Effects of a team-based assessment and intervention on patient safety culture in general practice: an open randomised controlled trial
Autor: | D Parker, K Weppler, Corina Güthlin, C Mießner, G Hofinger, Justine Rochon, Barbara Hoffmann, Beate S. Müller, Mareike Leifermann, Zeycan Albay, Matthias Gondan, Ferdinand M. Gerlach, Vera Müller |
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Rok vydání: | 2013 |
Předmět: |
Self-assessment
Self-Assessment medicine.medical_specialty Time Factors government.form_of_government General Practice Organizational culture law.invention Patient safety Randomized controlled trial law Germany Health care Humans Medicine Operations management Safety culture Quality Indicators Health Care Patient Care Team Medical Errors business.industry Health Policy Clinical study design Professional Practice Location Organizational Culture Group Processes Outcome and Process Assessment Health Care Nursing Evaluation Research Sample Size government Physical therapy Patient Safety business Incident report |
Zdroj: | BMJ Quality & Safety. 23:35-46 |
ISSN: | 2044-5423 2044-5415 |
Popis: | The measurement of safety culture in healthcare is generally regarded as a first step towards improvement. Based on a self-assessment of safety culture, the Frankfurt Patient Safety Matrix (FraTrix) aims to enable healthcare teams to improve safety culture in their organisations. In this study we assessed the effects of FraTrix on safety culture in general practice.We conducted an open randomised controlled trial in 60 general practices. FraTrix was applied over a period of 9 months during three facilitated team sessions in intervention practices. At baseline and after 12 months, scores were allocated for safety culture as expressed in practice structure and processes (indicators), in safety climate and in patient safety incident reporting. The primary outcome was the indicator error management.During the team sessions, practice teams reflected on their safety culture and decided on about 10 actions per practice to improve it. After 12 months, no significant differences were found between intervention and control groups in terms of error management (competing probability=0.48, 95% CI 0.34 to 0.63, p=0.823), 11 further patient safety culture indicators and safety climate scales. Intervention practices showed better reporting of patient safety incidents, reflected in a higher number of incident reports (mean (SD) 4.85 (4.94) vs 3.10 (5.42), p=0.045) and incident reports of higher quality (scoring 2.27 (1.93) vs 1.49 (1.67), p=0.038) than control practices.Applied as a team-based instrument to assess safety culture, FraTrix did not lead to measurable improvements in error management. Comparable studies with more positive results had less robust study designs. In future research, validated combined methods to measure safety culture will be required. In addition, more attention should be paid to evaluation of process parameters. Implemented actions and incident reporting may be more appropriate target endpoints.German Clinical Trials Register (Deutsches Register Klinischer Studien, DRKS) No. DRKS00000145. |
Databáze: | OpenAIRE |
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