title: Exploring patient safety culture in primary care.
abstract: OBJECTIVE
  To explore perceptions of safety culture in nine different types of primary care professions and to study possible differences.
  
  
  METHODS
  Cross-sectional survey.
  
  
  METHODS
  Three hundred and thirteen practices from nine types of primary care profession groups in the Netherlands.
  
  
  METHODS
  Professional staff from primary care practices. Nine professions participated: dental care, dietetics, exercise therapy, physiotherapy, occupational therapy, midwifery, anticoagulation clinics, skin therapy and speech therapy.
  
  
  METHODS
  Perceptions of seven patient safety culture dimensions were measured: 'open communication and learning from error', 'handover and teamwork', 'adequate procedures and working conditions', 'patient safety management', 'support and fellowship', 'intention to report events' and 'organizational learning'. Dimension means per profession were presented, and multilevel analyses were used to assess differences between professions. Also the so-called patient safety grade was self-reported.
  
  
  RESULTS
  Five hundred and nineteen practices responded (response rate: 24%) of which 313 (625 individual questionnaires) were included for analysis. Overall, patient safety culture was perceived as being positive. Occupational therapy and anticoagulation therapy deviated most from other professions in a negative way, whereas physiotherapy deviated the most in a positive way. In addition, most professions graded their patient safety as positive (mean = 4.03 on a five-point scale).
  
  
  CONCLUSIONS
  This study showed that patient safety culture in Dutch primary care professions on average is perceived positively. Also, it revealed variety between professions, indicating that a customized approach per profession group might contribute to successful implementation of safety strategies.
authors.affiliation: Department of General Practice, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands.
authors.forename: Natasha J
authors.initials: NJ
authors.lastname: Verbakel
authors.affiliation: Department of General Practice, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands.
authors.forename: Marije
authors.initials: M
authors.lastname: Van Melle
authors.affiliation: Quality and Organization, Nivel, Netherlands Institute for Health Services Research, Utrecht, The Netherlands.
authors.forename: Maaike
authors.initials: M
authors.lastname: Langelaan
authors.affiliation: Department of General Practice, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands.
authors.forename: Theo J M
authors.initials: TJ
authors.lastname: Verheij
authors.affiliation: Quality and Organization, Nivel, Netherlands Institute for Health Services Research, Utrecht, The Netherlands Department of Public and Occupational Health, EMGO+ Institute, VU University Medical Center, Amsterdam, The Netherlands.
authors.forename: Cordula
authors.initials: C
authors.lastname: Wagner
authors.affiliation: Department of General Practice, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands.
authors.forename: Dorien L M
authors.initials: DL
authors.lastname: Zwart
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D003142:Communication; D003266:Continuity of Patient Care; D003430:Cross-Sectional Studies; D004777:Environment; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D015279:Organizational Culture; D009936:Organizational Innovation; D010348:Patient Care Team; D061214:Patient Safety; D011320:Primary Health Care / Q000458:organization & administration*; D011787:Quality of Health Care; D012944:Social Support
keywords: patient safety; primary care; safety culture; survey