title: The Effect of a Freely Available Flipped Classroom Course on Health Care Worker Patient Safety Culture: A Prospective Controlled Study.
abstract: Patient safety culture is an integral aspect of good standard of care. A good patient safety culture is believed to be a prerequisite for safe medical care. However, there is little evidence on whether general education can enhance patient safety culture.
  
  
  
  Our aim was to assess the impact of a standardized patient safety course on health care worker patient safety culture.
  
  
  
  Health care workers from Intensive Care Units (ICU) at two hospitals (A and B) in Hong Kong were recruited to compare the changes in safety culture before and after a patient safety course. The BASIC Patient Safety course was administered only to staff from Hospital A ICU. Safety culture was assessed in both units at two time points, one before and one after the course, by using the Hospital Survey on Patient Safety Culture questionnaire. Responses were coded according to the Survey User's Guide, and positive response percentages for each patient safety domain were compared to the 2012 Agency for Healthcare Research and Quality ICU sample of 36,120 respondents.
  
  
  
  We distributed 127 questionnaires across the two hospitals with an overall response rate of 74.8% (95 respondents). After the safety course, ICU A significantly improved on teamwork within hospital units (P=.008) and hospital management support for patient safety (P<.001), but decreased in the frequency of reporting mistakes compared to the initial survey (P=.006). Overall, ICU A staff showed significantly greater enhancement in positive responses in five domains than staff from ICU B. Pooled data indicated that patient safety culture was poorer in the two ICUs than the average ICU in the Agency for Healthcare Research and Quality database, both overall and in every individual domain except hospital management support for patient safety and hospital handoffs and transitions.
  
  
  
  Our study demonstrates that a structured, reproducible short course on patient safety may be associated with an enhancement in several domains in ICU patient safety culture.
authors.affiliation: Prince of Wales Hospital, Department of Anaesthesia and Intensive Care, Shatin, China (Hong Kong).
authors.forename: Lowell
authors.identifier: 0000-0001-6639-7344
authors.initials: L
authors.lastname: Ling
authors.forename: Charles David
authors.identifier: 0000-0002-8494-8063
authors.initials: CD
authors.lastname: Gomersall
authors.forename: Winnie
authors.identifier: 0000-0002-2955-4942
authors.initials: W
authors.lastname: Samy
authors.forename: Gavin Matthew
authors.identifier: 0000-0002-5823-3435
authors.initials: GM
authors.lastname: Joynt
authors.forename: Czarina Ch
authors.identifier: 0000-0002-3291-8663
authors.initials: CCh
authors.lastname: Leung
authors.forename: Wai-Tat
authors.identifier: 0000-0002-7228-9486
authors.initials: WT
authors.lastname: Wong
authors.forename: Anna
authors.identifier: 0000-0003-2864-0045
authors.initials: A
authors.lastname: Lee
mesh_terms: D000488:Allied Health Personnel / Q000193:education*; D001291:Attitude of Health Personnel; D065187:Controlled Before-After Studies; D006282:Health Personnel / Q000193:education; D006723:Hong Kong; D006739:Hospital Administration; D006761:Hospitals; D006801:Humans; D007362:Intensive Care Units / Q000458:organization & administration*; D008505:Medical Staff, Hospital / Q000193:education*; D009741:Nursing Staff, Hospital / Q000193:education*; D015279:Organizational Culture; D061214:Patient Safety; D011446:Prospective Studies; D017751:Safety Management; D011795:Surveys and Questionnaires
keywords: critical care; education, distance; education, professional; patient safety; safety culture