Strategies for improving patient safety culture in hospitals: a systematic review

Strategies for improving patient safety culture in hospitals: a systematic review -- Morello et al. -- BMJ Quality and Safety Search the BMJ BMJ BMJ Journals BMJ Careers BMJ Learning Evidence Centre doc2doc BMJ Group Search this site

Advanced search

The international journal of healthcare improvement Online First Current issue Archive About the journal Submit a paper Subscribe Help Online First Current issue Archive Supplements eLetters Topic collections RSS Home > Online First > Article BMJ Qual Saf doi:10.1136/bmjqs-2011-000582 Systematic review Strategies for improving patient safety culture in hospitals: a systematic review Renata Teresa Morello1, Judy A Lowthian1, Anna Lucia Barker1, Rosemary McGinnes1, David Dunt2, Caroline Brand1

1Centre of Research Excellence in Patient Safety, Department of Epidemiology and Preventive Medicine, Monash University, Victoria, Australia

2Centre for Health Policy, Programs and Economics, Melbourne School of Population Health, University of Melbourne, Victoria, Australia Correspondence to Renata Teresa Morello, Centre of Research Excellence in Patient Safety (CRE-PS), School of Public Health and Preventive Medicine, Department of Epidemiology and Preventive Medicine, Monash University, The Alfred Centre, 99 Commercial Road, Melbourne, VIC 3004, Australia; renata.morello{at}monash.edu Contributors RM: primary reviewer of included studies (data extraction and critical appraisal), drafting and finalisation of manuscript. JL: secondary reviewer of included studies (data extraction and critical appraisal) and revision of manuscript. AB: third reviewer and review of critical appraisal of studies, revision of the manuscript and finalisation of the discussion section of the manuscript. RMc: assisted with data extraction and critical appraisal of included studies and revision of the manuscript. DD: review and revision of the manuscript, in particular the introduction and methods sections. CB: overseeing the drafting and finalisation of the manuscript, with particular focus on the introduction and discussion sections.

Accepted 4 July 2012 Published Online First 31 July 2012 Abstract Purpose To determine the effectiveness of patient safety culture strategies to improve hospital patient safety climate.

Data sources Electronic search of the Cochrane Library, OVID Medline, Embase, CINAHL, proQuest and psychinfo databases, with manual searches of quality and safety websites, bibliographies of included articles and key journals.

Study selection English language studies published between January 1996 and April 2011 that measured the effectiveness of patient safety culture strategies using a quantitative measure of patient safety climate in a hospital setting. Studies included were randomised controlled trials (RCTs), non-RCTs, controlled before and after studies, interrupted time series and historically controlled studies.

Data extraction Data extraction and critical appraisal were conducted by two independent reviewers. Study design, intervention, level of application, setting, study participants, safety climate outcome measures and implementation lessons were extracted from each article.

Results of data synthesis Over 2000 articles were screened, with 21 studies meeting the inclusion criteria, one cluster RCT, seven controlled before and after studies, and 13 historically controlled studies. There was marked methodological heterogeneity amongst studies. Impacts of 11 different strategies were reported. There was some evidence to support that leadership walk rounds (p=0.02) and multi-faceted unit-based programmes (p? Conclusions Despite strong face validity for a variety of patient safety culture strategies, there is limited evidence to support definitive impacts on patient safety climate outcomes. Organisations are advised to consider robust evaluation designs when implementing these potentially resource intensive strategies.

Safety culture Patient safety Quality improvement Health services research Footnotes Competing interests None.

Provenance and peer review Not commissioned; externally peer reviewed.

Data sharing statement Data extraction and critical appraisal of included studies are available on request from the corresponding author.

CiteULike Connotea Delicious Digg Facebook Google+ Mendeley Reddit Technorati Twitter What's this?

This Article Abstract Full text PDF Services Email this link to a friend Alert me when this article is cited Alert me if a correction is posted Alert me when eletters are published Article Usage Statistics Similar articles in this journal Similar articles in PubMed Add article to my folders Download to citation manager Request permissions Add to portfolio Responses Submit a response No responses published Citing articles Load citing article information Citing articles via Scopus Google Scholar Articles by Morello, R. T. Articles by Brand, C. Search for related content PubMed PubMed citation Articles by Morello, R. T. Articles by Brand, C. Related Content Load related web page information Social bookmarking CiteULike Connotea Delicious Digg Facebook Google+ Mendeley Reddit Technorati Twitter What's this?

Free sample

This recent issue is free to all users to allow everyone the opportunity to see the full scope and typical content of BMJ Quality & Safety.
View free sample issue >>

Online survey

Take 2 minutes to complete this survey and be entered into a prize draw to win £100 in Amazon vouchers.

Take the survey >>

Email alerts

Don't forget to sign up for content alerts so you keep up to date with all the articles as they are published.

 

Online First : Online First Current issue : Current issue | Mobile site Archive : Archive | Supplements | eLetters | Topic collections | RSS About the journal : About the journal | Editorial board | Instructions for authors | Unlocked |
                                   Thank you to our reviewers | Most read articles | Events Submit a paper : Online submission site | Instructions for authors | Unlocked | Track your article Subscribe : Subscribe to the journal | Prices | Email alerts Help : Contact us | Feedback form | Reprints | Permissions | Advertising Subscribe here
Activate your subscription User Name Password Remember me. Forgot your sign in details? Login via Athens or your home organisation
Recommend to your Institution  email alerts Register to receive email alerts   twitter  face-
book  my folders  Library recom-
mend

Online ISSN 2044-5423

Contact us | Website terms & conditions | Revenue sources | Privacy and Cookies | Home | Top

Copyright © 2012 by BMJ Publishing Group Ltd and the Health Foundation. All rights reserved.

View the original article here

This post was made using the Auto Blogging Software from WebMagnates.org This line will not appear when posts are made after activating the software to full version.