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Chavez-Maisterra I, Corona-Pantoja AC, Madrigal-Gómez LE, Zamora-González EO, López-Hernández LB. Student Engagement in Patient Safety and Healthcare Quality Improvement: A Brief Educational Approach. Healthcare (Basel) 2024; 12:1617. [PMID: 39201175 PMCID: PMC11353434 DOI: 10.3390/healthcare12161617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2024] [Revised: 07/30/2024] [Accepted: 08/10/2024] [Indexed: 09/02/2024] Open
Abstract
Achieving optimal patient safety (PS) remains a challenge in healthcare. Effective educational methods are critical for improving PS. Innovative teaching tools, like case-based learning, augmented reality, and active learning, can help students better understand and apply PS and healthcare quality improvement (HQI) principles. This study aimed to assess activities and tools implemented to improve PS and HQI education, as well as student engagement, in medical schools. We designed a two-week course for fourth-year medical students at the Autonomous University of Guadalajara, incorporating Fink's taxonomy of significant learning to create engaging activities. The course featured daily synchronous and asynchronous learning, with reinforcement activities using tools, like augmented reality and artificial intelligence. A total of 394 students participated, with their performance in activities and final exam outcomes analyzed using non-parametric tests. Students who passed the final exam scored higher in activities focused on application and reasoning (p = 0.02 and p = 0.018, respectively). Activity 7B, involving problem-solving and decision-making, was perceived as the most impactful. Activity 8A, a case-based learning exercise on incident reporting, received the highest score for perception of exam preparation. This study demonstrates innovative teaching methods and technology to enhance student understanding of PS and HQI, contributing to improved care quality and patient safety. Further research on the long-term impact is needed.
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Affiliation(s)
- Ileana Chavez-Maisterra
- Departamento Académico de Ciencias Clínicas, Universidad Autónoma de Guadalajara, Av Patria 1201, Zapopan 45129, Jalisco, Mexico; (I.C.-M.); (A.C.C.-P.); (L.E.M.-G.); (E.O.Z.-G.)
| | - Ana Cecilia Corona-Pantoja
- Departamento Académico de Ciencias Clínicas, Universidad Autónoma de Guadalajara, Av Patria 1201, Zapopan 45129, Jalisco, Mexico; (I.C.-M.); (A.C.C.-P.); (L.E.M.-G.); (E.O.Z.-G.)
| | - Luz Elena Madrigal-Gómez
- Departamento Académico de Ciencias Clínicas, Universidad Autónoma de Guadalajara, Av Patria 1201, Zapopan 45129, Jalisco, Mexico; (I.C.-M.); (A.C.C.-P.); (L.E.M.-G.); (E.O.Z.-G.)
| | - Edgar Oswaldo Zamora-González
- Departamento Académico de Ciencias Clínicas, Universidad Autónoma de Guadalajara, Av Patria 1201, Zapopan 45129, Jalisco, Mexico; (I.C.-M.); (A.C.C.-P.); (L.E.M.-G.); (E.O.Z.-G.)
- Departamento de Bienestar y Desarrollo Sustentable, División de Cultura y Sociedad, Centro Universitario del Norte, Universidad de Guadalajara, Colotlán 46200, Jalisco, Mexico
| | - Luz Berenice López-Hernández
- Departamento Académico de Ciencias Clínicas, Universidad Autónoma de Guadalajara, Av Patria 1201, Zapopan 45129, Jalisco, Mexico; (I.C.-M.); (A.C.C.-P.); (L.E.M.-G.); (E.O.Z.-G.)
