title: Orthopaedic Surgeons' View on Strategies for Improving Patient Safety.
abstract: BACKGROUND
  Many strategies have been introduced to improve safety in health care, but it is not clear that these efforts have reduced errors. This study assessed the experienced safety culture and preferred means of improving safety among orthopaedists.
  
  
  METHODS
  Members of the Science of Variation Group and Ankle Platform were invited to complete an eighty-nine-question survey. Outcomes measured were the modified Patient Safety Climate in Healthcare Organizations (PSCHO) questionnaire, which measures safety as perceived by hospital personnel, and the degree of enthusiasm expressed for seventeen means of improving safety.
  
  
  RESULTS
  The questionnaire was completed by 387 (92%) of the 422 participants. The rate of problematic responses, those implying a lack of safety climate, in the modified PSCHO questionnaire was 18%. In multivariable linear regression analysis, working in a non-teaching hospital (β, 3.7; 95% confidence interval [95% CI], 1.3 to 6.2; p = 0.003), having a safety program (β, 4.8; 95% CI, 0.74 to 8.8; p = 0.020), and male sex (β, 3.7; 95% CI, 0.079 to 7.3; p = 0.045) were associated with higher perceived safety as measured by the PSCHO questionnaire. The majority of participants were very enthusiastic about making safety everyone's responsibility (75%), promoting better communication (80%), standardizing procedures (58%), and standardizing equipment and supplies (63%) to improve safety.
  
  
  CONCLUSIONS
  We found a high problematic response rate concerning the perceived safety climate among surgeons, but there was a high rate of enthusiasm for means of improving safety. Knowledge of the variation in perceived safety and the enthusiasm for strategies to improve safety among surgeons can serve as a starting point for cultural change.
authors.affiliation: Hand and Upper Extremity Service, Department of Orthopaedic Surgery, Massachusetts General Hospital, Harvard Medical School, Yawkey Center, Suite 2100, 55 Fruit Street, Boston, MA 02114. E-mail address for S.J. Janssen: steinjanssen@gmail.com. E-mail address for T. Teunis: teunteunis@gmail.com. E-mail address for D. Ring: dring@mgh.harvard.edu. E-mail address for J.H. Herndon: jherndon@mgh.harvard.edu.
authors.forename: Stein J
authors.initials: SJ
authors.lastname: Janssen
authors.affiliation: Hand and Upper Extremity Service, Department of Orthopaedic Surgery, Massachusetts General Hospital, Harvard Medical School, Yawkey Center, Suite 2100, 55 Fruit Street, Boston, MA 02114. E-mail address for S.J. Janssen: steinjanssen@gmail.com. E-mail address for T. Teunis: teunteunis@gmail.com. E-mail address for D. Ring: dring@mgh.harvard.edu. E-mail address for J.H. Herndon: jherndon@mgh.harvard.edu.
authors.forename: Teun
authors.initials: T
authors.lastname: Teunis
authors.affiliation: Department of Orthopaedic Surgery, Academic Medical Center, Meibergdreef 9, 1100DD Amsterdam, the Netherlands. E-mail address: guitton@gmail.com.
authors.forename: Thierry G
authors.initials: TG
authors.lastname: Guitton
authors.affiliation: Hand and Upper Extremity Service, Department of Orthopaedic Surgery, Massachusetts General Hospital, Harvard Medical School, Yawkey Center, Suite 2100, 55 Fruit Street, Boston, MA 02114. E-mail address for S.J. Janssen: steinjanssen@gmail.com. E-mail address for T. Teunis: teunteunis@gmail.com. E-mail address for D. Ring: dring@mgh.harvard.edu. E-mail address for J.H. Herndon: jherndon@mgh.harvard.edu.
authors.forename: David
authors.initials: D
authors.lastname: Ring
authors.affiliation: Hand and Upper Extremity Service, Department of Orthopaedic Surgery, Massachusetts General Hospital, Harvard Medical School, Yawkey Center, Suite 2100, 55 Fruit Street, Boston, MA 02114. E-mail address for S.J. Janssen: steinjanssen@gmail.com. E-mail address for T. Teunis: teunteunis@gmail.com. E-mail address for D. Ring: dring@mgh.harvard.edu. E-mail address for J.H. Herndon: jherndon@mgh.harvard.edu.
authors.forename: James H
authors.initials: JH
authors.lastname: Herndon
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D005260:Female; D006801:Humans; D008297:Male; D009985:Orthopedics; D061214:Patient Safety; D013223:Statistics as Topic; D011795:Surveys and Questionnaires