Patient safety culture in China: a case study in an outpatient setting in Beijing

Liu, George; Liu, Weiwei; Wang, Yuanyuan; Zhang, Zhihong; Wang, Peng

doi:10.1136/bmjqs-2013-002172

Cited by 55 publications

(62 citation statements)

References 47 publications

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“…Consistent with this, impediments in implementing patient safety culture have been communicated in a recent study in Beijing [19]. Raising awareness and promoting a culture of healthcare safety, especially patient safety, should be the groundwork towards HCAI intervention.…”

Section: Discussionmentioning

confidence: 72%

Healthcare-Associated Infections and Shanghai Clinicians: A Multicenter Cross-Sectional Study

et al. 2014

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Literature about healthcare-associated infection (HCAI) in China is scarce. A cross-sectional anonymous survey was conducted on 647 clinicians (199 physicians and 448 nurses) from six Shanghai hospitals (grades A–C) to investigate their cognizance, knowledge, attitude, self-reported practice, and risks regarding HCAI with emphasis on precautions. The mean overall score of HCAI knowledge was 40.89±11.4 (mean±SD; range, 13∼72) out of 100 for physicians and 43.48±9.9 (10∼70) for nurses. The respondents generally received high scores in hand hygiene, HCAI core concept, and healthcare worker safety but low scores in HCAI pathogen identification and isolation precautions. There were substantial variations in the knowledge scores of various demographic groups across individual hospitals and within hospital grades (ps<0.05). Within-hospital comparisons showed that the nurses were better than physicians particularly in hand hygiene knowledge in 4 hospitals (ps<0.05). Multiple linear regression analysis showed that longer work experience was inversely and independently associated with the overall and categorical knowledge of nurses, whereas independent associations between older age or higher education and categorical knowledge were noted for physicians. The respondents' self-reported practices and adherence to standard precautions were less than satisfactory. This multi-center study reports a high level of cognizance, patchy knowledge, suboptimal adherence to infection control precautions, and self-protective attitudes among the practicing clinicians regarding HCAI, with potential safety risk to patients and healthcare providers. Providing quality learning resources, enforcing knowledge-informed practice, and promoting a healthcare safety culture are recommended as interventions. Future studies are warranted for social and behavioral aspects of healthcare safety with emphasis on infection control.

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Section: Discussionmentioning

confidence: 72%

Healthcare-Associated Infections and Shanghai Clinicians: A Multicenter Cross-Sectional Study

et al. 2014

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“…In view of the fact that methods of reducing errors have been successfully applied to aviation and other fields, improvements to the medical service have emerged, such as increasing investment in human resources, reducing working hours, establishing electronic health records, and reshaping the patient safety culture. [8][9][10][11] However, these countermeasures are slightly generic, because they tend to target a single department or the hospital as a whole without subdividing medical errors into different departments. Therefore, some scholars think that such general interventions may be ineffective.…”

Section: Introductionmentioning

confidence: 99%

<p>Relating Medical Errors to Medical Specialties: A Mixed Analysis Based on Litigation Documents and Qualitative Data</p>

Liu¹,

Liu²,

Gong³

et al. 2020

RMHP

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Background: We know a great deal about types, causes, and prevention of medical errors, as well as the risks of each medical specialties. Although we know something about medical errors, much remains to be done in this area particularly around effective prevention. However, little is known about whether medical errors are related to medical specialties. Our objective was to categorize and map the distribution of medical errors and analyze their relationships with medical specialties. Methods: First, public cases of medical disputes were searched on "China Judgment Online" according to the key words including medical errors. Second, we set up a database with 5237 medical litigations. After removing unrelated judgment documents, we used systematic random sampling to extract half of these. Then, we hired two frontline physicians with M.D. to review the litigation documents and independently determine the medical errors and the departments in which they took place. A third physician further reviewed the divergent results. After the descriptive statistical analysis and mind map analysis, semi-structured interviews were further conducted with 63 doctors to reveal the relationships mentioned above. Results: More than 97.8% of medical errors occurred in clinical departments. The insufficient implementation of informed consent obligations is the top medical error in all medical departments [internal medical departments (12.86%, N=36), surgical departments (14.57%, N=106), specialist departments (13.16%, N=86)]. The types of medical errors in diverse medical departments might be associated with therapeutic means used by physicians. Errors related to surgical operations were common in surgical departments, errors related to diagnoses were common in internal medicine departments, and errors related to therapy were common in specialist departments. A lack of clinical experience and undesirable work system design have contributed to the occurrence of medical errors. Inadequate human resources and unreasonable shift systems have increased the workload of staff members and this has in turn increased the incidence rate of medical errors. Conclusion: Medical departments are facing medical errors both in humanity and technology. Medical institutions should be alert to the harm caused by medical humanity (mainly including insufficient communication between physicians and patients, insufficient implementation of infringement of informed consent, infringement of patient's privacy and overtreatment). Improving the clinical skill and vigilance of medical staff is a top priority. Medical institutions should also improve undesirable system designs.

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“…The survey measures dimensional scores of the patient safety culture. Using a scale to quantify the scores for patient safety is, however, not explanatory 68. In addition, a shared decision between the patient and healthcare professional is central for a sustainable patient safety culture.…”

Section: Methods and Analysesmentioning

confidence: 99%

Medication reconciliation as a medication safety initiative in Ethiopia: a study protocol

et al. 2016

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IntroductionMedication related adverse events are common, particularly during transitions of care, and have a significant impact on patient outcomes and healthcare costs. Medication reconciliation (MedRec) is an important initiative to achieve the Quality Use of Medicines, and has been adopted as a standard practice in many developed countries. However, the impact of this strategy is rarely described in Ethiopia. The aims of this study are to explore patient safety culture, and to develop, implement and evaluate a theory informed MedRec intervention, with the aim of minimising the incidence of medication errors during hospital admission.Methods and analysesThe study will be conducted in a resource limited setting. There are three phases to this project. The first phase is a mixed methods study of healthcare professionals' perspectives of patient safety culture and patients' experiences of medication related adverse events. In this phase, the Hospital Survey on Patient Safety Culture will be used along with semi-structured indepth interviews to investigate patient safety culture and experiences of medication related adverse events. The second phase will use a semi-structured interview guide, designed according to the 12 domains of the Theoretical Domains Framework, to explore the barriers and facilitators to medication safety activities delivered by hospital pharmacists. The third phase will be a single centre, before and after study, that will evaluate the impact of pharmacist conducted admission MedRec in an emergency department (ED). The main outcome measure is the incidence and potential clinical severity of medication errors. We will then analyse the differences in the incidence and severity of medication errors before and after initiation of an ED pharmacy service.

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Patient safety culture in China: a case study in an outpatient setting in Beijing

Cited by 55 publications

References 47 publications

Healthcare-Associated Infections and Shanghai Clinicians: A Multicenter Cross-Sectional Study

Healthcare-Associated Infections and Shanghai Clinicians: A Multicenter Cross-Sectional Study

<p>Relating Medical Errors to Medical Specialties: A Mixed Analysis Based on Litigation Documents and Qualitative Data</p>

Medication reconciliation as a medication safety initiative in Ethiopia: a study protocol

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