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Carrillo I, Serpa P, Landa-Ramírez E, Guilabert M, Gómez-Ayala Y, López-Pineda A, Mira JJ. Speaking Up About Patient Safety, Withholding Voice and Safety Climate in Clinical Settings: a Cross-Sectional Study Among Ibero-American Healthcare Students. Int J Public Health 2024; 69:1607406. [PMID: 39011389 PMCID: PMC11246871 DOI: 10.3389/ijph.2024.1607406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2024] [Accepted: 06/17/2024] [Indexed: 07/17/2024] Open
Abstract
Objectives To explore speaking up behaviours, barriers to openly expressing patient safety concerns, and perceived psychological safety climate in the clinical setting in which healthcare trainees from Ibero-America were receiving their practical training. Methods Cross-sectional survey of healthcare trainees from Colombia, Mexico, and Spain (N = 1,152). Before the field study, the Speaking Up About Patient Safety Questionnaire (SUPS-Q) was translated into Spanish and assessed for face validity. A confirmatory factor analysis was conducted to establish the construct validity of the instrument, and the reliability was assessed. The SUPS-Q was used to evaluate voice behaviours and the perceived psychological safety climate among Ibero-American trainees. Descriptive and frequency analyses, tests for contrasting means and proportions, and logistic regression analyses were performed. Results Seven hundred and seventy-one trainees had experience in clinical settings. In the previous month, 88.3% had experienced patient safety concerns, and 68.9% had prevented a colleague from making an error. More than a third had remained silent in a risky situation. Perceiving concerns, being male or nursing student, and higher scores on the encouraging environment scale were associated with speaking up. Conclusion Patient safety concerns were frequent among Ibero-American healthcare trainees and often silenced by personal and cultural barriers. Training in speaking up and fostering safe interprofessional spaces is crucial.
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Affiliation(s)
- Irene Carrillo
- Department of Health Psychology, Miguel Hernández University of Elche, Elche, Spain
| | - Piedad Serpa
- Department of Clinical Management and Patient Safety, School of Medicine, Universidad de Santander, Bucaramanga, Colombia
| | - Edgar Landa-Ramírez
- Facultad de Psicología, National Autonomous University of Mexico, Mexico City, Mexico
- Programa de Psicología Urgencias, Hospital General Dr. Manuel Gea Gonzalez, Mexico City, Mexico
| | - Mercedes Guilabert
- Department of Health Psychology, Miguel Hernández University of Elche, Elche, Spain
| | - Yesenia Gómez-Ayala
- Facultad de Psicología, National Autonomous University of Mexico, Mexico City, Mexico
| | - Adriana López-Pineda
- Clinical Medicine Department, School of Medicine, Miguel Hernández University of Elche, Elche, Spain
- Research Network on Chronicity, Primary Care and Health Promotion (RICAPPS), Barcelona, Spain
| | - José Joaquín Mira
- Department of Health Psychology, Miguel Hernández University of Elche, Elche, Spain
- ATENEA Research Group, Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO), Valencia, Spain
- Alicante-Sant Joan Health District, Alicante, Spain
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Koca A, Schlatter S, Delas Q, Denoyel L, Lehot JJ, Lilot M, Rimmelé T. Influence of the embedded participant on learners' performance during high-fidelity simulation sessions in healthcare. BMC MEDICAL EDUCATION 2023; 23:751. [PMID: 37821900 PMCID: PMC10568852 DOI: 10.1186/s12909-023-04724-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Accepted: 09/25/2023] [Indexed: 10/13/2023]
Abstract
BACKGROUND The embedded participant (EP) plays a key role during a full scale/high-fidelity simulation (HFS) session. He/she is expected to guide the learner towards the achievement of the educational objectives of the scenario. However, his/her influence on learners' performance stands undetermined and this effect remains briefly addressed in the literature. This study primarily aims to assess whether the EP could have an influence on the performance of the learner during a HFS scenario. The secondary aim was to establish an inventory of the EP practices in France. METHODS This retrospective study was conducted in Lyon Claude Bernard University Health Simulation Centre (France). Anaesthesia and critical care residents in postgraduate years 1 to 5 who were scheduled for their HFS sessions during the 2016 to 2021 academic years were included. Two investigators independently evaluated the resident performance regarding both technical and non-technical skills from video recordings. In addition, a nationwide survey was sent out by email through the networks of the Francophone Healthcare Simulation Society (SoFraSimS, Société Francophone de Simulation en Santé) to collect information on EP practices in French-speaking Simulation centres. RESULTS From a total of 344 HFS videos analysed, a cohort of 19 experienced EPs was identified. The EPs had an influence on the technical and non-technical performances of the learners. The 147 responses to the survey showed that predefined rules of EP good practice existed in only 36% of the simulation centres and 65% of respondents believed that specific EP training would be justified. CONCLUSION The EP can exert an influence on the performance of the learners during HFS. For acting as an EP, a great variability of practices and a lack of training are reported by professionals working in simulation centres. These results suggest that more attention must be paid to EP training and attitudes during simulation, especially if summative simulations are extensively developed.
