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Group Finds 10 Nontechnical Factors That Influence Safety Culture in Hospitals
February 10, 2016
A hospital’s “safety culture” is as important as technical elements such as a surgeon’s skill and operating room (OR) equipment for delivering high-quality patient care, according to a new study published online in the Journal of the American College of Surgeons.
“The nontechnical skills of care coordination, teamwork and ownership over the delivery of care are measured as safety culture,” said lead study author Martin Makary, MD, MPH, professor of surgery and health policy & management, Johns Hopkins University School of Medicine, Baltimore.
This is the first study to assess the association between safety culture and surgical outcomes (2015 Dec 9. [Epub ahead of print]).
Investigators examined the relationship between 12 indicators of safety culture and surgical site infections (SSIs) in colon surgery. Analysis showed that, after adjusting for surgical volume and American Society of Anesthesiologists classification, 10 indicators of safety culture were associated with a lower incidence of SSIs.
“The study supports what many surgeons have known for a long time and that is that the organization culture matters,” Dr. Makary said.
“While we have traditionally only studied the incremental patient benefits of different medications and surgical interventions, it turns out that organizational culture has a big impact on patient outcomes.”
The study results, first presented at the 2014 annual meeting of the AMA Research Symposium in Dallas, measured 12 different safety culture factors and rates of SSIs after colon procedures at seven Minnesota hospitals. The hospitals’ average size was 168 beds.
The SSI rates at the hospitals ranged from 0% to 30%, with an average rate of 11.3%, and surgical unit safety culture scores ranged from 16 to 92 on a percent positive scale.
Of the 12 safety culture factors measured, 10 were found to influence the rates of SSIs after colon operations: overall perceptions of patient safety; teamwork across units; organizational learning; feedback and communication about error; management support for patient safety; teamwork within units; communication openness; supervisor/manager expectations of actions promoting safety; nonpunitive response to error; and frequency of events reported.
by: Christina Frangou