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Please use this identifier to cite or link to this item: http://hdl.handle.net/1942/20299

Title: Patient safety and safety culture in Belgian hospitals
Authors: Vlayen, Annemie
Advisors: Claes, Neree
Schrooten, Ward
Issue Date: 2013
Abstract: Since the publication of the report ‘To err is human’ by the Institute of Medicine (IOM) in 1999, public attention was drawn to the importance and magnitude of the issue of patient harm from medical errors. Patient safety is defined by the IOM as a subset of quality of care and focuses on the way in which risks on unintentional and evitable harm to the patient are handled in the organization of care. Patient safety should be the top priority in every healthcare organization. Still often, it is not enough in the attention of healthcare professionals and organizations. Lack of awareness of the severity of the problem, the complexity of healthcare organizations and the lack of data as a result of the paucity of measures are important barriers for improving safe care. Improving patient safety in healthcare organizations needs a system approach integrating different methods, such as the assessment and improvement of the safety culture, adverse events detection, analysis of the root causes and contributory factors of adverse events, prospective risk assessment, the implementation of improvement strategies and the education and training of healthcare staff. Although, patient safety is receiving growing attention, there is scarce evidence on estimations of adverse events in Belgian hospitals. In addition, safety culture has not been measured on a broad scale in order to provide a basis for improving patient safety systematically in Belgian hospitals. Therefore, the primary objective of this dissertation was to fill an important gap in the current research on patient safety and safety culture in the Belgian hospitals. A secondary objective was to help hospitals to understand the nature of the safety culture within their organizations in order to implement strategies for improving patient safety. First, a systematic review was conducted to estimate the incidence and preventability of adverse events that have a high impact for the patient, the hospital and society. The next phase built further on the available evidence and describes the development of a medical record review tool to investigate adverse events that require a higher level of care in Flemish hospitals. A case study was performed to evaluate the usefulness and time-investment of the method of Healthcare Failure Mode and Effects Analysis for the assessment of risks in healthcare processes. Within the federal program on quality and patient safety (2007-2012) two nationwide safety culture measurements were organized in the Belgian acute, psychiatric and long-term care hospitals. The Hospital Survey on Patient Safety Culture (AHRQ) was used to measure perceptions of hospital staff on a broad range of patient safety aspects. Hospitals were invited to participate in a comparative research to provide each hospital a patient safety profile for internal learning. A follow-up study after a period of three years aimed at tracking changes in safety culture after the implementation of a national patient safety plan. Furthermore, it was measured to what extent safety culture differed across hospital units and professional groups. Finally, it was assessed how well the Hospital Survey on Patient Safety Culture applies to the specific context of psychiatric care. As a conclusion, Belgian hospitals are interested in the potential for evaluating, benchmarking and improving safety culture perceptions. Our research approach proves that large comparative databases allow to identifying safety culture patterns, trends and areas for improvement. Our results highlight that a continuous attention is required for the transmission of patient information and the reporting of (near) incidents in the Belgian hospitals. Also, staffing is an area which is less susceptible for improvement and thus should be a signal for the federal authorities to invest into higher (nurse) staffing. The overall positive evolution of safety culture and the important improvement for ‘Management support for patient safety’ show that there is a high potential within the Belgian hospitals for structurally improving patient safety
URI: http://hdl.handle.net/1942/20299
Category: T1
Type: Theses and Dissertations
Appears in Collections: PhD theses
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