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Affiliation(s)
- Ayça Koca
- Department of Emergency Medicine, Ankara University School of Medicine, Ankara, Turkey.
| | - Sophie Schlatter
- Claude Bernard Lyon 1 University, Hospices Civils de Lyon, Centre Lyonnais d'Enseignement par la Simulation en Santé (CLESS), SimuLyon, Lyon, France
- Research on Healthcare Performance (RESHAPE), INSERM U1290, Lyon, France
| | - Quentin Delas
- Claude Bernard Lyon 1 University, Hospices Civils de Lyon, Centre Lyonnais d'Enseignement par la Simulation en Santé (CLESS), SimuLyon, Lyon, France
- Department of Anaesthesiology and Critical Care Medicine, Hospices Civils de Lyon, Edouard Herriot Hospital, Lyon, France
| | - Lucas Denoyel
- Claude Bernard Lyon 1 University, Hospices Civils de Lyon, Centre Lyonnais d'Enseignement par la Simulation en Santé (CLESS), SimuLyon, Lyon, France
| | - Jean-Jacques Lehot
- Claude Bernard Lyon 1 University, Hospices Civils de Lyon, Centre Lyonnais d'Enseignement par la Simulation en Santé (CLESS), SimuLyon, Lyon, France
- Research on Healthcare Performance (RESHAPE), INSERM U1290, Lyon, France
- Department of Anaesthesiology and Critical Care Medicine, Louis Pradel Hospital, Hospices Civils de Lyon, Groupement Hospitalier Est, Lyon, France
| | - Marc Lilot
- Claude Bernard Lyon 1 University, Hospices Civils de Lyon, Centre Lyonnais d'Enseignement par la Simulation en Santé (CLESS), SimuLyon, Lyon, France
- Research on Healthcare Performance (RESHAPE), INSERM U1290, Lyon, France
- Department of Anaesthesiology and Critical Care Medicine, Louis Pradel Hospital, Hospices Civils de Lyon, Groupement Hospitalier Est, Lyon, France
| | - Thomas Rimmelé
- Claude Bernard Lyon 1 University, Hospices Civils de Lyon, Centre Lyonnais d'Enseignement par la Simulation en Santé (CLESS), SimuLyon, Lyon, France
- Department of Anaesthesiology and Critical Care Medicine, Hospices Civils de Lyon, Edouard Herriot Hospital, Lyon, France
- Pathophysiology of Injury-Induced Immunosuppression (Pi3, Claude Bernard Lyon 1 University-Biomerieux-Hospices Civils de Lyon, Lyon, 7426, EA, France
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Gillissen A, Kochanek T, Zupanic M, Ehlers J. Bad things can happen: are medical students aware of patient centered care and safety? Diagnosis (Berl) 2022; 10:110-120. [PMID: 36351267 DOI: 10.1515/dx-2022-0072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Accepted: 10/25/2022] [Indexed: 11/10/2022]
Abstract
Abstract
Objectives
Quality and safety in healthcare are of the utmost importance, but little is known about whether undergraduate students are aware of patient safety concepts. The objectives of our study were to assess the perception of medical students of challenges in patient safety, and collect their perceptions of error management and prevention.
Methods
This study used an exploratory mixed method strategy. The first study phase collected data from semi-structured interviews of 28 students. Based on this, an online survey was constructed and sent to about 80,000 medical students in Germany. 1053 replies were received and analyzed for responses based on gender, curriculum type (problem based [PBC] vs. science based curriculum [SBC]) and years of training.
Results
Most students understand the importance of patient safety, error avoidance, and the challenges of patient safety interventions. Four themes were identified: (a) the culture of patient safety (what is a good doctor? Doctors’ responsibility), (b) the working environment (the inevitability of mistakes, high work load, hierarchy, competition, teamwork), (c) the challenges of risk reduction (error avoidance, management, skills), and (d) materialistic issue (income vs. humanistic values). Female students were more risk aware than male students. Sixteen percent of students expect negative effects (e.g. punishment) when medical errors were disclosed in a team. Regardless, >70% regard teamwork as an effective error avoidance measure. Error disclosure willingness was high (89.7%).
