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Patient safety culture in out-of-hours primary care services in the Netherlands: a cross-sectional survey.
Scand J Prim Health Care. 2018 Mar; 36(1):28-35.SJ

Abstract

OBJECTIVE

To examine patient safety culture in Dutch out-of-hours primary care using the safety attitudes questionnaire (SAQ) which includes five factors: teamwork climate, safety climate, job satisfaction, perceptions of management and communication openness.

DESIGN

Cross-sectional observational study using an anonymous web-survey. Setting Sixteen out-of-hours general practitioner (GP) cooperatives and two call centers in the Netherlands. Subjects Primary healthcare providers in out-of-hours services. Main outcome measures Mean scores on patient safety culture factors; association between patient safety culture and profession, gender, age, and working experience.

RESULTS

Overall response rate was 43%. A total of 784 respondents were included; mainly GPs (N = 470) and triage nurses (N = 189). The healthcare providers were most positive about teamwork climate and job satisfaction, and less about communication openness and safety climate. The largest variation between clinics was found on safety climate; the lowest on teamwork climate. Triage nurses scored significantly higher than GPs on each of the five patient safety factors. Older healthcare providers scored significantly higher than younger on safety climate and perceptions of management. More working experience was positively related to higher teamwork climate and communication openness. Gender was not associated with any of the patient safety factors.

CONCLUSIONS

Our study showed that healthcare providers perceive patient safety culture in Dutch GP cooperatives positively, but there are differences related to the respondents' profession, age and working experience. Recommendations for future studies are to examine reasons for these differences, to examine the effects of interventions to improve safety culture and to make international comparisons of safety culture. Key Points Creating a positive patient safety culture is assumed to be a prerequisite for quality and safety. We found that: • healthcare providers in Dutch GP cooperatives perceive patient safety culture positively; • triage nurses scored higher than GPs, and older and more experienced healthcare professionals scored higher than younger and less experienced professionals - on several patient safety culture factors; and • within the GP cooperatives, safety climate and openness of communication had the largest potential for improvement.

Authors+Show Affiliations

a Radboud Scientific Center for Quality of Healthcare (IQ healthcare), Radboud Institute for Health Sciences , Radboud university medical center , Nijmegen , The Netherlands. b NIVEL , Netherlands Institute for Health Services Research , Utrecht , The Netherlands.a Radboud Scientific Center for Quality of Healthcare (IQ healthcare), Radboud Institute for Health Sciences , Radboud university medical center , Nijmegen , The Netherlands.a Radboud Scientific Center for Quality of Healthcare (IQ healthcare), Radboud Institute for Health Sciences , Radboud university medical center , Nijmegen , The Netherlands.c Health Services Research Unit , Akershus University Hospital , Lørenskog , Norway. d The Norwegian Directorate of Health , Oslo , Norway.e Institute of Health and Society , University of Oslo , Oslo , Norway.f Department of Global Public Health and Primary Care , University of Bergen , Bergen , Norway. g National Centre for Emergency Primary Health Care , Uni Research Health , Bergen , Norway.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

29334826

Citation

Smits, Marleen, et al. "Patient Safety Culture in Out-of-hours Primary Care Services in the Netherlands: a Cross-sectional Survey." Scandinavian Journal of Primary Health Care, vol. 36, no. 1, 2018, pp. 28-35.
Smits M, Keizer E, Giesen P, et al. Patient safety culture in out-of-hours primary care services in the Netherlands: a cross-sectional survey. Scand J Prim Health Care. 2018;36(1):28-35.
Smits, M., Keizer, E., Giesen, P., Deilkås, E. C. T., Hofoss, D., & Bondevik, G. T. (2018). Patient safety culture in out-of-hours primary care services in the Netherlands: a cross-sectional survey. Scandinavian Journal of Primary Health Care, 36(1), 28-35. https://doi.org/10.1080/02813432.2018.1426150
Smits M, et al. Patient Safety Culture in Out-of-hours Primary Care Services in the Netherlands: a Cross-sectional Survey. Scand J Prim Health Care. 2018;36(1):28-35. PubMed PMID: 29334826.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Patient safety culture in out-of-hours primary care services in the Netherlands: a cross-sectional survey. AU - Smits,Marleen, AU - Keizer,Ellen, AU - Giesen,Paul, AU - Deilkås,Ellen Catharina Tveter, AU - Hofoss,Dag, AU - Bondevik,Gunnar Tschudi, Y1 - 2018/01/15/ PY - 2018/1/18/pubmed PY - 2018/8/23/medline PY - 2018/1/17/entrez KW - Patient safety culture KW - adverse events KW - after-hours KW - primary care KW - safety attitudes SP - 28 EP - 35 JF - Scandinavian journal of primary health care JO - Scand J Prim Health Care VL - 36 IS - 1 N2 - OBJECTIVE: To examine patient safety culture in Dutch out-of-hours primary care using the safety attitudes questionnaire (SAQ) which includes five factors: teamwork climate, safety climate, job satisfaction, perceptions of management and communication openness. DESIGN: Cross-sectional observational study using an anonymous web-survey. Setting Sixteen out-of-hours general practitioner (GP) cooperatives and two call centers in the Netherlands. Subjects Primary healthcare providers in out-of-hours services. Main outcome measures Mean scores on patient safety culture factors; association between patient safety culture and profession, gender, age, and working experience. RESULTS: Overall response rate was 43%. A total of 784 respondents were included; mainly GPs (N = 470) and triage nurses (N = 189). The healthcare providers were most positive about teamwork climate and job satisfaction, and less about communication openness and safety climate. The largest variation between clinics was found on safety climate; the lowest on teamwork climate. Triage nurses scored significantly higher than GPs on each of the five patient safety factors. Older healthcare providers scored significantly higher than younger on safety climate and perceptions of management. More working experience was positively related to higher teamwork climate and communication openness. Gender was not associated with any of the patient safety factors. CONCLUSIONS: Our study showed that healthcare providers perceive patient safety culture in Dutch GP cooperatives positively, but there are differences related to the respondents' profession, age and working experience. Recommendations for future studies are to examine reasons for these differences, to examine the effects of interventions to improve safety culture and to make international comparisons of safety culture. Key Points Creating a positive patient safety culture is assumed to be a prerequisite for quality and safety. We found that: • healthcare providers in Dutch GP cooperatives perceive patient safety culture positively; • triage nurses scored higher than GPs, and older and more experienced healthcare professionals scored higher than younger and less experienced professionals - on several patient safety culture factors; and • within the GP cooperatives, safety climate and openness of communication had the largest potential for improvement. SN - 1502-7724 UR - https://www.unboundmedicine.com/medline/citation/29334826/Patient_safety_culture_in_out_of_hours_primary_care_services_in_the_Netherlands:_a_cross_sectional_survey_ L2 - http://www.tandfonline.com/doi/full/10.1080/02813432.2018.1426150 DB - PRIME DP - Unbound Medicine ER -