RT Journal Article
SR Electronic
T1 Effects of patient safety culture interventions on incident reporting in general practice: a cluster randomised trial
JF British Journal of General Practice
JO Br J Gen Pract
FD British Journal of General Practice
SP e319
OP e329
DO 10.3399/bjgp15X684853
VO 65
IS 634
A1 Natasha J Verbakel
A1 Maaike Langelaan
A1 Theo JM Verheij
A1 Cordula Wagner
A1 Dorien LM Zwart
YR 2015
UL http://bjgp.org/content/65/634/e319.abstract
AB Background A constructive safety culture is essential for the successful implementation of patient safety improvements.Aim To assess the effect of two patient safety culture interventions on incident reporting as a proxy of safety culture.Design and setting A three-arm cluster randomised trial was conducted in a mixed method study, studying the effect of administering a patient safety culture questionnaire (intervention I), the questionnaire complemented with a practice-based workshop (intervention II) and no intervention (control) in 30 general practices in the Netherlands.Method The primary outcome, the number of reported incidents, was measured with a questionnaire at baseline and a year after. Analysis was performed using a negative binomial model. Secondary outcomes were quality and safety indicators and safety culture. Mixed effects linear regression was used to analyse the culture questionnaires.Results The number of incidents increased in both intervention groups, to 82 and 224 in intervention I and II respectively. Adjusted for baseline number of incidents, practice size and accreditation status, the study showed that practices that additionally participated in the workshop reported 42 (95% confidence interval [CI] = 9.81 to 177.50) times more incidents compared to the control group. Practices that only completed the questionnaire reported 5 (95% CI = 1.17 to 25.49) times more incidents. There were no statistically significant differences in staff perception of patient safety culture at follow-up between the three study groups.Conclusion Educating staff and facilitating discussion about patient safety culture in their own practice leads to increased reporting of incidents. It is beneficial to invest in a team-wise effort to improve patient safety.