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The Impact of a 22-Month Multistep Implementation Program on Speaking-Up Behavior in an Academic Anesthesia
Fabio Walther1, Carl Schick1, David Schwappach
1From the Department of Anaesthesiology, Kantonsspital Baden, Baden.
Journal of Patient Safety
|May 9, 2022
Summary
Implementing a multimodal program significantly improved speaking-up behaviors and safety culture in healthcare. This sustained approach is key to enhancing patient safety through effective assertive communication.
Area of Science:
- Healthcare quality improvement
- Patient safety research
- Organizational behavior in medicine
Background:
- Speaking-up, a form of assertive communication, is vital for enhancing patient safety but faces significant barriers.
- Existing interventions for promoting speaking-up have shown variable success, highlighting the need for comprehensive, sustained strategies.
- A multimodal and sustained approach is crucial for fostering behavioral and cultural changes necessary for safer healthcare environments.
Purpose of the Study:
- To evaluate the effectiveness of a 22-month multimodal program designed to establish and strengthen speaking-up behaviors within a healthcare institution.
- To assess changes in perceived safety culture before and after the implementation of the speaking-up program.
- To compare the institution's speaking-up and assertive communication levels against a national benchmark.
Main Methods:
- A 22-month multistep program was implemented to foster speaking-up.
- The Safety Attitudes Questionnaire (SAQ) was administered pre- and post-program to assess safety culture.
- The Speaking-up About Patient Safety Questionnaire was used to compare institutional performance against a Swiss benchmark.
Main Results:
- Post-program SAQ scores significantly improved in 2 of 3 relevant questions (P = 0.0002 and P = 0.002).
- The institution's composite score on the Speaking-up About Patient Safety Questionnaire was significantly higher than the benchmark (P < 0.001).
- These findings indicate a successful enhancement of speaking-up and assertive communication.
Conclusions:
- The long-term, multimodal speaking-up program was successfully implemented, leading to improved safety attitudes and climate.
- Post-program assessments revealed higher levels of assertive communication and speaking-up compared to benchmarks.
- The study validates the necessity of multimodal programs and sustained efforts for strengthening speaking-up and improving healthcare safety.
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