Supporting Error Management and Safety Climate in Ambulatory Care Practices: The CIRSforte Study

Area of Science:

• Healthcare Management
• Patient Safety Research
• Organizational Psychology

Background:

• Healthcare facilities must learn from critical incidents to improve patient safety.
• Effective error management and a strong safety climate are crucial in ambulatory care.
• Little research exists on improving error management and safety climate in ambulatory settings.

Purpose of the Study:

• To develop, implement, and evaluate a multicomponent intervention for improving error management and safety climate in ambulatory care practices.
• To assess the impact of the intervention on safety climate levels and psychological determinants of error management.
• To gather participant feedback on the intervention's effectiveness.

Main Methods:

• A prospective 1-group pretest-posttest implementation study was conducted.
• The intervention involved guidelines, workshops, e-learning, online meetings, and newsletters.
• Safety climate, psychological behavioral determinants, and error management were evaluated using questionnaires and surveys. Semistructured interviews were conducted.

Main Results:

• 184 German ambulatory care practices participated.
• Significant improvements were observed in safety climate level and strength.
• Key psychological determinants like 'action/coping planning' and 'action control' improved. 76% of practices implemented or modified reporting systems.

Conclusions:

• Training practice teams, providing practical tools, and facilitating information exchange are vital for improving safety climate and error management.
• The intervention shows promise in enhancing patient safety and learning from incidents in ambulatory care.
• Further randomized controlled trials are recommended to confirm the intervention's effectiveness.