Safety culture in a major accredited Irish university teaching hospital: a mixed methods study using the safety attitude
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ORIGINAL ARTICLE
Safety culture in a major accredited Irish university teaching hospital: a mixed methods study using the safety attitudes questionnaire Laura L. Gleeson 1 Stephen Byrne 1
&
Leanne Tobin 1 & Gary L. O’Brien 1 & Erin K. Crowley 1 & Aoife Delaney 2 & Denis O’Mahony 3,4 &
Received: 11 September 2019 / Accepted: 2 April 2020 # Royal Academy of Medicine in Ireland 2020
Abstract Background The measurement of safety culture, the way in which members of an organisation think about and prioritise safety, in a hospital can provide valuable insight and inform quality improvement strategies. Aims The aim of this study is to describe the safety culture of a university teaching hospital in the Republic of Ireland. Methods This is a mixed methods survey study using the Safety Attitudes Questionnaire (SAQ). The SAQ was distributed to all staff in the study hospital. Staff attitudes towards six domains of patient safety culture were assessed over 32 Likert-scaled items. Thematic analysis was performed on qualitative data. Results A total of 768 staff members completed and returned a copy of the SAQ. The hospital scored above the international benchmark in five out of six domains, indicating a positive safety culture, but scored below the international benchmark in the domain ‘Working Conditions’. This positive safety culture was not mirrored in the qualitative data, from which five themes emerged; three major—Staffing Issues, Patient-Focused Care and Hospital Environment—and two minor—Safe Reporting Culture and Training and Education. Conclusions In this study, a mixed methods approach was successfully used to investigate the safety culture in a large Irish hospital. Although the SAQ results indicated a positive safety culture, the qualitative data revealed a number of issues that the hospital staff felt impacted negatively on patient safety. The results of this study will inform future work on the design of an intervention to improve patient safety in the hospital. Keywords Safety culture . Patient safety . Quality improvement . Medication safety . Irish healthcare
Introduction In 2017, the World Health Organization (WHO) announced that its third Global Patient Safety Challenge, Medication Without Harm, would focus on medication safety, aiming to reduce the global rate of medication errors by 50% within
* Laura L. Gleeson [email protected] 1
Pharmaceutical Care Research Group, School of Pharmacy, University College Cork, Cork, Ireland
2
Medication Safety, Cork University Hospital, Wilton, Cork, Ireland
3
Department of Geriatric Medicine, Cork University Hospital, Cork, Ireland
4
Department of Medicine, School of Medicine, University College Cork, Cork, Ireland
5 years [1]. Medication errors, defined as ‘any preventable event that may cause or lead to inappropriate medication use or patient harm while the medication is in the control of the healthcare professional, patient or consumer’, are a leading cause of preventable harm worldwide, estimated to incur an annual global cost of US$42 billion [1,
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