Changes in Safety and Teamwork Climate After Adding Structured Observations to Patient Safety WalkRounds

Area of Science:

• Healthcare Quality and Safety
• Organizational Psychology

Background:

• Patient safety is critical for reliable healthcare delivery.
• Improving safety and teamwork climate enhances patient safety.
• Patient safety WalkRounds (WRs) are recognized methods for improving safety culture.

Purpose of the Study:

• To combine WRs with direct observations of patient safety dimensions.
• To measure changes in safety and teamwork climate following WRs.
• To evaluate the implementation of improvement actions.

Main Methods:

• An observational study conducted in eight work settings at a Swiss university hospital.
• Health care workers (HCWs) were observed during WRs focusing on patient safety dimensions.
• HCWs completed safety and teamwork climate surveys before WRs and six to nine months later.

Main Results:

• 810 HCW activities were observed, with 85.4% meeting safe care requirements.
• No significant changes in safety and teamwork climate were observed after nine months.
• Only 40.7% of 36 planned improvement actions were implemented within nine months.

Conclusions:

• Structured WRs effectively identified patient safety practices and deficits.
• Incomplete implementation of improvement plans hindered climate change.
• WRs alone did not lead to significant improvements in safety and teamwork climate within the study period.