Authors (including presenting author) :
Ling M, Leung W, Lam S, Chui M , Chu K, Wong B, Chan E, Chung E, Lau M, Mak H, Chan V, Miu G
Affiliation :
KCC Pharmacy Patient Safety Culture Working Group
Introduction :
Numerous initiatives have been instituted in HA to improve medication safety throughout the years. Have we developed a culture on safety? A positive culture would be the bedrock for all initiatives to build on. And it would make our projects meaningful and sustainable.
Objectives :
A questionnaire survey was conducted
(1) To understand our patient safety culture;
(2) to examine areas of strengths and weaknesses;
(3) to allow individual work units to self-examine;
(4) to benchmark internally and externally.
Methodology :
The validated Agency for Healthcare Research and Quality (AHRQ) Survey on Patient Safety Culture, comprising 42 questions, and grouped into 12 composites, was administered. KCC comprises 12 hospital/clinic pharmacies. A census approach, whereby all staff were required to be surveyed with an option of nil return, was adopted.
Result & Outcome :
A total of 317 forms were issued and collected, including 18 blanks returns. The overall ratings of patient safety are Excellent (5 returns), Very Good (130), Acceptable (142), Poor (7), Failing (1). The top 4 composite scores are Frequency of Events Reported (1.0), Feedback & Communication about Error (0.74), Management Support for Patient Safety (0.65) and Teamwork within Unit (0.61). The lowest 4 composites are Staffing (-0.31), Non-punitive Response of Error (-0.14), Overall Perception of Safety (0.23) and Communication Openness (0.23). [Scale range: -2.0 to +2.0]. Individual question scores are highest for “No-patient-harm Events Reporting” (1.22), “Staff Informed” (1.05), “Safety-a-Priority for Management” (0.97) and “Near-miss Reporting” (0.93). Scores are lowest for “Insufficient Staff” (-0.70), “Working in “Crisis Mode”” (-0.67), “Staff Worry Mistake Kept in File” (-0.63) and “Working Long Hours” (-0.30). Detailed analyses were done with stratification by different work units, and staff groups. Work units of similar sizes and operations show surprising differences in scores. Benchmarking with USA hospital survey is made showing interesting similarities and differences. Conclusions: This is the first survey of pharmacy patient safety culture in Hong Kong. It shows an overall positive culture for the KCC cluster, with strengths in incidents reporting and feedback, and weaknesses in staff and non-punitive culture. The database is useful in helping individual units to explore their shortcomings and formulate improvements. Focus groups would be formed to utlise the data in more details. Further surveys in the future could provide trending after improvement measures have been implemented.
