From Reporting to Improving: How Root Cause Analysis in Teams Shape Patient Safety Culture.

Area of Science:

• Healthcare Management
• Patient Safety
• Quality Improvement

Background:

• Continuous Quality Improvement Programs (QIPs) are vital for patient safety.
• Morbidity and Mortality Conferences (MMCs) and Experience Feedback Committees (EFCs) are key QIPs for enhancing safety culture.
• Understanding the impact of these programs on healthcare professionals' perceptions of safety is crucial.

Purpose of the Study:

• To determine if patient safety culture differs based on healthcare provider participation in MMCs and EFCs.
• To quantify the impact of involvement in MMCs and EFCs on specific dimensions of patient safety culture.

Main Methods:

• A cross-sectional web-only survey was conducted in 2022.
• The Hospital Survey on Patient Safety Culture (HSOPS) was administered to 4780 employees at a French university-affiliated hospital.
• Multivariate analysis of variance and Cohen d effect size were used to analyze differences in HSOPS dimension scores based on MMCs and EFCs participation.

Main Results:

• 1457 employees (30.5%) participated, with 571 (39.2%) involved in MMCs or EFCs.
• Participants in MMCs or EFCs reported significantly higher scores in six of twelve HSOPS dimensions, especially 'Nonpunitive response to error,' 'Feedback and communication about error,' and 'Organizational learning' (effect size = 0.14).
• Participation in both MMCs and EFCs showed greater improvements in patient safety culture than singular or no involvement, though dimensions like 'Staffing' and 'Hospital management support' were unaffected.

Conclusions:

• Participation in MMCs and EFCs positively correlates with an enhanced patient safety culture.
• These programs foster environments conducive to learning, communication, and nonpunitive error responses.
• Addressing broader systemic issues beyond MMCs and EFCs is necessary for comprehensive patient safety improvements.