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36 Patient Safety: Culture Shifts Over Time
  1. J Maaskant,
  2. M de Neef,
  3. J Wielenga
  1. Women’ and Children’ Clinic, Academic Medical Center, Amsterdam, The Netherlands


Background and aims Although patient safety is a major topic in organisations worldwide, many patients are still confronted with errors that cause discomfort, harm and sometimes even death. A safety program including activities to improve the healthcare processes and techniques is more effective when combined with a positive safety culture. The purpose of this study was to evaluate the safety culture in order to fine-tune our safety program.

Methods A survey was undertaken among paediatricians and specialized nurses by means of the Hospital Survey on Patient Safety Culture before (2009) and after (2011) the start of a safety program on five paediatric wards. The results of these five wards (group A) were compared with two wards (group B) where the program was implemented before 2009.

Results In group A significant more positive ratings were found on seven dimensions in 2011 compared to 2009:

  • ‘frequency of events reporting’: 64% versus 47% (p=0.003)

  • ‘non punitive response to error’: 93% versus 80% (p=0.001)

  • ‘communication openness’: 97% versus 87% (p=0.001)

  • ‘feedback and communication about error’: 90% versus 68% (p=0.000)

  • ‘hospital management support for safety’: 61% versus 37% (p=0.000)

  • ‘staffing’: 50% versus 32% (p=0.002)

  • ‘overall perceptions of safety’: 64% versus 50% (p=0.016)

The differences between group A and B became smaller on all dimensions except ‘communication openness’.

Conclusions Implementation of a patient safety programme improves the culture on most dimensions. Our results guide future activities focused on the dimensions that did not reach satisfactory levels.

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