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Research on Safety Culture & NSQIP

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Research on Safety Culture & NSQIP

Current activities

Context

Research

The proposed research is an

optional addition to the current

activities. It evaluates the

current activities.

Safety culture = shared beliefs and patterns of behaviour that determine how we work together to achieve quality care.

Safety culture affects patient outcomes. Communication breakdown patient harm.

Safety culture is also important for its effects on provider experience.

Background

To be part of new research that looks at the role of culture in BC (The aggregate findings from all sites will be published)

To receive your own results. Quantify the effects of culture at your hospital

Answer the question  ‘Is it worth investing in culture interventions?’

Identifies ingredients for successful culture change.

Novel contribution to the academic literature.

Why Participate?

1. Is safety culture in surgical departments in BC correlated with clinical outcomes, rates of adverse event reporting, overtime, sick time and/or staff turnover?

2. Can a conscious effort to change safety culture lead to culture change?

Research Questions

Variable Measured by FormatTime frame

for data collection

Safety Culture

Safety Attitudes Questionnaire (SAQ) and OR collaboration question

Average of each domain on SAQ + total culture score. Provincial averages of OR collaboration question.

Spring 2012 Wave 2 pending

Clinical Outcomes

NSQIP data (11 variables)

Aggregate rates of each post-operative outcome

July 2011 onwards

Adverse event reporting rate

Patient Safety Learning System

Number of adverse events reported at each severity level (0-5) in each unit

July 2011 onwards

Staff Overtime Health Authority HR Total overtime hours and total hours worked in each surgical unit

July 2011 onwards

Staff Sick time Health Authority HR Total sick time hours and total hours worked in each surgical unit

July 2011 onwards

Staff Turnover Health Authority HR Rate of staff turnover in surgical units

July 2011 onwards

Culture Improvement

10 questions completed by surgical unit leads.

Record of culture improvement activity Fall 2013

Data Requested

Is safety culture in surgical departments in BC correlated with clinical outcomes, rates of adverse event reporting, overtime, sick time and/or staff turnover?

◦ Is culture correlated with clinical outcomes?◦ Is culture correlated with the rate of adverse event reporting?◦ Is culture correlated with the level of overtime?◦ Is culture correlated with the level of sick time?◦ Is culture correlated with staff turnover?◦ Do correlations exist among any of these five elements of

health services (clinical outcomes, rate of adverse event reporting, overtime, sick time, and staff turnover)?

Data Analysis – Q1 (2012 & 2013)

Value of Q1 We would be able to provide evidence whether culture

matters in BC and in your hospital with YOUR data.

3 way association between safety culture, patient outcomes and provider experience.

Culture distribution across units and hospitals. Is culture local or is it more/less similar across the province?

Identify disconnect in perception of teamwork between surgeons, nurses and anesthesiologists.

What Q1 adds to literature?Makary et al. 2006 Our study

What Q1 adds to literature?

Safety Culture

Patient Outcomes

Provider Experience

2010

Our Study

What Q1 adds to literature?

2006

2008

Our Study

Units

% who agree or strongly agree that “disagreements are handled appropriately”

Can a conscious effort to change safety culture lead to culture change?

◦ Are there changes in culture and the five elements of health services over time?

◦ Are changes in culture associated with culture improvement efforts?

◦ What elements of the improvement process, or the process of implementing culture interventions, are the causal factors in observed changes in culture?

Data Analysis – Q2 (2013)

Value of Q2 Will provide evidence on the effectiveness of

culture interventions.

Identifies the mechanisms and causal ingredients of successful culture initiatives.

Will provide powerful insight when designing future culture improvement initiatives in the health care sector.

What Q2 adds to literature?

20132010

Neily et al.

Health authorities and physicians are invited to enrol and agree to submit data starting in Spring 2013.

Health authorities and physicians are invited to be co-investigators.

Identify one individual to act as a research liaison.

How can I be involved?

Return the Research Enrolment Form to [email protected]

Ethics◦ UBC BREB approved◦ BCPSQC will be responsible for all HA Ethics

applications

Data Submission – March 2013

Next steps…

More Information: http://bcpsqc.ca/clinical-improvement/sqan/research/

Contact:

Rebecca BrookeEmail: [email protected]

Tel: (604) 668-8227

THANK YOU!

Hospital level vs. Unit level?◦ This study is a multi-hospital study performed at the unit level.

We have taken into account the fact that different data is available at different levels and appropriate tools will be used to make data comparisons possible.

Aligning time frames?◦ NSQIP data monthly (annual year), HR data biweekly (fiscal

year), SAQ cross-sectional. Appropriate tools will be used to align time frames for comparisons/ correlational analysis.

Privacy?◦ We will be using aggregate data to see trends at a provincial

level, so individual hospitals will not be singled out.

FAQ