[Evolution of patient safety culture in a medium-stay hospital: monitoring indicators]. / Evolución de la cultura de seguridad del paciente en un hospital de media-larga estancia: indicadores de seguimiento.

BACKGROUND: Patient safety is a challenge for health care. The aim of this study is to identify the dimensions with the greatest impact on patient safety culture of healthcare staff in a medium-stay hospital; to asses its evolution over time and to check the sensitivity of monitoring indicators. METHODS: Two cross-sectional studies (2013 to 2015) were conducted. The safety culture assessment tool used was the Spanish version of the "Hospital Survey on Patient Safety" (AHRQ). Outcome variable is high perception of safety (score = 75th percentile). INDEPENDENT VARIABLES: socio-demographic characteristics and perceptions of the evaluated dimensions. The association between variables was quantified by Odds Ratio. RESULTS: The mean of perceived safety was similar in both studies: (7.81 and 7.48, N2013= 66; N2015=92). The best aspects evaluated were: "Supervisor actions" and "Teamwork within unit"; the worst evaluated were: "Staffing", "Management support" and "Teamwork across units". Socio-demographic variables had little significance, while a positive perception in some of the considered dimensions was associated with high perceived safety. The most strongly associated aspects were: "Supervisor actions", "Communication openness" and "Problems in transitions". In the comparative study, indicators based on individual dimensions detected changes better than the assessment of the degree of perceived safety. CONCLUSION: The regular assessment of Patient Safety Culture makes it possible to know the status and evolution of professionals' perceptions. The choice of appropriate indicators optimises the information obtained through these surveys.

Evolución de la cultura de seguridad del paciente en un hospital de media-larga estancia: indicadores de seguimiento / Evolution of patient safety culture in a medium-stay hospital: monitoring indicators

Fundamento: La seguridad del paciente es un reto para la asistencia sanitaria. El objetivo de este estudio es identificar las dimensiones con mayor impacto sobre la cultura de seguridad en un hospital de media-larga estancia, monitorizar su evolución y comprobar la sensibilidad de los indicadores de seguimiento. Material y métodos: Se realizaron 2 estudios transversales (2013-2015), utilizando la versión española del cuestionario «Hospital Survey on Patient Safety» (AHRQ). Variable resultado: alto grado de seguridad percibida (puntuación ≥ al percentil 75). Variables predictoras: características socio-demográficas y percepciones de las dimensiones evaluadas. La asociación entre variables se cuantificó mediante OddsRatio. Resultados: El grado de seguridad percibida fue similar en ambos estudios: (7,81-7,48; N2013=66; N2015=92). Los aspectos mejor evaluados fueron: «Acciones de los supervisores» y «Trabajo en equipo en la unidad»; los peor evaluados fueron: «Dotación de personal», «Apoyo de la dirección» y «Trabajo en equipo entre unidades». Las variables socio-demográficas presentaron escasa significación, mientras que una percepción positiva de algunas dimensiones consideradas, sí que se asociaba a un alto grado de seguridad percibida. Los aspectos más fuertemente asociados fueron: «Acciones de los supervisores», «Franqueza en la comunicación» y «Problemas en los cambios de turno». En el estudio comparativo de los resultados, los indicadores basados en las dimensiones individuales detectaron mejor los cambios que el grado de seguridad percibida. Conclusiones: La evaluación periódica de la cultura de seguridad permite conocer el estado y la evolución de las percepciones de los profesionales. La elección de indicadores apropiados optimiza la información obtenida a través de estas encuestas (AU)

Background: Patient safety is a challenge for health care. The aim of this study is to identify the dimensions with the greatest impact on patient safety culture of healthcare staff in a medium-stay hospital; to asses its evolution over time and to check the sensitivity of monitoring indicators. Methods: Two cross-sectional studies (2013 to 2015) were conducted. The safety culture assessment tool used was the Spanish version of the «Hospital Survey on Patient Safety» (AHRQ). Outcome variable is high perception of safety (score ≥ 75th percentile). Independent variables: socio-demographic characteristics and perceptions of the evaluated dimensions. The association between variables was quantified by Odds Ratio. Results: The mean of perceived safety was similar in both studies: (7.81 and 7.48, N2013= 66; N2015=92). The best aspects evaluated were: «Supervisor actions» and «Teamwork within unit»; the worst evaluated were: «Staffing», «Management support» and «Teamwork across units». Socio-demographic variables had little significance, while a positive perception in some of the considered dimensions was associated with high perceived safety. The most strongly associated aspects were: «Supervisor actions», «Communication openness» and «Problems in transitions». In the comparative study, indicators based on individual dimensions detected changes better than the assessment of the degree of perceived safety. Conclusion: The regular assessment of Patient Safety Culture makes it possible to know the status and evolution of professionals' perceptions. The choice of appropriate indicators optimises the information obtained through these surveys (AU)