Involvement in Root Cause Analysis and Patient Safety Culture Among Hospital Care Providers

Boussat, Bastien; Seigneurin, Arnaud; Giai, Joris; Kamalanavin, Kevin; Labarère, José; François, Patrice

doi:10.1097/pts.0000000000000456

Cited by 26 publications

(27 citation statements)

References 28 publications

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“…For example, the staff interviewed raised the possibility of decentralizing risk management in hospital departments by promoting programs directly involving the medical teams in patient safety, such as experience feedback committees and the morbidity and mortality conferences. [ 23 , 24 ]…”

Section: Discussionmentioning

confidence: 99%

The contribution of open comments to understanding the results from the Hospital Survey on Patient Safety Culture (HSOPS): A qualitative study

Boussat¹,

Kamalanavin²,

François³

2018

PLoS ONE

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IntroductionTo develop high-quality and safe healthcare, a good safety culture is an important feature of healthcare-providing structures. The objective of this study was to analyze the qualitative data of the comments section of a Hospital Survey on Patient Safety (HSOPS) questionnaire to clarify the answers given to the closed questions.MethodUsing the original data from a cross-sectional survey of 5,064 employees at a single university hospital in France, we conducted a qualitative study by analyzing the comments of a HSOPS survey and conducting in-depth interviews with 19 healthcare providers. We submitted the comments and the interviews to a thematic analysis.ResultsA total of 3,978 questionnaires were returned, with 247 comments collected. The qualitative analysis identified several structural failures. The main categories of the open comments were concordant with the lowest dimension scores found in the quantitative analysis. The most frequently reported failures were related to the staffing and hospital management support dimensions. The healthcare professionals perceived the lack of resources, including understaffing, as the major barrier to the development of a patient safety culture. Concrete organizational issues related to hospital handoffs and risk coordination were identified, such as transfers from the emergency departments and the lack of feedback following self-reporting of incidents.ConclusionThe analysis of the open comments complemented the HSOPS scores, increasing the level of detail in the description of the hospital’s patient safety culture. Combined with a classical quantitative approach used in HSOPS-based surveys, the qualitative analysis of open comments is useful to identify organizational weaknesses within the hospital.

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Section: Discussionmentioning

confidence: 99%

The contribution of open comments to understanding the results from the Hospital Survey on Patient Safety Culture (HSOPS): A qualitative study

Boussat¹,

Kamalanavin²,

François³

2018

PLoS ONE

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“…5 Hitachinaka General Hospital, Ibaraki, Japan. 6 Department of Common Fundamental Nursing, Iwate Medical University School of Nursing, Iwate, Japan.…”

Section: Supplementary Informationmentioning

confidence: 99%

“…Patient safety culture is a product of individual and group values, attitudes, perceptions, competencies, and behavior patterns that determines the commitment as well as the style and proficiency of an organization's health and safety management [2]. Patient safety education and training [3,4] as well as utilization of Team Strategies and Tools to Enhance Performance and Patient Safety [5] and root cause analysis [6] are useful for improving patient safety culture. We have reported that long working hours of nurses may deteriorate their patient safety culture [7], and two studies in China and a study in Korea have also reported same results [8][9][10].…”

Section: Introductionmentioning

confidence: 99%

Relationship of patient safety culture with factors influencing working environment such as working hours, the number of night shifts, and the number of days off among healthcare workers in Japan: a cross-sectional study

Hayashi

Fujita

Iida

et al. 2020

BMC Health Serv Res

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Background: Patient safety culture is defined as a product of individual and group values, attitudes, perceptions, competencies, and patterns of behavior that determine the commitment to, and the style and proficiency of, an organization's health and safety management. Factors influencing healthcare workers' working environment such as working hours, the number of night shifts, and the number of days off may be associated with patient safety culture, and the association pattern may differ by profession. This study aimed to examine the relationship between patient safety culture and working environment. Methods: Questionnaire surveys were conducted in 2015 and 2016. The first survey was conducted in hospitals in Japan to investigate their patient safety management system and activities and intention to participate in the second survey. The second survey was conducted in 40 hospitals; 100 healthcare workers from each hospital answered a questionnaire that was the Japanese version of the Hospital Survey on Patient Safety Culture for measuring patient safety culture. The relationship of patient safety culture with working hours in a week, the number of night shifts in a month, and the number of days off in a month was analyzed. Results: Response rates for the first and second surveys were 22.4% (731/3270) and 94.2% (3768/4000), respectively. Long working hours, numerous night shifts, and few days off were associated with low patient safety culture. Despite adjusting the working hours, the number of event reports increased with an increase in the number of night shifts. Physicians worked longer and had fewer days off than nurses. However, physicians had fewer composites of patient safety culture score related to working hours, the number of night shifts, and the number of days off than nurses.

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“…[ 26 ] In another study, we analyzed the association between patient safety culture, as measured by the Hospital Survey on Patient Safety Culture (HSOPS), and the care provider involvement in EFC activities. [ 9 ] We showed that EFC participants had a more highly developed patient safety culture, with nine of the 12 HSOPS dimension scores significantly higher than EFC non-participants. The three largest differences in the HSOPS score were related to the “feedback and communication about error”, organisational learning” and “non-punitive response to error” dimensions.…”

Section: Discussionmentioning

confidence: 93%

“…A recent study reported a favourable association between involvement in EFC activities and the patient safety culture among hospital care providers. [ 9 ] Moreover, several studies have reported promising adherence of medical teams involved in EFC in emergency, psychiatry and pharmacy departments. [ 10 – 12 ] However, these studies identified several limitations related to the initial EFC framework.…”

Section: Introductionmentioning

confidence: 99%

Experience feedback committees: A way of implementing a root cause analysis practice in hospital medical departments

et al. 2018

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BackgroundThe experience feedback committee (EFC) is a tool designed to involve medical teams in patient safety management, through root cause analysis (RCA) within the team.ObjectivesTo investigate the functioning of EFCs in the departments of a large university-affiliated hospital in France and to consider its potential contribution to the management of patient safety.MethodsCross-sectional, observational study, based on an analysis of the documents produced by the EFCs for 1 year. Data were collected independently by two investigators in meeting minutes, adverse event reports and event analysis reports.ResultsThe study included all 20 EFCs operating in the hospital's medical departments. During the study year, committees held 164 meetings, reviewed 1707 adverse events, conducted 91 event analyses and decided on 206 corrective actions. The median number of corrective actions adopted by each EFC was five actions (range, 0–62). A root cause analysis (RCA) was present in 76% of the analysis reports, and these analyses were complete in only 23% of the reports. There was also a lack of planning corrective actions: an implementation deadline was only defined in 26% of the actions.ConclusionsHealthcare professionals adhered to the system-based approach to patient safety, but we observed difficulties in holding regular meetings and deviations from the theoretical framework. These findings confirm the difficulties of practicing RCA in the healthcare setting. Nevertheless, EFCs can be vectors of safety culture and teamwork.

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Involvement in Root Cause Analysis and Patient Safety Culture Among Hospital Care Providers

Cited by 26 publications

References 28 publications

The contribution of open comments to understanding the results from the Hospital Survey on Patient Safety Culture (HSOPS): A qualitative study

The contribution of open comments to understanding the results from the Hospital Survey on Patient Safety Culture (HSOPS): A qualitative study

Relationship of patient safety culture with factors influencing working environment such as working hours, the number of night shifts, and the number of days off among healthcare workers in Japan: a cross-sectional study

Experience feedback committees: A way of implementing a root cause analysis practice in hospital medical departments

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