Conclusions
Although not formally part of the curriculum, students had a positive perspective concerning patient safety. The opportunities and challenges for incorporating patient safety content into the training curriculum were identified and presented.
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Affiliation(s)
- Adrian Gillissen
- Department of Medicine, Faculty of Health , Institute for Didactics and Educational Research in Health Care, Witten/Herdecke University , Witten , Germany
| | - Tonja Kochanek
- Department of Medicine, Faculty of Health , Institute for Didactics and Educational Research in Health Care, Witten/Herdecke University , Witten , Germany
| | - Michaela Zupanic
- Department of Medicine, Faculty of Health, Interprofessional and Collaborative Didactics in Medicine-and Health Professions , Witten/Herdecke University , Witten , Germany
| | - Jan Ehlers
- Department of Medicine, Faculty of Health , Institute for Didactics and Educational Research in Health Care, Witten/Herdecke University , Witten , Germany
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Taylor DJ, Goodwin D. Organisational failure: rethinking whistleblowing for tomorrow's doctors. JOURNAL OF MEDICAL ETHICS 2022; 48:medethics-2022-108328. [PMID: 35803713 DOI: 10.1136/jme-2022-108328] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Accepted: 06/24/2022] [Indexed: 06/15/2023]
Abstract
The duty to protect patient welfare underpins undergraduate medical ethics and patient safety teaching. The current syllabus for patient safety emphasises the significance of organisational contribution to healthcare failures. However, the ongoing over-reliance on whistleblowing disproportionately emphasises individual contributions, alongside promoting a culture of blame and defensiveness among practitioners. Diane Vaughan's 'Normalisation of Deviance' (NoD) provides a counterpoise to such individualism, describing how signals of potential danger are collectively misinterpreted and incorporated into the accepted margins of safe operation. NoD is an insidious process that often goes unnoticed, thus minimising the efficacy of whistleblowing as a defence against inevitable disaster. In this paper, we illustrate what can be learnt by greater attention to the collective, organisational contributions to healthcare failings by applying NoD to The Morecambe Bay Investigation. By focusing on a cluster of five 'serious untoward incidents' occurring in 2008, we describe a cycle of NoD affecting trust handling of events that allowed poor standards of care to persist for several years, before concluding with a poignant example of the limitations of whistleblowing, whereby the raising of concerns by a senior consultant failed to generate a response at trust board level. We suggest that greater space in medical education is needed to develop a thorough understanding of the cultural and organisational processes that underpin healthcare failures, and that medical education would benefit from integrating the teaching of medical ethics and patient safety to resolve the tension between systems approaches to safety and the individualism of whistleblowing.
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Affiliation(s)
- Daniel James Taylor
- Lancaster Medical School, Faculty of Health and Medicine, Lancaster University, Lancaster, UK
| | - Dawn Goodwin
- Lancaster Medical School, Faculty of Health and Medicine, Lancaster University, Lancaster, UK
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Organizational Factors That Promote Error Reporting in Healthcare: A Scoping Review. J Healthc Manag 2022; 67:283-301. [PMID: 35802929 DOI: 10.1097/jhm-d-21-00166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
GOAL The overarching aim of this systematic review was to offer guidelines for organizations and healthcare providers to create psychological safety in error reporting. The authors wanted to identify organizational factors that promote psychological safety for error reporting and identify gaps in the literature to explore innovative avenues for future research. METHODS The authors conducted an online search of peer-reviewed articles that contain organizational processes promoting or preventing error reporting. The search yielded 420 articles published from 2015 to 2021. From this set, 52 full-text articles were assessed for eligibility. Data from 29 articles were evaluated for quality using Joanna Briggs Institute critical appraisal tools. PRINCIPAL FINDINGS We present a narrative review of the 29 studies that reported factors either promoting error reporting or serving as barriers. We also present our findings in tables to highlight the most frequently reported themes. Our findings reveal that many healthcare organizations work at opposite ends of the process continuum to achieve the same goals. Finally, our results highlight the need to explore cultural differences and personal biases among both healthcare leaders and clinicians. APPLICATIONS TO PRACTICE The findings underscore the need for a deeper dive into understanding error reporting from the perspective of individual characteristics and organizational interests toward increasing psychological safety in healthcare teams and the workplace to strengthen patient safety.
