Evaluation of Patient Safety Culture: A Survey of Clinicians in a Cardiovascular Operating Room
Abstract
Objective
The aim of this study was to understand the perceived safety culture and attitudes of caregivers in a large cardiovascular operating room (CVOR) in a mid-Atlantic state where more than 1500 procedures are performed annually to include ventricular assist device placement and heart and lung transplantations.
Methods
We analyzed deidentified data obtained from a safety survey completed anonymously by frontline caregivers in the CVOR via the Safety Attitudes Questionnaire developed by Pasquel Metrics.
Results
The responses from the CVOR clinicians were overall positive for their perceptions of the CVOR safety climate, with the majority saying they would feel safe being treated as a patient, liked their job, and were aware of the proper channels regarding patient safety. However, many made claims of experiencing fatigue and stress due to an excessive workload and participation in emergency situations. Furthermore, the support/clinical perfusion teams were found to have experienced the greatest amount of stress and discomfort, whereas it seems the surgeons were impacted the least.
Conclusions
This study suggests that reactions to different situations in the operating room are dependent on the role of the caregiver. Therefore, interventions to improve communication among the caregivers must be geared on an individual group basis.
Get full access to this article
View all access and purchase options for this article.
References
1. Aspden P., Corrigan J., Wolcott J., Erickson S. Patient safety: achieving a new standard for care. Washington, DC: The National Academies Press; 2004.
2. Institute of Medicine Committee on the Quality of Health Care in America. To Err Is Human: Building a Safer Health System. 1st ed. Washington DC: The National Academies Press; 2000.
3. Wllsworth WA., Iverson R.E. Patient safety in the operating room. Semin Plast Surg. 2006; 20: 214–218.
4. Singer S., Meterko M., Baker L., Gaba D., Falwell A., Rosen A. Workforce perceptions of hospital safety culture: development and validation of the Patient Safety Climate in Healthcare Organization Survey. Health Serv Res. 2007; 42: 1999–2021.
5. Pronovost P.J., Weast B., Holzmueller C.G. et al. Evaluation of the culture of safety: survey of clinicians and managers in an academic medical center. Qual Saf Health Care. 2003; 12: 405–410.
6. ElBardissi A.W., Wiegman D.A., Dearani J.A., Daly R.C., Sundt TM 3rd. Application of the human factors analysis and classification system methodology to the cardiovascular surgery operating room. Ann Thorac Surg. 2007; 83: 1412–1419.
7. Pasquel Metrics. The Safety Attitudes Questionnaire. Available at: http://www.pascalmetrics.com/about/. Accessed June 29, 2012.
8. Sexton J.B., Helmreich R.L., Neilands T.B. et al. The Safety Attitudes Questionnaire: psychometric properties, benchmarking data, and emerging research. BMC Health Serv Res. 2006; 6: 44.
9. Makary M.A., Sexton J.B., Freischlang J.A. et al. Operating room teamwork among physicians and nurses: teamwork in the eye of the beholder. J Am Coll Surg. 2006; 202: 746–752.
10. Graling P.R. Designing an applied model of perioperative patient safety. Clin Scholars Rev. 2011; 4: 104–114.
11. The Leapfrog Group. Never events factsheet, 2008. Available at: http://www.leapfroggroup.org/media/file/Leapfrog-Never_Events_Fact_Sheet.pdf. Accessed on March 9, 2012.
12. Schimpff S. Improving operating room and perioperative safety: background and specific recommendations. Surg Innov. 2007; 14: 127–135.
13. Wadhera R.K., Parker S.H., Burkhardt H.M. et al. Is the “sterile cockpit” concept applicable to cardiovascular surgery critical intervals or critical events? The impact of protocol-driven communication during cardiopulmonary bypass. J Thorac Cardiovasc Surg. 2010; 139: 312–319.
14. Bognar A., Barach P., Johnson J. et al. Errors and the burden of errors: attitudes, perceptions and the culture of safety in pediatric cardiac surgical teams. Ann Thorac Surg. 2008; 85: 1374–1381.
15. Spiess B.D. Human errors in medicine: change in cardiac operating rooms through the FOCUS initiative. JECT. 2011; 43: 33–38.
16. Gurses A.P., Kim G., Martinez E.A. et al. Identifying and categorising patient safety hazards in cardiovascular operating rooms using an interdisciplinary approach: a multisite study [published online ahead of print May 5, 2012]. BMJ Qual Saf.
17. France D.J., Leming-Lee S., Jackson T., Feistritzer N.R., Higgins M.S. An observational analysis of surgical team compliance with perioperative safety practices after crew resource management training. Am J Surg. 2008; 195: 546–553.
18. Helmreich R.L., Merritt A.C., Wilhelm J.A. The evolution of Crew Resource Management training in commercial aviation. Int J Aviat Psychol. 1999; 9: 19–32. University of Texas at Austin Human Factors Research Project: 235.
19. Zeltser M.V., Nash D. Approaching the evidence basis for aviation derived teamwork training in medicine. Am J Med Qual. 2010; 25: 13–23.
20. Grogan E.L., Stiles R.A., France D.J. et al. The impact of aviation based teamwork training on the attitudes of health care professionals. J Am Coll Surg. 2004; 199: 843–848.
21. Clay-Williams R., Braithwaite J. Determination of health care teamwork training competencies—Adelphi study. Int J Qual Health Care. 2009; 21: 433–440.
22. Kozhimannil T., Prielipp R.C. Safety in the operating room: team approach saves lives. Semin Thoracic Surg. 2010; 22: 267–268.
23. Leonard M.W., Frankel A.S. Role of effective teamwork and communication in delivering safe, high-quality care. Mt Sinai J Med. 2011; 78: 820–826.
Cite article
Cite article
Cite article
OR
Download to reference manager
If you have citation software installed, you can download article citation data to the citation manager of your choice
Information, rights and permissions
Information
Published In
Article first published online: September 1, 2012
Issue published: September/October 2012
Keywords
PubMed: 23274865
Authors
Metrics and citations
Metrics
Journals metrics
This article was published in Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery.
VIEW ALL JOURNAL METRICSArticle usage*
Total views and downloads: 73
*Article usage tracking started in December 2016
Altmetric
See the impact this article is making through the number of times it’s been read, and the Altmetric Score.
Learn more about the Altmetric Scores
Articles citing this one
Receive email alerts when this article is cited
Web of Science: 0
Crossref: 10
- Patient safety and staff psychological safety: A mixed methods study o...
- Perioperative patient safety management activities: A modified theory ...
- Patient safety attitude and associated factors among nurses at Mansour...
- Patient Safety Attitude of Nurses Working in Surgical Units: A Cross-S...
- Attitudes Toward Patient Safety and Tendencies to Medical Error Among ...
- Evaluation of the communication skills of operating room staff
- How Does Patient Safety Culture in the Surgical Departments Compare to...
- Use of patient safety culture instruments in operating rooms: A system...
- What Does a Hospital Survey on Patient Safety Reveal About Patient Saf...
- Erratum
Figures and tables
Figures & Media
Tables
View Options
Get access
Access options
If you have access to journal content via a personal subscription, university, library, employer or society, select from the options below:
loading institutional access options
ISMICS members can access this journal content using society membership credentials.
ISMICS members can access this journal content using society membership credentials.
Alternatively, view purchase options below:
Purchase 24 hour online access to view and download content.
Access journal content via a DeepDyve subscription or find out more about this option.
