Introduction: The Safety Attitudes Questionnaire (SAQ) is among the most frequently cited tools for measuring safety culture in healthcare settings. Its ambulatory version was used in this study. The aim was to assess safety culture in out-of-hours (OOH) family medicine service and its variation across job positions, regions, and respondents' demographic characteristic.
Methods: A cross-sectional observational study was carried out targeting 358 health professionals working in the 29 largest Croatian healthcare centres providing out-of-hours family medicine service. The response rate was 51.7% (185 questionnaires). The questionnaire comprised 62 Likert items with 5 responses (fully disagree to fully agree). Scores of negatively worded items were reversed before analysis. Scores on the total scale and subscales were calculated as additive scores. The study included demographic data on gender, age, working experience, and job position. Repeated measurement analysis of variance was used to assess variation of Safety Attitudes Questionnaire - Ambulatory Version (SAQ-AV) sub-scales.
Results: Nurses assessed safety culture higher than did physicians and residents. Teamwork climate had higher scores than Ambulatory process of care and Organizational climate. Stress recognition and Perceptions of workload had the lowest overall scores. Variation across gender, age, working experience, and region was not statistically significant.
Conclusions: SAQ-AV can be used to identify areas for improvement in patient safety at OOH GPs. There is a need to improve staffing and support for OOH GP residents. Further research is needed in order to gain better understanding of factors influencing observed variations among job positions.
Uvod: Vprašalnik o kulturi varnosti (SAQ) je med najpogosteje citiranimi orodji za merjenje kulture varnosti v zdravstvu. V tej raziskavi je bila uporabljena različica vprašalnika za ambulante. Cilj je bil oceniti kulturo varnosti v dežurnih ambulantah družinske medicine ter razlike v kulturi varnosti med delovnimi mesti, regijami in demografskimi značilnostmi respondentov.
Metode: Izvedena je bila presečna opazovalna študija, usmerjena na 358 zdravstvenih delavcev, zaposlenih v 29 največjih hrvaških zdravstvenih centrih, v katerih delujejo dežurne ambulante družinske medicine. Stopnja odgovorov je bila 51,7 % (185 vprašalnikov). Vprašalnik je vseboval Likertovo lestvico z 62 trditvami s 5 odgovori (od »sploh se ne strinjam« do »popolnoma se strinjam«). Pred izvajanjem analiz so bile ocene negativnih trditev obrnjene. Ocene na skupni lestvici in pomožnih lestvicah so bile izračunane kot aditivne ocene. Raziskava je vključevala demografske podatke o spolu, starosti, delovnih izkušnjah in delovnem mestu. Za oceno razlik med pomožnimi lestvicami vprašalnika o kulturi varnosti – različice za ambulante (SAQ-AV) je bila uporabljena analiza variance za ponovljene meritve.
Rezultati: Medicinske sestre so kulturo varnosti ocenile višje kot zdravniki in specializanti. Ozračje pri timskem delu je imelo višje ocene od ambulantne oskrbe in organizacijskega ozračja. Prepoznavanje stresa in dojemanje delovnih obremenitev sta prejela najnižje skupne ocene. Razlike med spoloma, starostjo, delovnimi izkušnjami in regijami niso bile statistično značilne.
Zaključki: Vprašalnik SAQ-AV je mogoče uporabiti za opredelitev področij za izboljšave pri varnosti pacientov v dežurnih ambulantah splošne medicine. Ni potrebe po izboljšanju kadrovskih razmer in podpore za specializante v dežurnih ambulantah splošne medicine. Potrebne so nadaljnje raziskave za boljše razumevanje dejavnikov, ki vplivajo na ugotovljene razlike med delovnimi mesti.
Keywords: Croatia; attitudes of health personnel; family medicine; management; patient safety; questionnaires, out-of-hours care; safety; surveys.
© 2021 National Institute of Public Health, Slovenia, published by Sciendo.