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Wang Q, Liu C, Xu J, Song P, Yang S, Zhang Q. The Experience of the Fight Against COVID-19 in Clinical Laboratory Departments from Chengdu, China. Risk Manag Healthc Policy 2021; 14:4177-4183. [PMID: 34675712 PMCID: PMC8505680 DOI: 10.2147/rmhp.s323605] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2021] [Accepted: 09/23/2021] [Indexed: 11/23/2022] Open
Abstract
Objective In order to fight against coronavirus disease 2019 (COVID-19) better and to share our experience as a reference for clinical laboratory departments. Methods This was a retrospective study conducted in the clinical laboratory department of Chengdu Women's and Children's Central Hospital in Chengdu, China, from April 2020 to January 2021. The number of nucleic acid and antibody testing specimens of suspected COVID-19 cases was analyzed. The key points of suspected-case sample processing and detection in the clinical laboratory department were summarized. The laboratory was directly involved in the sample processing and testing of suspected cases, the release of reports, and the transfer of specimens to the fever clinic. Results The number of COVID-19 nucleic acid test specimens in our laboratory ranged from 102 to 2170 per day, and the number of antibody test specimens ranged from 24 to 391 per day. There were four main considerations in the treatment and detection of suspected-case specimens in the clinical laboratory: biosafety management in clinical laboratory departments, measures to ensure the health of the staff, the eight time points for processing suspected-case samples (turn-around time), and key points for the detection of suspected case specimens. Conclusion The laboratory developed a protective process for COVID-19 antibody and nucleic acid detection during the pandemic. At present, the detection of COVID-19 antibodies and nucleic acids in the clinical laboratory department is orderly, and there have been no cases of laboratory infection.
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Affiliation(s)
- Qin Wang
- Department of Clinical Laboratory, Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, 611731, People's Republic of China
| | - Chenggui Liu
- Department of Clinical Laboratory, Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, 611731, People's Republic of China
| | - Jian Xu
- Department of Clinical Laboratory, Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, 611731, People's Republic of China
| | - Peipei Song
- Department of Clinical Laboratory, Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, 611731, People's Republic of China
| | - Shuzhe Yang
- Department of Clinical Laboratory, Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, 611731, People's Republic of China
| | - Qin Zhang
- Department of Clinical Laboratory, Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, 611731, People's Republic of China
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Empowering Patients and Supporting Health Care Providers-New Avenues for High Quality Care and Safety. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18189438. [PMID: 34574364 PMCID: PMC8472216 DOI: 10.3390/ijerph18189438] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Accepted: 09/01/2021] [Indexed: 01/31/2023]
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Lee J, Park KH. The effect of the COVID-19 pandemic on the patient safety attitude of medical students. KOREAN JOURNAL OF MEDICAL EDUCATION 2021; 33:227-232. [PMID: 34474529 PMCID: PMC8413848 DOI: 10.3946/kjme.2021.202] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Revised: 08/05/2021] [Accepted: 08/09/2021] [Indexed: 06/13/2023]
Abstract
PURPOSE This study aimed to examine the differences in scores of the Attitude to Patient Safety Questionnaire (APSQ) by medical students before and after the outbreak of COVID-19. METHODS In total, 97 and 118 medical students completed patient safety courses at Yonsei University Wonju College of Medicine in 2019 and 2020, respectively. In 2019, the course was conducted using traditional learning in the classroom, whereas, in 2020, most of the classes were conducted using non-face-to-face learning methods. RESULTS In 2019 and 2020, 49 and 53 students responded to the APSQ. Only one item "Patients are not really aware of how safe their care is" had a lower score in 2020 than in 2019. CONCLUSION Although the total APSQ score did not differ between 2019 and 2020, the students in 2020 might have a poor understanding of the role of patients in medical errors.
