Interventions to improve resident reporting of patient safety events: a quality improvement initiative

Improving Resident Physician Participation in Reporting Patient Safety and Quality Concerns

Background: Reporting medical errors, near misses, and adverse events is an important component of improving patient safety and resident learning. Studies have revealed that event reporting rates can be low for physicians, resident physicians, and fellows. The objective of this quality improvement project was to improve resident reporting of patient safety and quality events and engage residents in the analysis of events at a community-based teaching hospital in the United States. Methods: We developed a program to engage 122 residents from 6 Accreditation Council for Graduate Medical Education-accredited residency programs using a multifaceted approach that included instructing residents how to use the hospital's adverse event reporting system; requiring first-year residents to submit at least 1 report; reviewing all resident reports during a monthly multidisciplinary meeting; and ensuring that each resident who submitted a report received feedback on how the concern was being addressed. Results: The program resulted in a 41.8% (95% CI 31%-53%) absolute increase in the number of residents reporting a concern, and resident submissions led to several documented improvements in patient care. A survey was administered to the residents who submitted reports, and the majority (76.0% response rate) expressed satisfaction with both the reporting system and the feedback about how their submission was being addressed. The responding residents agreed that they were more likely to submit reports because of their experience with the program and that they felt the program would improve safety and the quality of care at the institution. Conclusion: This quality improvement project successfully increased resident event reporting and engaged residents in the review of submitted events. The program can serve as a model for other teaching hospitals.

Nurses' perceptions about patient safety culture in public hospital in Vietnam

AIM

This paper is aimed to assess nurses' perceptions of patient safety culture in four public general hospitals in Hanoi, Vietnam.

BACKGROUND

Patient safety culture is a vital component in ensuring high quality and safe patient care. Assessment of nurses' perceptions on existing hospital patient safety culture (PSC) is the first step to promote PSC.

METHODS

The cross-sectional study surveyed 705 nurses utilizing the validated Hospital Survey on Patient Safety Culture (HSOPSC) in an online format.

RESULTS

The average positive response rate was high at 72.8 % and varied from 52.9 % to 93.4 %. The strongest areas are teamwork within units (93.7 %) and supervisor/manager expectations and actions promoting patient safety (85.0 %). The areas for improvement are staffing (52.9 %) and non-punitive response to error (57.6 %). The communication openness, staffing, frequency of events reported, lengths of services in hospital and unit are significant factors that predict the overall patient safety grade.

CONCLUSIONS

Initiatives are necessary to improve response to errors, staffing, and error reporting. Nurse managers could develop and implement interventions and program to improve patient safety, including providing education related to patient safety culture, encouraging staff to notify incidents and avoiding punitive responses.

Quality Improvement and Patient Safety Education in Internal Medicine Residency Training Program: An Exploratory Qualitative Study

BACKGROUND

Quality improvement and patient safety (QIPS) are a global health priority. Accordingly, QIPS education in medical education became mandatory. Despite that, information about QIPS education in postgraduate training in Saudi Arabia is limited. This study aimed to explore the educational aspects of QIPS in the internal medicine residency training program at King Abdulaziz Hospital in Al Ahsa, Saudi Arabia.

METHODS

This was a qualitative study employing the constructivist grounded theory approach. The sample size was determined using the theoretical saturation point, and we utilized a purposeful sampling technique. A semi-structured interview was used for data collection and was conducted between September 6 and October 20, 2020.

RESULTS

Twenty-two internal medicine trainee residents were required to serve the study purpose. The emerged themes were organized under awareness, education, barriers and opportunities and improvement priorities. Awareness of participants about the QIPS concept, importance, and value of education was found. The participants did not recognize specific dedicated QIPS education components under the structured training program. However, they recognized participation in patient safety-oriented activities but not in quality improvement activities. Consultants' observations and written exams were perceived as the assessment tools. Barriers including time limitation and opportunities including participation in quality improvement projects were identified. Participants suggested making QIPS education mandatory under the training program as an improvement priority.

CONCLUSION

This study highlighted the awareness of internal medicine residents of the QIPS concept, importance, and value of QIPS education. However, we found crucial gaps related to education including lack of a dedicated QIPS component under the training program. There is a need for multicenter studies to measure the magnitude of our findings for improvement of QIPS education in residency training in Saudi Arabia. This is the first study about QIPS education in residency training in Saudi Arabia up to our best knowledge.