title: Achieving a climate for patient safety by focusing on relationships.
abstract: OBJECTIVE
  Despite many initiatives, advances in patient safety remain uneven in part because poor relationships among health professionals have not been addressed. The purpose of this study was to determine whether relationships between health professionals contributed to a patient safety climate, after implementation of an intervention to improve inter-professional collaboration.
  
  
  METHODS
  This was a secondary analysis of data collected to evaluate the Interprofessional Model of Patient Care (IPMPC) at The Ottawa Hospital in Ontario, Canada, which consists of five sites. A series of generalized estimating equation models were generated, accounting for the clustering of responses by site.
  
  
  METHODS
  Thirteen health professionals including physicians, nurses, physiotherapists and others (n = 1896) completed anonymous surveys about 1 year after the IPMPC was introduced.
  
  
  METHODS
  The IPMPC was implemented to improve interdisciplinary collaboration.
  
  
  METHODS
  Reliable instruments were used to measure collaboration, respect, inter-professional conflict and patient safety climate.
  
  
  RESULTS
  Collaboration (β = 0.13; P = 0.002) and respect (β = 1.07; P = 0.03) were significant independent predictors of patient safety climate. Conflict was an independent and significant inverse predictor of patient safety climate (β = -0.29; P = 0.03), but did not moderate linkages between collaboration and patient safety climate or between respect and patient safety climate.
  
  
  CONCLUSIONS
  Through the IPMPC, all health professionals learned how to collaborate and build a patient safety climate, even in the presence of inter-professional conflict. Efforts by others to foster better work relationships may yield similar improvements in patient safety climate.
authors: School of Nursing, University of Michigan School of Nursing, 400 North Ingalls, Room 4306, Ann Arbor, MI, USA.
authors: Milisa
authors: M
authors: Manojlovich
authors: The Arthur Labatt Family School of Nursing, Faculty of Health Sciences, University of Western Ontario, Health Science Addition, London, Ontario, N6A 5C1, Canada.
authors: Mickey
authors: M
authors: Kerr
authors: School of Nursing, University of Ottawa, 451 Smyth Road, Ottawa, ON K1H 8M5, Canada.
authors: Barbara
authors: B
authors: Davies
authors: School of Nursing, University of Ottawa, 451 Smyth Road, Ottawa, ON K1H 8M5, Canada Clinical Epidemiology Program, Ottawa Hospital Research Institute, 501 Smyth Road, Ottawa, ON K1H 8L6, Canada.
authors: Janet
authors: J
authors: Squires
authors: Clinical Epidemiology Program, Ottawa Hospital Research Institute, 501 Smyth Road, Ottawa, ON K1H 8L6, Canada.
authors: Ranjeeta
authors: R
authors: Mallick
authors: Department of Nursing, The Ottawa Hospital, General Campus room M, 501 Smyth Road, Ottawa, Ontario, K1H 8L6, Canada.
authors: Ginette L
authors: GL
authors: Rodger
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D001291:Attitude of Health Personnel; D003299:Cooperative Behavior; D005260:Female; D006801:Humans; D007400:Interprofessional Relations; D008297:Male; D008875:Middle Aged; D015279:Organizational Culture; D010348:Patient Care Team; D061214:Patient Safety; D011787:Quality of Health Care; D012737:Sex Factors; D012959:Socioeconomic Factors; D055815:Young Adult
keywords: inter-professional collaboration; inter-professional conflict; inter-professional relationships; patient safety climate; secondary analysis