Quality and Safety Unit, Riviera-Chablais Hospital, Vevey, Switzerland.
IFROSS Institute, University of Lyon 3, Lyon, France.
Int J Qual Health Care. 2020 Nov 16;32(9):618-624. doi: 10.1093/intqhc/mzz062.
To assess the impact of implementation of the TeamSTEPPS teamwork improvement concept on patient safety culture.
Pre-post culture assessment using the Hospital Survey on Patient Safety Culture, at baseline and one year after implementation of TeamSTEPPS.
Two maternity wards within the same 480-bed multisite teaching hospital.
Implementation of the TeamSTEPPS teamwork improvement concept.
Analysis of variation of the percentage of positive responses (score) in both wards (intervention and control) was conducted.
There was a significant increase in scores in three dimensions of patient safety culture in the intervention ward: Supervisor/Manager Expectations and Actions Promoting Safety increased from 48.7% in 2015 to 70.8% in 2016 (P < 0.005); Teamwork Within Units increased from 35.5% in 2015 to 54.5% in 2016 (P < 0.005); Nonpunitive Response to Errors increased from 16.7% in 2015 to 32.3% in 2016 (P < 0.005). Other dimensions showed no significant changes. In the control ward, there was a significant decrease in scores in one dimension. A secondary analysis of differences in differences still shows significant improvement in one dimension (Supervisor/Manager Expectations and Actions Promoting Safety P < 0.005).
After implementing the TeamSTEPPS teamwork concept, patient safety culture significantly improved for three of twelve dimensions in the intervention group. When controlling for differences in baseline scores between implementation and control wards, a significant improvement remains in one dimension. This suggests that TeamSTEPPS could be considered when seeking to enhance patient safety culture, especially in high-risk environments such as maternity wards.
评估实施 TeamSTEPPS 团队改进理念对患者安全文化的影响。
使用患者安全文化医院调查，在实施 TeamSTEPPS 之前和一年后进行前后文化评估。
同一 480 床位多站点教学医院的两个产科病房。
实施 TeamSTEPPS 团队改进理念。
对两个病房（干预组和对照组）的正答率（分数）百分比的差异进行分析。
干预病房患者安全文化的三个维度的分数显著增加：主管/经理对安全的期望和行动从 2015 年的 48.7%增加到 2016 年的 70.8%（P <0.005）；单位内的团队合作从 2015 年的 35.5%增加到 2016 年的 54.5%（P <0.005）；对错误的非惩罚性反应从 2015 年的 16.7%增加到 2016 年的 32.3%（P <0.005）。其他维度没有显著变化。在对照组中，一个维度的分数显著下降。差异分析的二次分析仍然显示一个维度（主管/经理对安全的期望和行动）有显著改善（P <0.005）。
实施 TeamSTEPPS 团队理念后，干预组 12 个维度中的三个维度的患者安全文化显著改善。当控制实施和对照组之间的基线分数差异时，一个维度仍然有显著改善。这表明，在寻求增强患者安全文化时，可以考虑 TeamSTEPPS，尤其是在高风险环境（如产科病房）中。
