Assessment of Patient Safety Culture in a Pediatric Department.

Mohammed Alsabri,Fiorella B Castillo,Tracy Dowlat,Ahmad Soliman,Salome Wiredu,Viswanathan Kusum,Fernanda E Kupferman

doi:10.7759/cureus.14646

Abstract

BackgroundAn assessment of the prevalent culture needs to be the first step when building patient safety programs in healthcare organizations to achieve high-quality health care.ObjectiveTo conduct a baseline assessment of patient safety culture, to provide insight into the factors that contribute to patient safety, and to use the information to make improvements. MethodsThe Hospital Survey on Patient Safety Culture (PSC) questionnaire was conducted from October through December 2020 at the Brookdale Hospital Medical Center (BHMC) Pediatric departments (Pediatric Inpatient Unit, Neonatal Intensive Care Unit [NICU], Pediatric Intensive Care Unit [PICU], and Pediatric Emergency Department) and four community-based ambulatory pediatric practices (Brookdale Family Care Centers [BFCC]). The percentages of positive responses on the 12 patient-safety dimensions and the summation of PSC and two outcomes (overall patient safety grade and adverse events reported in the past year) were assessed. Factors associated with PSC aggregate score were analyzed.ResultsFrom the 385 emails that were sent, 136 surveys were considered for analysis. This gives us a response rate of 35.3%. Most of the participants were nurses (58%) with direct contact with patients (94.2%). Most respondents did not report any events (60.7%), whereas 30.3% reported 1-2 events in the past year. The patient safety composites with the highest positive scores were teamwork within units (78%), supervisor/manager expectations and actions promoting patient safety (71.2%), and organizational learning--continuous improvement (66.8%). The composites with the lowest scores were non-punitive response to error (35.9%) and staffing (38%).ConclusionsAll of our composite measures, with the exception of teamwork within units, appear to be low, which means that all the other composite measures require interventions for improvement of overall safety culture. In order for healthcare leaders and policymakers to establish a culture of safety and improvement, they must create a climate of open communication, continuous learning, and eliminate the fear of blame and punitive feedback.

Highlights

Patient safety is defined by the Institute of Medicine (IOM) as ‘the freedom from accidental injury due to medical care or medical errors’ [1]
The Hospital Survey on Patient Safety Culture (PSC) questionnaire was conducted from October through December 2020 at the Brookdale Hospital Medical Center (BHMC) Pediatric departments (Pediatric Inpatient Unit, Neonatal Intensive Care Unit [NICU], Pediatric Intensive Care Unit [PICU], and Pediatric Emergency Department) and four community-based ambulatory pediatric practices (Brookdale Family Care Centers [BFCC])
In order for healthcare leaders and policymakers to establish a culture of safety and improvement, they must create a climate of open communication, continuous learning, and eliminate the fear of blame and punitive feedback

Summary

Introduction

Patient safety is defined by the Institute of Medicine (IOM) as ‘the freedom from accidental injury due to medical care or medical errors’ [1]. Patient safety and Patient Safety Culture (PSC) are becoming areas of increasing interest in healthcare. Developing a positive patient safety culture is a crucial element in the improvement of patient safety in a healthcare organization [4,5]. Achieving a culture of patient safety requires an understanding of the values, beliefs, and norms about what is important in an organization, and what attitudes and behaviors related to patient safety are supported, rewarded, and expected [6]. An assessment of the prevalent culture needs to be the first step when building patient safety programs in healthcare organizations to achieve high-quality health care

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