Does lean management improve patient safety culture? An extensive evaluation of safety culture in a radiotherapy institute

Simons, Pascale A.M.; Houben, Ruud; Vlayen, Annemie; Hellings, Johan; Pijls‐Johannesma, Madelon; Marneffe, Wim; Vandijck, Dominique

doi:10.1016/j.ejon.2014.08.001

Cited by 26 publications

(37 citation statements)

References 19 publications

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“…On the contrary, it often reflects the willingness of the clinic to report incidents/near incidents. 24 , 25 In another study, we concluded that our clinic has a long history with safety improvement, which explains the high levels of willingness to report incidents/near incidents 26 (for the number of reports per radiotherapy centre in the Netherlands, see Figure 3 ). Furthermore, the number of real incidents in this clinic was low ( e.g.…”

Section: Discussionmentioning

confidence: 91%

“…However, a further safety study at the MAASTRO clinic (Maastricht, Netherlands) found, based on a triangulation of methodologies (two surveys were distributed three times, workshops were performed twice, data from an incident reporting system was monitored and results were explored using structured interviews with professionals) that the decreased number of reported incidents/near incidents was not explained by decreased safety awareness or a decreased willingness to report, but by improved treatment processes. 26 …”

Section: Discussionmentioning

confidence: 99%

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Organizational development trajectory of a large academic radiotherapy department set up similarly to a prospective clinical trial: the MAASTRO experience

Jacobs

Boersma²,

Dekker

et al. 2015

BJR

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Objective:To simultaneously improve patient care processes and clinical research activities by starting a hypothesis-driven reorganization trajectory mimicking the rigorous methodology of a prospective clinical trial.Methods:The design of this reorganization trajectory was based on the model of a prospective trial. It consisted of (1) listing problems and analysing their potential causes, (2) defining interventions, (3) defining end points and (4) measuring the effect of the interventions (i.e. at baseline and after 1 and 2 years). The primary end point for patient care was the number of organizational root causes of incidents/near incidents; for clinical research, it was the number of patients in trials. There were several secondary end points. We analysed the data using two sample z-tests, χ2 test, a Mann–Whitney U test and the one-way analysis of variance with Bonferroni correction.Results:The number of organizational root causes was reduced by 27% (p < 0.001). There was no effect on the percentage of patients included in trials.Conclusion:The reorganizational trajectory was successful for the primary end point of patient care and had no effect on clinical research. Some confounding events hampered our ability to draw strong conclusions. Nevertheless, the transparency of this approach can give medical professionals more confidence in moving forward with other organizational changes in the same way.Advances in knowledge:This article is novel because managerial interventions were set up similarly to a prospective clinical trial. This study is the first of its kind in radiotherapy, and this approach can contribute to discussions about the effectiveness of managerial interventions.

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Section: Discussionmentioning

confidence: 91%

Section: Discussionmentioning

confidence: 99%

Organizational development trajectory of a large academic radiotherapy department set up similarly to a prospective clinical trial: the MAASTRO experience

Jacobs

Boersma²,

Dekker

et al. 2015

BJR

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“…The research has focused on the development and testing of perception surveys rather than on the deeper examination of the nature of patient safety culture. Only a few papers (Ginsburg, Norton, Casebeer, & Lewis, ; Hooper & Charney, ; Simons et al, ) have evaluated interventions designed to enhance patient safety culture, yet this is an area of great interest to practitioners (Bishop et al, ). It is likely that the relative lack of published research on interventions is due to the complex nature of culture change and the challenge of demonstrating meaningful change.…”

Section: Resultsmentioning

confidence: 99%

Safety culture research and practice: A review of 30 years of research collaboration

Fleming

Harvey

Cregan

2018

J Appl Biobehavioral Res

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as a means of reinforcing rules and operational procedures upon employees (IAEA, 1986). The report describes "nuclear safety culture" as a "reinforcement process which should be used in conjunction with the necessary disciplinary measures (IAEA, 1986, p. 9)." From this perspective, the intent of having a safety culture was to "foster an atmosphere" where demanding practices were seen as a benefit (e.g., tedious quality checks) as opposed to a hindrance for employees.Although the INSAG-1 report used the term safety culture to describe a general issue of rule compliance that could be present in any nuclear power plant, the term was used by some governments to support the claim that a Chernobyl-type incident could not happen in their country. For example, Organization for Economic Cooperation and Development (OECD), headquartered in France, produced a report concerning Chernobyl (OECD, 1987) arguing that member states have a superior safety culture than that of the Soviet Union and that no action in this area was necessary. They argued that OECD member countries had a good safety culture due to their operator qualification systems, good control room design, effective control of operator behavior, and effective regulatory oversight. In short, they argued that safety culture was a Soviet problem and that no actions were required by OECD countries. It is interesting to note that neither the INSAG-1 nor OECD reports define safety culture, even though the OECD report contains a glossary of terms.

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“…According to Hutchinson et al (2009) there is a clear correlation between reporting culture and safety indicators within the hospital environment. Simons et al (2015) consider that the reporting culture not only should be measured positively according to the global number of entries, because the implementation of many improvement programs could lead to decreased reporting even if safety culture improved.…”

Section: Reporting Culture Determinantsmentioning

confidence: 99%

Understanding Reporting and Problem-Solving Behaviors in a High Reliability Organization: A Case Study in a Spanish Nuclear Company

Navajas¹,

Badia²

2020

PSYCH

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The safety of high-reliability organizations is a factor resulting from the interaction between technology and organizational factors. The existence of a system to openly report incidents and without being afraid is paramount for safety. Previous research has identified organizational factors that foster or inhibit employees' participation in reporting as well as several organizational dilemmas. From this theoretical approach, this research presents a case study in a Spanish nuclear organization to understand how the event reporting system is perceived by its workers. Researchers carried out focus groups, which were designed to generate discourse around the organization's reporting system. Participants' discourse was analyzed to identify key interpretative repertoires. Results obtained show two main aspects related with the notifying and problem-solution behaviors: 1) the ineludible cultural nature of the reporting system and 2) the misleading relationship between reporting and problem-solving. These findings should be considered in order to manage the safety in risky industry.

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Does lean management improve patient safety culture? An extensive evaluation of safety culture in a radiotherapy institute

Cited by 26 publications

References 19 publications

Organizational development trajectory of a large academic radiotherapy department set up similarly to a prospective clinical trial: the MAASTRO experience

Organizational development trajectory of a large academic radiotherapy department set up similarly to a prospective clinical trial: the MAASTRO experience

Safety culture research and practice: A review of 30 years of research collaboration

Understanding Reporting and Problem-Solving Behaviors in a High Reliability Organization: A Case Study in a Spanish Nuclear Company

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