Improving patient safety culture in general practice: an interview study

Verbakel, Natasha J.; Bont, Antoinette de; Verheij, Theo; Wagner, Cordula; Zwart, Dorien

doi:10.3399/bjgp15x687865

Cited by 17 publications

(19 citation statements)

References 38 publications

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“…Communication openness includes, for example the perceived difficulty to discuss errors, to express disagreement or to speak up if one sees a problem with patient care. Patient safety culture questionnaires can act as an intervention to improve communication openness, especially when accompanied by a practice workshop enhancing the interaction of team members and creation of shared goals [ 33 ]. Communication openness might also be stimulated by blame-free incident reporting.…”

Section: Discussionmentioning

confidence: 99%

Patient safety culture in out-of-hours primary care services in the Netherlands: a cross-sectional survey

Smits

Keizer²,

Giesen³

et al. 2018

Scandinavian Journal of Primary Health Care

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ObjectiveTo examine patient safety culture in Dutch out-of-hours primary care using the safety attitudes questionnaire (SAQ) which includes five factors: teamwork climate, safety climate, job satisfaction, perceptions of management and communication openness.DesignCross-sectional observational study using an anonymous web-survey. Setting Sixteen out-of-hours general practitioner (GP) cooperatives and two call centers in the Netherlands. Subjects Primary healthcare providers in out-of-hours services. Main outcome measures Mean scores on patient safety culture factors; association between patient safety culture and profession, gender, age, and working experience.ResultsOverall response rate was 43%. A total of 784 respondents were included; mainly GPs (N = 470) and triage nurses (N = 189). The healthcare providers were most positive about teamwork climate and job satisfaction, and less about communication openness and safety climate. The largest variation between clinics was found on safety climate; the lowest on teamwork climate. Triage nurses scored significantly higher than GPs on each of the five patient safety factors. Older healthcare providers scored significantly higher than younger on safety climate and perceptions of management. More working experience was positively related to higher teamwork climate and communication openness. Gender was not associated with any of the patient safety factors.ConclusionsOur study showed that healthcare providers perceive patient safety culture in Dutch GP cooperatives positively, but there are differences related to the respondents’ profession, age and working experience. Recommendations for future studies are to examine reasons for these differences, to examine the effects of interventions to improve safety culture and to make international comparisons of safety culture.Key PointsCreating a positive patient safety culture is assumed to be a prerequisite for quality and safety. We found that:• healthcare providers in Dutch GP cooperatives perceive patient safety culture positively;• triage nurses scored higher than GPs, and older and more experienced healthcare professionals scored higher than younger and less experienced professionals – on several patient safety culture factors; and• within the GP cooperatives, safety climate and openness of communication had the largest potential for improvement.

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Section: Discussionmentioning

confidence: 99%

Patient safety culture in out-of-hours primary care services in the Netherlands: a cross-sectional survey

Smits

Keizer²,

Giesen³

et al. 2018

Scandinavian Journal of Primary Health Care

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“…In general, studies showed that patient safety culture was perceived positively among primary care professionals (12). However, awareness of the safety problems was only raised after getting together and discussing patient safety, therefore, measuring safety culture alone was not enough (11). There seems to be some differences among different health professionals regarding the perception of safety culture (10,18).…”

Section: Introductionmentioning

confidence: 99%

Safety Culture at Primary Healthcare Level: A Cross-Sectional Study among Employees with a Leadership Role

Klemenc–Ketiš

Susič

2019

Slovenian Journal of Public Health

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Introduction An effective leadership is critical to the development of a safety culture within an organization. With this study, the authors wanted to assess the self-perceived level of safety culture among the employees with a leadership function in the Ljubljana Community Health Centre. Methods This was a cross-sectional study in the largest community health centre in Slovenia. We sent an invitation to all employees with a leadership role (N=211). The Slovenian version of the SAQ – Short Form as a measurement of a safety culture was used. The data on demographic characteristics (gender, age, role, work experience, working hours, and location of work) were also collected. An electronic survey was used. Results The final sample consisted of 154 (69.7%) participants, out of which 136 (88.3%) were women. The mean age and standard deviation of the sample was 46.2±10.5 years. The average scores for the safety culture domains on a scale from 1 to 5 were 4.1±0.6 for Teamwork Climate, Safety Climate, and Working Conditions and Satisfaction, 3.7±0.5 for Perception of Management, 3.6±0.4 for Communication, and 3.5±0.6 for Stress Recognition. Conclusion The safety culture among leaders in primary healthcare organizations in Slovenia is perceived as positive. There is also a strong organizational culture. Certain improvements are needed, especially in the field of communication and stress recognition with regards to safety culture.

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“…In order to fully understand these issues, it is therefore important, and possibly essential, that health care policy makers and researchers elicit and attempt to understand the perceptions of frontline staff groups (the ‘on-the-ground’ implementers) before attempting to implement such complex interventions, not least because these perceptions largely determine how an intervention is understood and implemented in routine practice [ 16 ]. However, to date, the perceptions of general practice team members remains, for the most part, unknown [ 17 ].…”

Section: Introductionmentioning

confidence: 99%

‘The big buzz’: a qualitative study of how safe care is perceived, understood and improved in general practice

2018

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BackgroundExploring frontline staff perceptions of patient safety is important, because they largely determine how improvement interventions are understood and implemented. However, research evidence in this area is very limited. This study therefore: explores participants’ understanding of patient safety as a concept; describes the factors thought to contribute to patient safety incidents (PSIs); and identifies existing improvement actions and potential opportunities for future interventions to help mitigate risks.MethodsA total of 34 semi-structured interviews were conducted with 11 general practitioners, 12 practice nurses and 11 practice managers in the West of Scotland. The data were thematically analysed.ResultsPatient safety was considered an important and integral part of routine practice. Participants perceived a proportion of PSIs as being inevitable and therefore not preventable. However, there was consensus that most factors contributing to PSIs are amenable to improvement efforts and acknolwedgement that the potential exists for further enhancements in care procedures and systems. Most were aware of, or already using, a wide range of safety improvement tools for this purpose. While the vast majority was able to identify specific, safety-critical areas requiring further action, this was counter-balanced by the reality that additional resources were a decisive requirment.ConclusionThe perceptions of participants in this study are comparable with the international patient safety literature: frontline staff and clinicians are aware of and potentially able to address a wide range of safety threats. However, they require additional resources and support to do so.

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Improving patient safety culture in general practice: an interview study

Cited by 17 publications

References 38 publications

Patient safety culture in out-of-hours primary care services in the Netherlands: a cross-sectional survey

Patient safety culture in out-of-hours primary care services in the Netherlands: a cross-sectional survey

Safety Culture at Primary Healthcare Level: A Cross-Sectional Study among Employees with a Leadership Role

‘The big buzz’: a qualitative study of how safe care is perceived, understood and improved in general practice

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