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Please use this identifier to cite or link to this item: http://hdl.handle.net/1942/17844

Title: Does lean management improve patient safety culture? An extensive evaluation of safety culture in a radiotherapy institute.
Authors: SIMONS, Pascale
Houben, Ruud
Vlayen, Annemie
Hellings, Johan
Pijls-Johannesma, Madelon
Marneffe, Wim
Vandijck, Dominique
Issue Date: 2015
Abstract: PURPOSE: The importance of a safety culture to maximize safety is no longer questioned. However, achieving sustainable culture improvements are less evident. Evidence is growing for a multifaceted approach, where multiple safety interventions are combined. Lean management is such an integral approach to improve safety, quality and efficiency and therefore, could be expected to improve the safety culture. This paper presents the effects of lean management activities on the patient safety culture in a radiotherapy institute. METHODS: Patient safety culture was evaluated over a three year period using triangulation of methodologies. Two surveys were distributed three times, workshops were performed twice, data from an incident reporting system (IRS) was monitored and results were explored using structured interviews with professionals. Averages, chi-square, logistical and multi-level regression were used for analysis. RESULTS: The workshops showed no changes in safety culture, whereas the surveys showed improvements on six out of twelve dimensions of safety climate. The intention to report incidents not reaching patient-level decreased in accordance with the decreasing number of reports in the IRS. However, the intention to take action in order to prevent future incidents improved (factorial survey presented β: 1.19 with p: 0.01). CONCLUSIONS: Due to increased problem solving and improvements in equipment, the number of incidents decreased. Although the intention to report incidents not reaching patient-level decreased, employees experienced sustained safety awareness and an increased intention to structurally improve. The patient safety culture improved due to the lean activities combined with an organizational restructure, and actual patient safety outcomes might have improved as well.
Notes: [Simons, Pascale A. M.; Marneffe, Wim; Vandijck, Dominique] Hasselt Univ, Fac Business Econ, BE-3500 Hasselt, Belgium. [Houben, Ruud; Pijls-Johannesma, Madelon] MAASTRO Clin, Maastricht, Netherlands. [Houben, Ruud; Pijls-Johannesma, Madelon] Maastricht Univ, Ctr Med, GROW Sch Oncol, Dept Radiat Oncol MAASTRO, NL-6200 MD Maastricht, Netherlands. [Vlayen, Annemie; Hellings, Johan] Hasselt Univ, Fac Med, Hasselt, Belgium. [Vandijck, Dominique] Univ Ghent, Fac Med & Hlth Sci, B-9000 Ghent, Belgium.
URI: http://hdl.handle.net/1942/17844
DOI: 10.1016/j.ejon.2014.08.001
ISI #: 000350074400006
ISSN: 1462-3889
Category: A1
Type: Journal Contribution
Validation: ecoom, 2016
Appears in Collections: Research publications

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