Interventions to Promote Safety Culture in Cancer Care: A Systematic Review

Area of Science:

• Healthcare Management
• Patient Safety
• Oncology

Background:

• Effective promotion of safety culture in healthcare settings lacks clear guidance.
• Oncology settings present unique challenges for implementing safety culture interventions.

Purpose of the Study:

• To systematically review interventions aimed at promoting safety culture specifically within oncology settings.
• To identify effective strategies for enhancing safety culture in cancer care.

Main Methods:

• A systematic review was conducted using keywords for "safety culture" and "cancer care" across multiple databases (1999-2021).
• Included studies evaluated safety culture interventions in oncology using various designs (randomized, non-randomized, pre-post, interrupted time series).
• Study quality was assessed using the ROBINS-I risk of bias tool, adhering to PRISMA guidelines.

Main Results:

• Eighteen articles reported interventions in radiation, medical, or general oncology.
• Incident learning systems were the most common intervention (7/18), followed by lean initiatives (4/18).
• While 72% of studies reported improved safety culture, heterogeneity in evaluation methods and high risk of bias (67% severe) were noted.

Conclusions:

• Definitive recommendations for promoting safety culture in cancer care are limited by heterogeneity in study designs and outcomes.
• Incident learning systems appear to be the most promising intervention for improving safety culture in oncology.
• Further research with standardized evaluation is needed to establish best practices.