Assessment of the safety culture of the Clinical Center of Sechenov University
https://doi.org/10.47093/2713-069X.2024.5.1.18-28
Abstract
Formation of safety culture is a basic requirement of international standards and Roszdravnadzor’s Proposals (Practical Recommendations) for quality and safety of medical activities in Russian Federation. A developed safety culture influences the reduction of undesirable events in medical organization.
Aim. To assess the level of safety culture of the Clinical Center of Sechenov University with the subsequent development of a strategy for its improvement.
Materials and methods. The study was conducted using the Hospital Survey on Patient Safety questionnaire adapted by the authors according to the methodology of the Agency of Healthcare Research and Quality. A total of 1049 medical workers of the Clinical Center of Sechenov University participated in the survey. Statistics To assess the reliability and consistency of the obtained results, the Cronbach’s Alpha coefficient was calculated in IBM SPSS program, statistical analysis was performed, and comparative analysis with international databases was carried out.
Results. Middle medical personnel 45.2 % (n = 474), physicians 40.6 % (n = 426), junior medical personnel 11.7 % (n = 123), residents 2.5 % (n = 26) participated in the survey. Representatives of the most high-risk specialties participated more actively: anesthesiology and resuscitation 12.3 % (n = 129), surgery 9.6 % (n = 101), cardiology 8.3 % (n = 87). The strongest component of safety culture was teamwork within departments 83.1 % (n = 872). Nine components were found to be neutral. Two components were the weakest requiring improvement: staffing 44,5 % (n = 467) and non-punitive response to adverse events 47.1 % (n = 495). The overall safety culture level of the Clinical Center was 64 %. Comparative analysis with foreign data showed that the level of safety culture of the Clinical Center is higher than the average of the Organization for Economic Cooperation and Development countries and Saudi Arabia (52 %), and is on par with the indicators of medical organizations in the United States of America (65 %). The strategy for improving the safety culture of the Clinical Center has been to develop a culture of reporting: anonymous collection of reports of adverse events electronically, role-playing training of employees in a game format on how to report and deal with adverse events, and launching a competition, “Sechenovtsy for Safety. Incidents”.
About the Authors
V. V. FominRussian Federation
Victor V. Fomin – Corresponding Member of the RAS, Dr. of Sci. (Medicine), Professor, Vice-Rector for Innovation and Clinical Activities, Head of the Department of Faculty Therapy No.1
8/2, Trubetskaya str., Moscow, 119048
N. Yu. Gabuniya
Russian Federation
Nino Yu. Gabuniya – Deputy Director, Institute for Leadership and Health Management
8/2, Trubetskaya str., Moscow, 119048
N. A. Sokolov
Russian Federation
Nikita A. Sokolov – Cand. of Sci. (Medicine), Associate Professor, Department of Public Health and Healthcare named after N.A. Semashko; Head of the Department of monitoring of health care management, National Medical Research Center for «Anesthesiology and Critical Care Medicine (for adults)»
8/2, Trubetskaya str., Moscow, 119048
O. S. Volkova
Russian Federation
Olga S. Volkova – Cand. of Sci. (Medicine), Director of the Clinical Center
8/2, Trubetskaya str., Moscow, 119048
E. L. Rebrova
Russian Federation
Ekaterina L. Rebrova – Cand. of Sci. (Medicine), Head of the Department of Organizational Support and Quality Control of Clinical Center
8/2, Trubetskaya str., Moscow, 119048
V. V. Royuk
Russian Federation
Valeriy V. Royuk – Cand. of Sci. (Medicine), Associate Professor, Department of Public Health and Healthcare named after N.A. Semashko; Vice-Rector for Youth and Educational Work
8/2, Trubetskaya str., Moscow, 119048
V. Yu. Mikhailov
Russian Federation
Vasily Yu. Mikhailov – Cand. of Sci. (Medicine), Senior Researcher, Institute of Urology and Human Reproductive Health, Chief Physician, Clinical Hospital No. 2
8/2, Trubetskaya str., Moscow, 119048
D. O. Rozhkov
Russian Federation
Dmitry O. Rozhkov – Chief Physician, Clinical Hospital No. 3
8/2, Trubetskaya str., Moscow, 119048
A. A. Kovalenko
Russian Federation
Aleksey A. Kovalenko – Cand. of Sci. (Medicine), Associate Professor, Department of Restorative Medicine, Rehabilitation and Balneology, Chief Physician of Clinical Hospital No. 5
8/2, Trubetskaya str., Moscow, 119048
S. P. Semitko
Russian Federation
Sergey P. Semitko – Dr. of Sci. (Medicine), Professor, Department of Interventional Cardioangiology; Director of the Scientific and Practical Center for Interventional Cardioangiology
8/2, Trubetskaya str., Moscow, 119048
References
1. Roytberg G.E., Kondratova N.V. Methodological approaches to assessing safety culture in a medical organization. Siberian Journal of Life Sciences and Agriculture. 2016; 3(75): 57–71 (In Russian). https://doi.org/10.12731/wsd-2016-3-5
2. Gabunia N.Yu., Ivanov I.V., Matytsin N.O. Accreditation according to JCI standards of quality and safety of medical activities. Control points. Quality management in medicine. 2021; 4: 2–8 (In Russian). https://doi.org/10.35400/2658-5898-2021-4-2-8
3. Braithwaite J., Herkes J., Ludlow K., et al. Association between organisational and workplace cultures, and patient outcomes: systematic review. BMJ Open. 2016; 6: e017708. https://doi.org/10.1136/bmjopen-2016-013758
4. Sorra J., Khanna K., Dyer N., et al. Exploring relationships between patient safety culture and patients’ assessments of hospital care. J Patient Saf. 2012; 8(3): 131–139. https://doi.org/10.1097/PTS.0b013e318258ca46
5. Smith D.R., Muto T., Sairenchi T., et al. Hospital safety climate, psychosocial risk factors and needlestick injuries in Japan. Ind Health. 2010; 48(1): 85–95. https://doi.org/10.2486/indhealth.48.85
6. Mardon R.E., Khanna K., Sorra J., et al. Exploring relationships between hospital patient safety culture and adverse events. J Patient Saf. 2010; 6(4): 226–232. https://doi.org/10.1097/PTS.0b013e3181fd1a00
7. De Bienassis K., Klazinga N. Developing international benchmarks of patient safety culture in hospital care: Findings of the OECD patient safety culture pilot data collection and considerations for future work. Paris: OECD Health Working Papers. 2022; 134. 69 p. https://doi.org/10.1787/95ae65a3-en
8. Nieva V.F., Sorra J. Safety culture assessment: a tool for improving patient safety in healthcare organizations. Qual Saf Health Care. 2003; 12(2): 17–23. https://doi.org/10.1136/qhc.12.suppl_2.ii17
9. Gavrilenko O.V. Organizational culture and labor ethics in Soviet and Russian organizations: continuity and differences. Sociology. 2022; 5: 98–107 (In Russian)
10. Reason J. The contribution of latent human failures to the breakdown of complex systems. Philos Trans R Soc Lond B Biol Sci. 1990; 327(1241): 475–84. https://doi.org/10.1098/rstb.1990.0090
Review
For citations:
Fomin V.V., Gabuniya N.Yu., Sokolov N.A., Volkova O.S., Rebrova E.L., Royuk V.V., Mikhailov V.Yu., Rozhkov D.O., Kovalenko A.A., Semitko S.P. Assessment of the safety culture of the Clinical Center of Sechenov University. National Health Care (Russia). 2024;5(1):18-28. (In Russ.) https://doi.org/10.47093/2713-069X.2024.5.1.18-28