Study Examines Safety Climate and Support Within Cardiac Surgical Teams

MedicalResearch.com Interview with:
Jill A. Marsteller, PhD, MPP
Department of Health Policy and Management,
Johns Hopkins Bloomberg School of Public Health
Baltimore, Maryland and
Juan A. Sanchez, MD, MPA, FACS, FACC
Associate Professor of Surgery
Associate Faculty, Armstrong Institute for Patient Safety and Quality
Johns Hopkins Medicine

Medical Research: What is the background for this study? What are the main findings?

Response: The culture of healthcare organizations with regards to safety has an impact on patient outcomes.  A strong culture serves as a platform for preventing medical errors. This study examines the culture of safety along several dimensions in cardiac surgical teams and compares this data to surgery of all types using a large database. In our study, cardiac surgery teams scored highest in teamwork and lowest in non-punitive responses to error.  In addition, there was substantial variation on safety climate perception across team roles. For example, surgeons and support staff had higher perceptions of a safety climate than other team members. Compared to all types of surgery teams, cardiac surgery teams scored higher in overall perceptions of safety except for anesthesiologists who reported lower scores on communication about errors and communication openness.

Medical Research: What should clinicians and patients take away from your report?

Response: Surgical teams vary substantially in their perception of safety culture. In general, cardiac surgical teams have a higher perception of safety than other surgical teams but this perception varies considerably among different team members. Cardiac surgical teams may need to focus on ways to improve their level of communication and non-punitive responses in order to make improvements in the safety attitudes of their teams.

Medical Research: What recommendations do you have for future research as a result of this study?

Response: Further research should focus on understanding the causes of variability in perceptions and on designing interventions to identify and replicate team behaviors which accentuate positive perceptions and mitigate negative ones.​

Citation:

Safety Culture in Cardiac Surgical Teams: Data From Five Programs and National Surgical Comparison

Jill A. Marsteller, PhD, MPP,  Mei Wen, PhD,Yea-Jen Hsu, PhD,  Laura C. Bauer, MPH, Nanette M. Schwann, MD, Christopher J. Young, MD, Juan A. Sanchez, MD, MPA, Nicole A. Errett, MSPH,Ayse P. Gurses, PhD, David A. Thompson, DNS, MS, Joyce A. Wahr, MD, Elizabeth A. Martinez, MD, MHS

Annals Thoracic Surgery Accepted: May 20, 2015; Published Online: August 29, 2015
Publication stage: In Press Corrected Proof

DOI: http://dx.doi.org/10.1016/j.athoracsur.2015.05.109

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Last Updated on September 1, 2015 by Marie Benz MD FAAD

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