Exploring patient safety culture in preventive medicine settings: an experience from Northern Italy.

INTRODUCTION: Patient safety and quality in healthcare are inseparable. Examining patient safety culture in staff members contributes to further develop quality in healthcare. In Italy there has been some experience in assessing patient safety culture in staff working in hospital. In this pilot study we explored patient safety culture in public health staff working in Italian Local Health Authorities. METHODS: We carried out a descriptive cross sectional study in four Italian territorial Prevention facilities in Northern Italy. We administrated an adapted Italian version of the US Hospital Survey of Patient Safety Culture to all the staff within these facilities. The survey consisted of 10 dimensions based on 33 items, according to the results of a previous psychometric validation. RESULTS: Seventy per cent of the staff responded to the survey (N = 479). Overall, six out of the 10 dimensions exhibited composite scores of positive response frequency for patient safety culture below 50%. While "communication openness" (65%) was the most developed factor, "teamwork across Units" (37%) was the least developed. The work areas with the highest composite scores were Management and the Public Health Laboratory, while in terms of professional categories, Physicians had the highest scores. Patient safety culture in the staff participating in this study was lower than in hospital staff. DISCUSSION: Our descriptive cross sectional study is the first to be carried out in Preventive medicine settings in Italy. It has clearly indicated the need of improvement. Consequently, several interventions with this aim have been implemented.

[The network of health promoting companies (WHP) in the province of Bergamo]. / La rete WHP delle aziende che promuovono la salute nella provincia di Bergamo.

OBJECTIVES: To create, by 2012, a network of Promoting Health companies in the Province of Bergamo, with at least 10% of companies with over 90 employees (about 10,000 workers) adherent, and attending up to 15% by 2015. METHODS: The work was carried out by building partnerships and collaboration with Confindustria Bergamo and the main healthcare and Union stakeholders in the province, selecting good practices and experimenting feasibility and effectiveness in two mid-sized companies, before extending the proposal A system of accreditation was defined. Member companies should implement a at least 18 good practices in three years. The areas of good practices are: nutrition, tobacco, physical activity, road safety, alcohol and substance and wellbeing. The results are surprising in terms of network and adhesion. Currently 46 companies are involved (over 9,200 employees). CONCLUSIONS: The model seems to work well and in our opinion is extensible on a larger scale.

[The role of the factory doctor in the health promotion of workers: the experience of the "WHP Bergamo" network]. / Il ruolo del medico competente nella promozione della salute dei lavoratori: l'esperienza della rete WHP Bergamasca.

In Bergamo there is a huge network of 46 "health promoting companies" following an accreditation system which requires the implementation of best practices on health promotion in the workplace. For some of these practices, Company Doctor are involved: management of smokers and workers with alcohol consumption; courses for employees about WHP, use of SMS and web-based systems. Local Public Health Authority has created an annual training which also provided tools to Doctors for their activities in the project. Nowadays 55 doctors have been trained. For Accreditation 2012 eight companies will declare as good practice the training of its CD about smoking and three companies their activities on alcohol abuse prevention and control.

[Courses for smoking cessation in the workplaces: results and opportunities]. / Corsi per smettere di fumare in azienda: risultati ed opportunità.

In the context of the "WHP- District Network Project", 6 group-treatments for smoking cessation have been performed in five companies, with the voluntary participation of 88 smokers. Health professionals, with specific training, conducted the groups according to specific guidelines. The quitting rate recorded at the end of the course (and confirmed, in two groups, by measurement of exhaled CO) was on average 49% (range 34-70%). The abstainers at one year, recorded by a telephonic follow-up, mounted to 38% (range 29-50%, 4 courses out of 6). The courses have proved to be a good tool to help people to quit smoking and so reducing smoking-associated risks and its synergism with occupational risk factors.