Safety culture healthcare

Itoh, K., Abe, T. and Andersen, H.B. 2005. A questionnaire-based survey on healthcare safety culture from six thousand Japanese hospital staff Organisational, professional and department/ward differences. InR. Tartagha,... 

Itoh, K. and Andersen, H.B. 2008. A national survey on healthcare safety culture in Japan Analysis of 20,000 staff responses from 84 hospitals. Proceedings of the International Conference on Healthcare Systems Ergonomics and Patient Safety, HEPS 2008. Strasbourg, France, June 2008 (CD-ROM). 

To increase awareness of the importance of medication errors among healthcare professionals, institutions, organizations, the pharmaceutical industry, the patients themselves, and throughout the entire healthcare system, and to build a safety culture of commitment to medication error reporting and prevention. 

It is therefore essential to develop comprehensive safeguards around any new technological developments to establish a strong safety culture and ensure that our patients always receive the best possible, safe care. These responsibilities fall both to IT suppliers and to the healthcare organisations that implement the solutions. 

The term culture is used in many different ways in discussions of safety in healthcare and many different claims are made for its importance. Consider these two apparently contradictory reflections on safety culture ... 

A positive safety culture seems like a good idea. Surely to have a safety aware workforce, imbued with safety attitudes, open about error and so forth must be helpful But is there any evidence that changing the culture is likely to improve the quality of healthcare or the safety of patients A few years ago the answer to this was simply no, or at best only indirect evidence. Now however, a cadre of brave researchers undaunted by conceptual and methodological minefields have begun to address this issue. But it is difficult and there are no simple answers. 

Nieva, V.F. and Sorra, J. (2003) Safety culture assessment a tool for improving patient safety in healthcare organizations. Quality and Safety in Health Care, 12(Suppl. II), iiI7-ii23. 

Defining what we mean by safety culture has taken up many of the pages of scientific articles and books in the last few decades. A recent round table involving experts, organised by the Healthcare Foundation in Mareh 2013, touched upon one of the thornier issues which was raised by a number of these articles, namely the culture vs climate debate (e.g. Schein 1984 Meams and Flin 1999). The definitions provided by the round table (Healthcare Foundation 2013 3) attempted to distinguish between the two, whilst noting that definitions vary within the research literature ... 

Around 2004 the first safety culture tools designed for healthcare began to appear. Maity of these tools are in the form of survey instruments or questioimaires, the two most well-known being the Hospital Survey on Patient Safety Culture (HSPSC) developed by the US Agency for Healthcare Research and Quality (AHRQ) and the Safety Attitudes Questionnaire (SAQ - Sexton et al. 2006). Both instruments are described in detail within the book and illustrated with... 

Health and Safety Executive (HSE) 2002. Health and Safety Laboratory, Human Factors Group. Safety Culture A Review of the Literature . HSL/2002/25. Healthcare Foundation 2013. Safety Culture What is It and How Do We Monitor and Measure It Event Report. Available at http //www.health.oig.uk/ publications/safety-culture-what-is-it-and-how-do-we-monitor-and-measure-it/ (last accessed on 11 July 2013). 

Flin, R. 2007. Measuring safety culture in healthcare Acase for accurate diagnosis. 

Halligan, M. and Zecevic, A. 2011. Safety culture in healthcare A review of concepts, dimensions, measures and progress. BMJ Quality Safety, 20(4), 338-43. doi 10.1136/bmjqs.2010.040964. 

Generalising from a number of dimensions suggested by former studies, safety culture dimensions can be classified into two parts (1) general, core elements that are conunonly applicable to any healthcare context, e.g. field, organisational type and coimtry, and (2) nation-dependent elements that are specific to a national culture or the coimtry s healthcare system. 

Partial resnlts in the Japanese snrvey are shown in Table 4.2 in terms of the percentage of positive respondents for each factor of safety culture as well as significance levels across fom professional groups - although every factor was significantly different. As an overall trend, almost all Japanese healthcare professionals have a strong awareness of communication as well as strong respect for seniority and senior members. There is a small power distance as well as a blame-free atmosphere within a hospital. 

Singer, S., Meterko, M., Baker, L., Gaba, D., Falwell, A. and Rosen, A. 2007. Workforce perceptions of hospital safety culture Development and vahdation of the patient safety climate in healthcare organizations survey. Health Services Research, 42(5), 1999-2021. 

Sorra, J., Famolaro, T., Dyer, N., Nelson, D. andKhanna, K. 2009. Hospital Survey on Patient Safety Culture 2009 Comparative Database Report. Agency for Healthcare Research and CJrrality, AHRQ Ptrblication No. 09-0030, Rockville, MD. 

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