culture or measurement of patient safety culture using one of the instruments of measurement of patient safety culture. The results of the literature review unravel the findings of three instruments such as HSOPSC (Hospital Survey on Patient Safety Culture), MaPSaF (Manchester Patient Safety Assessment Framework) and SAQ (Safety Attitudes Questionnaire). We concluded all three instruments contained four dimensions of patient safety culture, namely open culture, just culture, reporting culture and learning culture and were widely used to measure patient safety culture in hospitals, primary health facilities and other health facilities.

Patient safety culture in the perception of health professionals: A mixed methods research study

2021 ◽  
Vol 42 ◽  
Author(s):  
Cassiana Gil Prates ◽  
Rita Catalina Aquino Caregnato ◽  
Ana Maria Müller de Magalhães ◽  
Daiane Dal Pai ◽  
Janete de Souza Urbanetto ◽  
...  
Keyword(s):  
Patient Safety ◽  
Mixed Methods ◽  
Safety Culture ◽  
Health Professionals ◽  
Mixed Methods Research ◽  
Work Organization ◽  
Patient Safety Culture ◽  
Integrated Analysis ◽  
Explanatory Mixed Methods ◽  
Perception Of Health

ABSTRACT Objective: To analyze the patient safety culture perceived by health professionals working in a hospital and to understand the elements influencing it. Methods: A sequential explanatory mixed methods study, conducted in 2017 in two interrelated stages in a hospital. The quantitative stage was carried out by applying the questionnaire to 618 professionals and the qualitative stage, with ten, using the focus group technique. The analysis was descriptive statistics for the quantitative data and of content for the qualitative data. Subsequently, the data were submitted to integrated analysis. Results: Of the 12 dimensions, seven were considered weak, the most critical being “non-punitive response to error” with 28.5% of positive answers. Bureaucratic, poorly designed and uncoordinated processes, regional decisions, communication failures, hierarchy, overload, punishment and judicialization were related to the perception. Conclusions: The patient safety culture was considered weak, and elements related to work organization, people management and legal risk influenced this negative perception.

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 The Patient Safety Culture of a Nursing Team From a Central Ambulatory / A Cultura de Segurança do Paciente da Equipe de Enfermagem de um Ambulatório Centra

2019 ◽  
Vol 11 (2) ◽  
pp. 333 ◽  
Author(s):  
Aline Picolotto ◽  
Daniela Barella ◽  
Fernando Roberto Moraes ◽  
Patrícia De Gasperi
Keyword(s):  
Patient Safety ◽  
Safety Culture ◽  
Patient Safety Culture ◽  
Safety Attitudes ◽  
Safety Attitudes Questionnaire ◽  
Nursing Team

Objetivo: identificar a cultura de segurança do paciente dos profissionais da equipe de enfermagem de um Ambulatório Central. Métodos: estudo de abordagem quantitativa do tipo Survey transversal. A coleta dos dados foi realizada no primeiro semestre de 2015, com auxílio do questionário Safety Attitudes Questionnaire. A amostra foi composta por três enfermeiros e cinco técnicos de enfermagem. Resultados: nenhuma das dimensões alcançou a média mínima (75 pontos) para uma cultura de segurança do paciente adequada. Conclusão: percebe-se a necessidade de uma mudança cultural, sendo necessária uma atuação conjunta entre a equipe e gestores para alcançar índices adequados. A cultura de segurança do paciente deve ser constantemente avaliada. Sugere-se a aplicação do SAQ em todas as equipes deste ambulatório, uma vez que o cuidado multidisciplinar proporciona uma assistência de qualidade à comunidade assistida. Descritores: Segurança do paciente; Enfermagem; Instituições de assistência ambulatorial.

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.

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