Luke R Putnam1, Shauna M Levy2, Caroline M Kellagher3, Jason M Etchegaray4, Eric J Thomas4, Lillian S Kao5, Kevin P Lally1, KuoJen Tsao6. 1. Center for Surgical Trials and Evidence-Based Practice, University of Texas Medical School at Houston, Houston, Texas; Department of Pediatric Surgery, University of Texas Medical School at Houston, Houston, Texas; Children's Memorial Hermann Hospital, Houston, Texas. 2. Center for Surgical Trials and Evidence-Based Practice, University of Texas Medical School at Houston, Houston, Texas; Department of Pediatric Surgery, University of Texas Medical School at Houston, Houston, Texas. 3. Department of Pediatric Surgery, University of Texas Medical School at Houston, Houston, Texas. 4. Department of Internal Medicine, University of Texas Medical School at Houston, Houston, Texas. 5. Center for Surgical Trials and Evidence-Based Practice, University of Texas Medical School at Houston, Houston, Texas; Department of General Surgery, University of Texas Medical School at Houston, Houston, Texas. 6. Center for Surgical Trials and Evidence-Based Practice, University of Texas Medical School at Houston, Houston, Texas; Department of Pediatric Surgery, University of Texas Medical School at Houston, Houston, Texas; Children's Memorial Hermann Hospital, Houston, Texas. Electronic address: kuojen.tsao@uth.tmc.edu.
Abstract
BACKGROUND: Effective communication and patient safety practices are paramount in health care. Surgical residents play an integral role in the perioperative team, yet their perceptions of patient safety remain unclear. We hypothesized that surgical residents perceive the perioperative environment as more unsafe than their faculty and operating room staff despite completing a required safety curriculum. MATERIALS AND METHODS: Surgeons, anesthesiologists, and perioperative nurses in a large academic children's hospital participated in multifaceted, physician-led workshops aimed at enhancing communication and safety culture over a 3-y period. All general surgery residents from the same academic center completed a hospital-based online safety curriculum only. All groups subsequently completed the psychometrically validated safety attitudes questionnaire to evaluate three domains: safety culture, teamwork, and speaking up. Results reflect the percent of respondents who slightly or strongly agreed. Chi-square analysis was performed. RESULTS: Sixty-three of 84 perioperative personnel (75%) and 48 of 52 surgical residents (92%) completed the safety attitudes questionnaire. A higher percentage of perioperative personnel perceived a safer environment than the surgical residents in all three domains, which was significantly higher for safety culture (68% versus 46%, P = 0.03). When stratified into two groups, junior residents (postgraduate years 1-2) and senior residents (postgraduate years 3-5) had lower scores for all three domains, but the differences were not statistically significant. CONCLUSIONS: Surgical residents' perceptions of perioperative safety remain suboptimal. With an enhanced safety curriculum, perioperative staff demonstrated higher perceptions of safety compared with residents who participated in an online-only curriculum. Optimal surgical education on patient safety remains unknown but should require a dedicated, systematic approach.
BACKGROUND: Effective communication and patient safety practices are paramount in health care. Surgical residents play an integral role in the perioperative team, yet their perceptions of patient safety remain unclear. We hypothesized that surgical residents perceive the perioperative environment as more unsafe than their faculty and operating room staff despite completing a required safety curriculum. MATERIALS AND METHODS: Surgeons, anesthesiologists, and perioperative nurses in a large academic children's hospital participated in multifaceted, physician-led workshops aimed at enhancing communication and safety culture over a 3-y period. All general surgery residents from the same academic center completed a hospital-based online safety curriculum only. All groups subsequently completed the psychometrically validated safety attitudes questionnaire to evaluate three domains: safety culture, teamwork, and speaking up. Results reflect the percent of respondents who slightly or strongly agreed. Chi-square analysis was performed. RESULTS: Sixty-three of 84 perioperative personnel (75%) and 48 of 52 surgical residents (92%) completed the safety attitudes questionnaire. A higher percentage of perioperative personnel perceived a safer environment than the surgical residents in all three domains, which was significantly higher for safety culture (68% versus 46%, P = 0.03). When stratified into two groups, junior residents (postgraduate years 1-2) and senior residents (postgraduate years 3-5) had lower scores for all three domains, but the differences were not statistically significant. CONCLUSIONS: Surgical residents' perceptions of perioperative safety remain suboptimal. With an enhanced safety curriculum, perioperative staff demonstrated higher perceptions of safety compared with residents who participated in an online-only curriculum. Optimal surgical education on patient safety remains unknown but should require a dedicated, systematic approach.
Authors: Ji Hyun Yang; Klaorat Prasongdee; Ivy Riano; Elman Urbina; Alekya Poloju; Thomas Treadwell; Eric Chun Journal: J Community Hosp Intern Med Perspect Date: 2022-01-31