Healthcare professionals' views on feedback of a patient safety culture assessment.

BACKGROUND: By assessing patient safety culture, healthcare providers can identify areas for improvement in patient safety culture. To achieve this, these assessment outcomes have to be relevant and presented clearly. The aim of our study was to explore healthcare professionals' views on the feedback of a patient safety culture assessment. METHODS: Twenty four hospitals participated in a patient safety culture assessment in 2012. Hospital departments received feedback in a report and on a website. In a survey, we evaluated healthcare professionals' views on this feedback and the effect of additional information about patient safety culture improvement strategies on the appraisal of the feedback. 20 hospitals participated in part I (evaluation of the report), 13 hospitals participated in part II (evaluation of the website). RESULTS: Healthcare professionals (e.g. members of staff and department heads/managers) rated the feedback in the report and on the website positively (average mean on different aspects = 7.2 on a scale from 1 to 10). Interpreting results was sometimes difficult, and information was sometimes lacking, like specific recommendations and improvement strategies. The provision of additional general information on patient safety culture improvement strategies resulted only in a higher appraisal of the attractiveness (lay-out) of the report and the understandability of the feedback report. The majority (84 %) of the healthcare professionals agreed or partly agreed that the feedback on patient safety culture stimulated actions to improve patient safety culture. However, a quarter also stated that although the feedback report provided insight into the patient safety culture, they did not know how to improve patient safety culture in their hospital. CONCLUSIONS: Healthcare professionals seem to be positive about the feedback on patient safety culture and its effect on stimulating patient safety culture improvement. To optimally tune feedback on patient safety culture towards healthcare professionals, the following might help: 1) pay attention to the understandability of outcomes for its intended users; and 2) create feedback that is tailored towards specific hospital departments.

Excess length of stay and economic consequences of adverse events in Dutch hospital patients.

BACKGROUND: To investigate the average and extrapolated excess length of stay and direct costs of adverse events (AEs) and preventable AEs in Dutch hospitals, and to evaluate patient characteristics associated with excess length of stay and costs. METHODS: Data of a large retrospective patient record review study on AEs was used. A stratified sample of 20 Dutch hospitals was included. Excess length of stay and costs attributable to AEs and preventable AEs were calculated and extrapolated to a national estimate. The association between patient characteristics and excess length of stay (and costs thereof) attributable to AEs and preventable AEs was investigated through multilevel linear regression analyses. RESULTS: A total of 2975 patient records were included in the analysis, of which 325 experienced one or more AEs. Hospital patients experiencing an AE stayed 5.11 (95% CI 3.91-6.30) more days in hospital and cost €2600 (95% CI €1968-€3232) more compared to those without an AE. There was no significant difference in days and costs between preventable and non-preventable AEs. Extrapolated to a national level, AEs cost more than €300 million, which was 1.3% of the national hospital care budget. Patients with hospital-acquired infections had a statistically significant longer length of stay compared to the reference group (patients with AEs on the cardiovascular system). CONCLUSIONS: This study showed that AEs lead to substantial excess length of stay and increased costs. Special attention should be paid to patients with AEs due to an hospital-acquired infection.

Study protocol of a national multicentre prospective evaluation study assessing the validity and impact of the Dutch Paediatric Early Warning Score (PEWS) in the Netherlands.

INTRODUCTION: Early recognition of clinical deterioration and timely intervention are important to improve morbidity and mortality in paediatric care. The Paediatric Early Warning Score (PEWS) is a scoring system aiming to identify hospitalised children at risk for deterioration. Currently, there is a large heterogeneity of PEWS systems in the Netherlands, with a considerable number remaining unvalidated or self-designed. Therefore, a consensus-based Dutch PEWS has been developed in a national study using the Core Outcome Measures in Effectiveness Trials initiative. The Dutch PEWS is a uniform system that integrates a core set of vital parameters together with pre-existing risk factors and uses risk stratification to proactively follow-up on patients at risk (so-called 'watcher patients'). This study aims to validate the Dutch PEWS and to determine its impact on improving patient safety in various hospital settings. METHODS AND ANALYSIS: This national study will be a large multicentre evaluation study, in which the Dutch PEWS will be implemented and evaluated in 12 hospitals in the Netherlands. In this study, a mixed methods methodology will be used and evaluated on predefined outcome measures. To examine the validity of the Dutch PEWS, statistical analyses will be undertaken on quantitative data retrieved from electronic health records. Surveys among physicians and nurses; semistructured interviews with healthcare providers and parents; and daily evaluation forms are being conducted to determine the impact of the Dutch PEWS. The study is being conducted from December 2020 to June 2024.