Building a Resilient Patient Safety Culture: A Large Healthcare Organization's Approach to Systematically Reviewing...

Area of Science:

• Healthcare Management
• Patient Safety
• Quality Improvement

Background:

• Canadian healthcare systems face significant pressures from staffing shortages, burnout, and funding deficits.
• These challenges negatively affect the quality of care and patient access, increasing the risk of preventable harm, especially during hospital overcrowding.
• Rising rates of preventable harm in Canadian hospitals underscore the urgent need for effective patient safety strategies.

Purpose of the Study:

• To describe Unity Health Toronto's systematic approach to reviewing serious harm events.
• To evaluate the impact of their critical incident review process on patient safety culture and outcomes.
• To assess the resilience of their patient safety initiatives during the COVID-19 pandemic.

Main Methods:

• Implementation of a systematic, formal case review process for serious harm events.
• Utilized a mixed-methods evaluation approach, incorporating both quantitative and qualitative metrics.
• Focused on assessing the impact on patient safety culture and the reduction of adverse events.

Main Results:

• The critical incident review process demonstrated effectiveness in enhancing patient safety culture.
• Quantitative and qualitative data indicated a positive impact on patient safety within the organization.
• The established patient safety culture proved resilient during the challenges posed by the COVID-19 pandemic.

Conclusions:

• Systematic critical incident reviews are a key lever for improving patient safety culture and reducing preventable harm.
• Unity Health Toronto's approach has successfully built a resilient patient safety culture.
• The process continues to positively influence patient safety outcomes within the organization.