Speaking up about traditional and professionalism-related patient safety threats: a national survey of interns and residents
| Autor: | Gerald B. Hickson, Donald W. Brady, Anneliese M. Schleyer, Natalie B. May, Eric J. Thomas, Julia T. Shelburne, William Martinez, Jason M. Etchegaray, Lisa Soleymani Lehmann, Jennifer A. Best, Sigall K. Bell |
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| Rok vydání: | 2017 |
| Předmět: |
Male
Safety Management Attitude of Health Personnel media_common.quotation_subject Graduate medical education 03 medical and health sciences Patient safety 0302 clinical medicine Nursing Patient harm Humans Medicine 030212 general & internal medicine Safety culture Open communication High potential media_common Academic Medical Centers Teamwork Health professionals business.industry Communication 030503 health policy & services Health Policy Internship and Residency Courage United States Cross-Sectional Studies Professionalism Female Patient Safety Professional Misconduct 0305 other medical science business |
| Zdroj: | BMJ Quality & Safety. 26:869-880 |
| ISSN: | 2044-5423 2044-5415 |
| DOI: | 10.1136/bmjqs-2016-006284 |
| Popis: | Open communication between healthcare professionals about care concerns, also known as 'speaking up', is essential to patient safety.Compare interns' and residents' experiences, attitudes and factors associated with speaking up about traditional versus professionalism-related safety threats.Anonymous, cross-sectional survey.Six US academic medical centres, 2013-2014.1800 medical and surgical interns and residents (47% responded).Attitudes about, barriers and facilitators for, and self-reported experience with speaking up. Likelihood of speaking up and the potential for patient harm in two vignettes. Safety Attitude Questionnaire (SAQ) teamwork and safety scales; and Speaking Up Climate for Patient Safety (SUC-Safe) and Speaking Up Climate for Professionalism (SUC-Prof) scales.Respondents more commonly observed unprofessional behaviour (75%, 628/837) than traditional safety threats (49%, 410/837); p0.001, but reported speaking up about unprofessional behaviour less commonly (46%, 287/628 vs 71%, 291/410; p0.001). Respondents more commonly reported fear of conflict as a barrier to speaking up about unprofessional behaviour compared with traditional safety threats (58%, 482/837 vs 42%, 348/837; p0.001). Respondents were also less likely to speak up to an attending physician in the professionalism vignette than the traditional safety vignette, even when they perceived high potential patient harm (20%, 49/251 vs 71%, 179/251; p0.001). Positive perceptions of SAQ teamwork climate and SUC-Safe were independently associated with speaking up in the traditional safety vignette (OR 1.90, 99% CI 1.36 to 2.66 and 1.46, 1.02 to 2.09, respectively), while only a positive perception of SUC-Prof was associated with speaking up in the professionalism vignette (1.76, 1.23 to 2.50).Interns and residents commonly observed unprofessional behaviour yet were less likely to speak up about it compared with traditional safety threats even when they perceived high potential patient harm. Measuring SUC-Safe, and particularly SUC-Prof, may fill an existing gap in safety culture assessment. |
| Databáze: | OpenAIRE |
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