Authors (including presenting author) :
Chu KY(1), Lam MWS(1), Leung WYS(1) and KCC Pharmacy Patient Safety Culture Working Group(2)
Affiliation :
(1)Pharmacy Department, Queen Elizabeth Hospital (2)Pharmacy Department, Kowloon Central Cluster
Introduction :
Creating a culture of patient safety is important for safe delivery of healthcare including pharmacy service.
Objectives :
1. Report the subgroup analysis of patient safety survey findings in QEH pharmacy staff 2. Conduct comparisons within QEH pharmacy: Main Pharmacy, Ambulatory Care Center(ACC) pharmacy and Aseptic Dispensing Unit(ADU) 3. Identify improvement areas for enhancing medication safety
Methodology :
A patient safety culture survey was conducted in all KCC pharmacies using the validated AHRQ questionnaire. The survey contained 12 composites and 42 questions which were scored using Likert scale (1=strongly disagree and 5=strongly agree). The scores were converted to -2.0 to +2.0. A census approach, whereby all staff were required to be surveyed with an option of nil return, was adopted.
Result & Outcome :
A total of 123 surveys were issued and collected in QEH pharmacy. The overall ratings of patient safety are Excellent(3 returns), Very Good(53), Acceptable(57), Poor(4), Failing(0). In Main Pharmacy, the top three composite scores are Frequency of Events Reported(0.95), Feedback about Error(0.78) and Management Support for Patient Safety(0.53). The lowest three composites are Staffing(-0.41), Nonpunitive Response to Errors(-0.20) and Communication Openness(0.03). In ACC pharmacy, the top three composite scores are the same as in Main Pharmacy: Events Reported(0.86), Feedback about Error(0.77) and Management Support for Safety(0.66). The lowest three composites are Staffing(-0.57), Nonpunitive Response to Errors(-0.30) and Overall Perceptions of Patient Safety(0). In ADU, the top three composite scores are Teamwork Within Units (1.17), Communication Openness(0.90) and Feedback about Error(0.89). The lowest three composites are Staffing(-0.15), Nonpunitive Response to Errors(0.10) and Overall Perceptions of Patient Safety(0.41). The pharmacist-to-dispenser proportion, dispensing job nature, physical environment and year of supervisors’ experience appear to account for the significant variations in scores between ADU vs ACC+Main Pharmacy. ADU demonstrates relatively higher scores in ‘people treat each other with respect’, and ‘staff freely speak up if something negatively affects patient care’. All sections show relatively low scores in ‘insufficient staff’ and ‘staff worry mistakes kept in file’. Results are also benchmarked with other KCC pharmacies and US hospitals. Survey findings reflect an overall positive culture. The variations in ratings between QEH pharmacy sections suggest different views on the patient safety from staff’s perspective. A focus group has been formed from different staff ranks and sections to share good practices and suggest safety initiatives. Further surveys in future could provide trending after improvement measures have been implemented.
