open access: What do surgical trainees think about patient safety culture, and is this different from their consultants?

What do surgical trainees think about patient safety culture, and is this different from their consultants?

Abstract

Introduction Little is known about the patient safety culture within surgical departments in UK hospitals. What has been done to date is to survey only permanent senior staff opinion of the safety culture in their institution. This study surveyed both consultant and trainee views on perceived patient safety and compared the results between these two groups. 

Material and methods The previously validated Team Work and Safety Climate Questionnaire was configured in Survey Monkey format and sent to all surgical trainees and consultant surgeons in the South West Strategic Health Authority. Two reminders were sent to achieve as high a return rate as possible. 

Results Two hundred and ninety-six replies were received. Forty-four percent of trainees and 30% of consultants responded to the survey. Consultants consistently rated a higher safety culture than surgical trainees. Only 2.9% of trainees believe their patient safety concerns would be acted upon by hospital management. There is notable variation in perceived patient safety culture between hospitals. 

Conclusion This study has suggested that the patient safety culture in hospitals, within a Strategic Health Authority, is variable and sub-optimal when viewed by surgical trainees and their consultants. This study also provides some evidence that the perception of patient safety in an organization varies according to clinical experience. As trainees deliver a great deal of clinical care, surveys of safety culture should include this group. As perceived patient safety culture is correlated to clinical outcomes, validated safety surveys might form part of the assessment of a hospital's performance, along with outcome and patient satisfaction.

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Introduction

Medical errors are a major cause of mortality and morbidity. The National Patient Safety Agency (NPSA) estimates that 10% of all hospital admissions suffer an adverse event defined as a medical error that results in harm to the patient. One percent of all admissions die as a result of an adverse event. In practice this means that in England and Wales 300,000 adverse events and 30,000 deaths are recorded every year. This figure of 30,000 deaths a year is a greater number of deaths than the combined annual mortality from colorectal, prostate and breast cancer.¹ Even these striking figures may be underestimating the extent of the problem because recent studies in the surgical literature² indicate the adverse event rate could even be as high as 20%...........