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Affiliation(s)
- Jisoo Lee
- Department of Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Kyung Hye Park
- Department of Medical Education, Yonsei University Wonju College of Medicine, Wonju, Korea
- Department of Emergency Medicine, Wonju Severance Christian Hospital, Wonju, Korea
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Tocco Tussardi I, Benoni R, Moretti F, Tardivo S, Poli A, Wu AW, Rimondini M, Busch IM. Patient Safety in the Eyes of Aspiring Healthcare Professionals: A Systematic Review of Their Attitudes. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18147524. [PMID: 34299975 PMCID: PMC8306767 DOI: 10.3390/ijerph18147524] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Revised: 06/29/2021] [Accepted: 07/13/2021] [Indexed: 11/16/2022]
Abstract
A culture of safety is important for the delivery of safe, high-quality care, as well as for healthcare providers' wellbeing. This systematic review aimed to describe and synthesize the literature on patient safety attitudes of the next generation of healthcare workers (health professional students, new graduates, newly registered health professionals, resident trainees) and assess potential differences in this population related to years of study, specialties, and gender. We screened four electronic databases up to 20 February 2020 and additional sources, including weekly e-mailed search alerts up to 18 October 2020. Two independent reviewers conducted the search, study selection, quality rating, data extraction, and formal narrative synthesis, involving a third reviewer in case of dissent. We retrieved 6606 records, assessed 188 full-texts, and included 31 studies. Across articles, healthcare students and young professionals showed overwhelmingly positive patient safety attitudes in some areas (e.g., teamwork climate, error inevitability) but more negative perceptions in other domains (e.g., safety climate, disclosure responsibility). Women tend to report more positive attitudes. To improve safety culture in medical settings, health professions educators and institutions should ensure education and training on patient safety.
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Affiliation(s)
- Ilaria Tocco Tussardi
- Department of Diagnostics and Public Health, University of Verona, 37134 Verona, Italy; (I.T.T.); (R.B.); (S.T.); (A.P.)
| | - Roberto Benoni
- Department of Diagnostics and Public Health, University of Verona, 37134 Verona, Italy; (I.T.T.); (R.B.); (S.T.); (A.P.)
| | - Francesca Moretti
- Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, 37134 Verona, Italy; (F.M.); (I.M.B.)
| | - Stefano Tardivo
- Department of Diagnostics and Public Health, University of Verona, 37134 Verona, Italy; (I.T.T.); (R.B.); (S.T.); (A.P.)
| | - Albino Poli
- Department of Diagnostics and Public Health, University of Verona, 37134 Verona, Italy; (I.T.T.); (R.B.); (S.T.); (A.P.)
| | - Albert W. Wu
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA;
| | - Michela Rimondini
- Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, 37134 Verona, Italy; (F.M.); (I.M.B.)
- Correspondence:
| | - Isolde Martina Busch
- Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, 37134 Verona, Italy; (F.M.); (I.M.B.)
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Chirinos Muñoz MS, Orrego C, Montoya C, Suñol R. Predictors of patient safety culture in hospitals in Venezuela: A cross-sectional study. Medicine (Baltimore) 2021; 100:e25316. [PMID: 33950920 PMCID: PMC8104285 DOI: 10.1097/md.0000000000025316] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Accepted: 03/02/2021] [Indexed: 01/04/2023] Open
Abstract
An organization's culture with regard to patient safety is important because it defines the beliefs and practices of the organization, and consequently its efficiency and productivity.Knowing the level of this and the factors that influence or not their dynamic represents a challenge, due to the degree of complexity and specificity of the elements involved.The aim of this study was to analyze predictors of patient safety culture in public and private hospitals and examining the factors that contribute to it, constructing a new and specific theoretical and methodological model.This study was carried out by reviewing medical records, detecting healthcare professionals directly involved in caring (N = 588), for patients in 2 public hospitals and 2 private hospitals in Venezuela (N = 566), conducting an "Analysis of Patient Safety Culture" questionnaire. The results were subsequently analyzed, derived 3 predictors factors and using a Patient Safety Culture Index (PSCI) for specific determination to evaluate patient safety culture level.The analysis showed that all hospitals had a "moderately unfavorable" PSCI (public = 52.96, private = 52.67, sig = 0.90). The PSCI was calculated by assessing the weight of the following factors in the index: occupational factors (factor loading = 32.03), communication factors (factor loading = 11.83), and organizational factors (factor loading = 9.10). Traumatology presented the lowest PSCI of all the care units, falling into the "unfavorable" category (36.48), and Laboratory the highest (70.02) (sig = 0.174), falling into the "moderately favorable" category. When analyzing professional groups, nurses had the highest PSCI, with a "moderately unfavorable" rating (PSCI = 61.1) and medical residents the lowest, falling into the "unfavorable" category (35.2). Adverse event reporting is determined by "management expectations and actions" (sig = 0.048) and "direct interaction with the patient" (sig = 0.049).The use of this theoretical and methodological approach in other contexts may provide a more objective system for identifying more specific needs and factors that influence in patient safety culture, and consequently, opportunities for improvement when constructing a patient safety culture in healthcare institutions. Efforts need to be made to improve safety culture in the hospitals studied, irrespective of whether they are public or private.
