Promoting safety: longer-term responses of three health professional groups to a safety improvement programme.
OBJECTIVE
Patient safety has been addressed since 2002 in the health system of New South Wales, Australia via a Safety Improvement Programme (SIP), which took a system-wide approach. The programme involved two-day courses to educate healthcare professionals to monitor and report incidents and analyse adverse events by conducting root cause analysis (RCA). This paper aims to predict that all professions would favour SIP but that their work and educational histories would result in doctors holding the least and nurses the most positive attitudes. Alternative hypotheses were that doctors' relative power and other professions' team-working skills would advantage the respective groups when conducting RCAs.


METHODS
Responses to a 2005 follow-up questionnaire survey of doctors (n = 53), nurses (209) and allied health staff (59), who had participated in SIP courses, were analysed to compare: their attitudes toward the course; safety skills acquired and applied; perceived benefits of SIP and RCAs; and their experiences conducting RCAs.


RESULTS
Significant differences existed between professions' responses with nurses being the most and doctors the least affirming. Allied health responses resembled those of nurses more than those of doctors. The professions' experiences conducting RCAs (number conducted, leadership, barriers encountered, findings implemented) were similar.


CONCLUSIONS
Observational studies are needed to determine possible professional differences in the conduct of RCAs and any ensuing culture change that this may be eliciting.


CONCLUSIONS
There is strong professional support for SIPs but less endorsement from doctors, who tend not to prefer the knowledge content and multidisciplinary teaching environment considered optimal for safety improvement education. This is a dilemma that needs to be addressed.


CONCLUSIONS
Few longer-term SIPs' assessments have been realised and the differences between professional groups have not been well quantified. As a result of this paper, benefits of and barriers to conducting RCAs are now more clearly understood.
Westbrook
Mary T
MT
Centre for Clinical Governance Research, University of New South Wales, Sydney, Australia.
Braithwaite
Jeffrey
J
Travaglia
Joanne F
JF
Long
Debbi
D
Jorm
Christine
C
Iedema
Rick A
RA
Ledema
Rick A
RA
D000488:Allied Health Personnel / Q000193:education* / Q000523:psychology; D001291:Attitude of Health Personnel; D003162:Competency-Based Education; D004502:Education, Medical, Continuing; D004509:Education, Nursing, Continuing; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D008297:Male; D019300:Medical Errors / Q000517:prevention & control; D008503:Medical Staff / Q000193:education* / Q000523:psychology; D009313:National Health Programs; D009517:New South Wales; D009740:Nursing Staff / Q000193:education* / Q000523:psychology; D015279:Organizational Culture; D011787:Quality of Health Care; D017751:Safety Management / Q000458:organization & administration*; D011795:Surveys and Questionnaires