Views
2 years ago

Does improving safety culture affect patient outcomes? - Health ...

Does improving safety culture affect patient outcomes? - Health ...

Table 2: Link between

Table 2: Link between safety culture and climate and staff outcomesOutcome Studies Key findings RelationshipSafety cultureSafety behaviours• 1 before and after studyfrom the USA• 3 cross-sectionalcorrelation studies fromChina, the Netherlandsand USASafety culture impacted on staff safety behaviours,but the link may not be straightforward. Positivesafety culture may inhibit as well as motivatesafety behavioursPositive linkError reporting• 2 cross-sectionalcorrelation studies fromHungary and Lebanon• 1 before and after studyfrom KoreaPositive safety culture was associated withincreased willingness among staff to report errors,but there were complexitiesMixed findingsInjury rates• 1 before and after studyfrom the USAImproving safety climate reduced nurse injuriesPositive linkSafety climateSafety behaviours• 3 cross-sectionalcorrelation studies fromAustralia, China andNorwaySafety culture impacted on staff safety behaviours,but there may be complex relationships involvedPositive link• 1 meta analysisError reporting• 2 cross-sectionalcorrelation studies fromCanada and IsraelPositive safety climate was associated withincreased willingness to report errorsPositive link• 1 literature reviewStaff turnover• 1 literature review• 1 before and after studyfrom the USASafety climate was associated with reduced nurseturnover, but the relationship is not necessarilycausalIndirect link• 1 literature review• 2 meta analysesInjury rates• 6 cross-sectionalcorrelation studies fromCosta Rica, Japan andthe USABetter safety climate was associated with reducedstaff injury rates, although there are some caveatsPositive link• 1 before and after studyfrom AustraliaTHE HEALTH FOUNDATION Research scan: Does improving safety culture affect patient outcomes? 20

4.2 CaveatsWhen interpreting the findings it is important tobear in mind several caveats. First, the researchscan is not exhaustive. It presents examples ofavailable research but does not purport to representevery study.Although there are numerous studies about safetyculture that may have found links with patientoutcomes, the search strategy focused on studiesthat set out to test this relationship. Studies thatmay have indirectly found a link were included ifidentified, but were not the focus of the search.Conclusions about the link between safety cultureand outcomes are problematic because there is areal paucity of research in this area. A number ofdescriptive articles put forward theories about thelink between safety culture and patient outcomes,but the research scan focused on empirical studies,so narrative material was excluded.However, just because there is limited researchon this topic does not mean that there is no linkbetween safety culture and outcomes, merely thatthis needs further examination.Even where comparable definitions are used andgeographic contexts can be compared, the level ofdetail reported is sometimes insufficient to considerthe links between safety culture and outcomes.Furthermore, most of the research focuses on ahospital context.The quality of the included studies is alsovariable. Most research examines one point intime, sometimes at a single site and with limitedsample sizes or unspecified statistical power. Mostimportantly, the research is correlational so itshows that safety culture and patient outcomes mayboth be positive, but not that one causes the other.A small number of before and after studies showthat actively improving culture is associated withimproved patient or staff outcomes, but these are inthe minority.Thus, it cannot be assumed that safety cultureinfluences patient outcomes directly. Therelationship is likely to be more complex and nonlinear,and definitely in need of further exploration.Conclusions are difficult given that articles definesafety culture and safety climate in various ways,use the terms interchangeably, and do not alwaysgive details about how culture was measured.Inadequate measurement of safety culture may alsoimpact on observed changes, or lack of change.Even when findings are positive, there is anissue with generalisation because most of theresearch has been undertaken in the USA whichhas significant differences to the UK healthcarecontext. A relationship found in a US hospital maynot necessarily be replicable in UK primary orsecondary care.THE HEALTH FOUNDATION Research scan: Does improving safety culture affect patient outcomes? 21

Pathology Improving Patient Outcomes
Improving Safety Culture at Vale - Health and Safety Laboratory
Health Care Quality Improvement and Patient Safety
Improving patient outcomes by family inclusion in adult patients with ...
Improving Healthcare Quality and Patient Outcomes with ... - IUPUI
Improving Outcomes of the Acute Hospital Patients with ... - amrpa
Positive Approaches to Improving Patient Fistula Outcomes
Improving Health Outcomes - Institute for Strategy and ...
Immunonutrition In ICU: Does It Improve Patient ... - RM Solutions
Improving patient outcomes in hip fractures - Smith & Nephew
educating to improve population health outcomes in chronic disease
Improving Health Outcomes for Rural and Ethnic Elders - National ...
Registries for Evaluating Patient Outcomes - AHRQ Effective Health ...
e-Health and Patient Safety - biomedea
Improving outcomes with community health workers.pdf - GHDonline
Improving health outcomes across the wellness spectrum
Rapid clot removal Improved patient outcome - Mercy Medical ...
Patient Safety and Quality Improvement – A National Perspective
Providing watertight Patient Reported Outcomes ... - Kantar Health
Does it Improve Safety? Michael Diringer, MD - Neurocritical Care ...
Verifying and Improving the Patient Handoff - Health Systems Institute
Toward Improving Birth Outcomes - Center for Health Care Strategies
The Patient-Centered Outcomes Research Institute (PCORI) - Health ...
improving outcomes in restorative dentistry - the British Association ...
Patient Safety Curriculum Guide - libdoc.who.int - World Health ...
Autism: Improving Health Care Outcomes - Pope's Kids Place
Patient's Safety Culture - Syndicate of Hospitals in Lebanon
Incorporating patient-reported outcomes in clinical research and ...
Patient Safety Executive - Institute for Healthcare Improvement