Improving patient safety culture in general practice: an interview study

Br J Gen Pract. 2015 Dec;65(641):e822-8. doi: 10.3399/bjgp15X687865.

Abstract

Background: When improving patient safety a positive safety culture is key. As little is known about improving patient safety culture in primary care, this study examined whether administering a culture questionnaire with or without a complementary workshop could be used as an intervention for improving safety culture.

Aim: To gain insight into how two interventions affected patient safety culture in everyday practice.

Design and setting: After conducting a randomised control trial of two interventions, this was a qualitative study conducted in 30 general practices to aid interpretation of the previous quantitative findings.

Method: Interviews were conducted at practice locations (n = 27) with 24 GPs and 24 practice nurses. The theory of communities of practice--in particular, its concepts of a domain, a community, and a practice--was used to interpret the findings by examining which elements were or were not present in the participating practices.

Results: Communal awareness of the problem was only raised after getting together and discussing patient safety. The combination of a questionnaire and workshop enhanced the interaction of team members and nourished team feelings. This shared experience also helped them to understand and develop tools and language for daily practice.

Conclusion: In order for patient safety culture to improve, the safety culture questionnaire was more successful when accompanied by a practice workshop. Initial discussion and negotiation of shared goals during the workshop fuelled feelings of coherence and belonging to a community wishing to learn about enhancing patient safety. Team meetings and day-to-day interactions enhanced further liaison and sharing, making patient safety a common and conscious goal.

Keywords: intervention; interview study; patient safety; primary health care; safety; safety culture.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Attitude of Health Personnel
  • Evidence-Based Practice
  • General Practice / organization & administration
  • General Practice / standards*
  • Humans
  • Interviews as Topic
  • Medical Errors / prevention & control*
  • Medical Errors / statistics & numerical data
  • Organizational Culture
  • Outcome and Process Assessment, Health Care
  • Patient Safety
  • Quality Improvement / organization & administration*
  • Quality Indicators, Health Care
  • Risk Management
  • Surveys and Questionnaires