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Affiliation(s)
- Mónica Susana Chirinos Muñoz
- Health Sector Management Program –University of Zulia, Maracaibo, Venezuela
- Methodology of Biomedical Research and Public Health programme. Universitat Autonoma de Barcelona
- Research Network on Health Service Chronic Diseases REDISSEC. Barcelona, Spain
- Instituto Universitario de Tecnología de Maracaibo, Venezuela
| | - Carola Orrego
- Methodology of Biomedical Research and Public Health programme. Universitat Autonoma de Barcelona
- Avedis Donabedian Research Institute (FAD)
- Research Network on Health Service Chronic Diseases REDISSEC. Barcelona, Spain
- Instituto Universitario de Tecnología de Maracaibo, Venezuela
| | - Cesar Montoya
- Methodology of Biomedical Research and Public Health programme. Universitat Autonoma de Barcelona
- Research Network on Health Service Chronic Diseases REDISSEC. Barcelona, Spain
- Instituto Universitario de Tecnología de Maracaibo, Venezuela
| | - Rosa Suñol
- Methodology of Biomedical Research and Public Health programme. Universitat Autonoma de Barcelona
- Avedis Donabedian Research Institute (FAD)
- Research Network on Health Service Chronic Diseases REDISSEC. Barcelona, Spain
- Instituto Universitario de Tecnología de Maracaibo, Venezuela
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Ohta R, Ryu Y, Sano C. The Uncertainty of COVID-19 Inducing Social Fear and Pressure on the Continuity of Rural, Community-Based Medical Education: A Thematic Analysis. Healthcare (Basel) 2021; 9:223. [PMID: 33671392 PMCID: PMC7922333 DOI: 10.3390/healthcare9020223] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Revised: 02/09/2021] [Accepted: 02/14/2021] [Indexed: 11/16/2022] Open
Abstract
Rural community-based medical education (CBME) enriches undergraduate and postgraduate students' learning but has been impacted by the coronavirus disease 2019 (COVID-19) pandemic. We identified the challenges faced by stakeholders as well as the relevant solutions to provide recommendations for sustainable CBME in community hospitals during the COVID-19 pandemic. A total of 31 pages of field and reflection notes were collated through direct observation and used for analysis. Five physicians, eight nurses, one clerk, fourteen medical trainees, and three rural citizens were interviewed between 1 April and 30 September 2020. The interviews were recorded and their contents were transcribed verbatim and analyzed using thematic analysis. Three themes emerged: uncertainty surrounding COVID-19, an overwhelming sense of social fear and pressure within and outside communities, and motivation and determination to continue providing CBME. Rural CBME was impacted by not only the fear of infection but also social fear and pressure within and outside communities. Constant assessment of the risks associated with the pandemic and the implications for CMBE is essential to ensure the sustainability of CBME in rural settings, not only for medical educators and students but also stakeholders who administrate rural CBME.
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Affiliation(s)
- Ryuichi Ohta
- Community Care, Unnan City Hospital, Unnan 699-1221, Japan;
| | - Yoshinori Ryu
- Community Care, Unnan City Hospital, Unnan 699-1221, Japan;
| | - Chiaki Sano
- Department of Community Medicine Management, Faculty of Medicine, Shimane University, Izumo 693-8501, Japan;
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