PMID- 29917154
OWN - NLM
STAT- MEDLINE
DCOM- 20190723
LR  - 20190723
IS  - 1464-3677 (Electronic)
IS  - 1353-4505 (Linking)
VI  - 31
IP  - 3
DP  - 2019 Apr 1
TI  - Improving the safety climate in hospitals by a vignette-based analysis of adverse 
      events: a cluster randomised study.
PG  - 212-218
LID - 10.1093/intqhc/mzy126 [doi]
AB  - OBJECTIVE: To assess the impact of a vignette-based analysis of adverse events 
      (AEs) on the safety climate (SC) of care units. DESIGN: Prospective, open, 
      cluster (a unit) randomised controlled trial. SETTING: Eighteen acute care units 
      of seven hospitals in France. PARTICIPANTS: Healthcare providers who worked in 
      the units. INTERVENTION: Vignette-based analyses of AEs were conducted with 
      unit's providers once per month for six consecutive months. The AEs were real 
      cases that occurred in other hospitals. The hospital risk manager conducted each 
      analysis as follows: analysis of the immediate and root causes of the AE; 
      assessment of the care unit's vulnerabilities and existing barriers in the 
      occurrence of an identical AE and search for solutions. MAIN OUTCOME MEASURE: SC 
      was measured using the French version of the Hospital Survey on Patient Safety 
      Culture questionnaire. The primary outcome was the difference in the 
      'Organisational learning and continuous improvement' dimension score, from before 
      to after the analyses. RESULTS: Median participation rate in the analyses was 20% 
      (range: 7-45%). Before intervention, the response rate to the SC survey was 80% 
      (n = 210) in the intervention group and 73% (n = 191) in the control group. After 
      intervention, it was 59% (n = 141) and 63% (n = 148), respectively. The dimension 
      score evolved differently for the groups from before to after intervention 
      (intervention: +10.2 points +/-8.8; control: -3.0 points +/-8.5, P = 0.04). Side 
      effects were not measured. CONCLUSIONS: Vignette-based analysis was associated 
      with the improvement of the perception of participants regarding their 
      institution's capacity for organisational learning and continuous improvement.
CI  - (c) The Author(s) 2018. Published by Oxford University Press in association with 
      the International Society for Quality in Health Care. All rights reserved. For 
      permissions, please e-mail: journals.permissions@oup.com.
FAU - Occelli, Pauline
AU  - Occelli P
AD  - Hospices Civils de Lyon, Pole de Sante Publique, Lyon, France.
AD  - Health Services and Performance Research (EA 7425 HESPER), Universite de Lyon 1, 
      Lyon, France.
FAU - Quenon, Jean-Luc
AU  - Quenon JL
AD  - Comite de coordination de l'evaluation clinique et de la qualite en Aquitaine, 
      Pessac, France.
FAU - Kret, Marion
AU  - Kret M
AD  - Comite de coordination de l'evaluation clinique et de la qualite en Aquitaine, 
      Pessac, France.
FAU - Domecq, Sandrine
AU  - Domecq S
AD  - Comite de coordination de l'evaluation clinique et de la qualite en Aquitaine, 
      Pessac, France.
FAU - Denis, Angelique
AU  - Denis A
AD  - Hospices Civils de Lyon, Pole de Sante Publique, Lyon, France.
AD  - Health Services and Performance Research (EA 7425 HESPER), Universite de Lyon 1, 
      Lyon, France.
FAU - Delaperche, Florence
AU  - Delaperche F
AD  - Comite de coordination de l'evaluation clinique et de la qualite en Aquitaine, 
      Pessac, France.
FAU - Claverie, Olivier
AU  - Claverie O
AD  - Laboratoire des problemes sociaux et de l'action collective departement de 
      sociologie, Universite Victor Segalen, Bordeaux, France.
FAU - Castets-Fontaine, Benjamin
AU  - Castets-Fontaine B
AD  - Laboratoire des problemes sociaux et de l'action collective departement de 
      sociologie, Universite Victor Segalen, Bordeaux, France.
FAU - Amalberti, Rene
AU  - Amalberti R
AD  - Institut de medecine aerospatiale du service de sante des armees, Bretigny sur 
      Orge, France.
AD  - Haute autorite de sante, Saint-Denis, France.
FAU - Auroy, Yves
AU  - Auroy Y
AD  - Institut de medecine aerospatiale du service de sante des armees, Bretigny sur 
      Orge, France.
AD  - Hopital d'instruction des armees du Val de Grace, Paris, France.
FAU - Parneix, Pierre
AU  - Parneix P
AD  - Centre de coordination de la lutte contre les infections nosocomiales Sud-Ouest, 
      Bordeaux, France.
FAU - Michel, Philippe
AU  - Michel P
AD  - Health Services and Performance Research (EA 7425 HESPER), Universite de Lyon 1, 
      Lyon, France.
AD  - Comite de coordination de l'evaluation clinique et de la qualite en Aquitaine, 
      Pessac, France.
AD  - Hospices Civils de Lyon, Lyon France.
LA  - eng
PT  - Journal Article
PT  - Randomized Controlled Trial
PL  - England
TA  - Int J Qual Health Care
JT  - International journal for quality in health care : journal of the International 
      Society for Quality in Health Care
JID - 9434628
MH  - Cluster Analysis
MH  - France
MH  - Hospitals
MH  - Humans
MH  - Medical Errors/*prevention & control
MH  - Patient Safety/*standards
MH  - Prospective Studies
MH  - Quality Improvement/*organization & administration
MH  - Safety Management/organization & administration/*standards
MH  - Surveys and Questionnaires
OTO - NOTNLM
OT  - cluster trials
OT  - healthcare quality improvement
OT  - risk management
OT  - root cause analysis
OT  - safety culture
EDAT- 2018/06/20 06:00
MHDA- 2019/07/25 06:00
CRDT- 2018/06/20 06:00
PHST- 2017/01/09 00:00 [received]
PHST- 2018/03/20 00:00 [revised]
PHST- 2018/05/26 00:00 [accepted]
PHST- 2018/06/20 06:00 [pubmed]
PHST- 2019/07/25 06:00 [medline]
PHST- 2018/06/20 06:00 [entrez]
AID - 5039884 [pii]
AID - 10.1093/intqhc/mzy126 [doi]
PST - ppublish
SO  - Int J Qual Health Care. 2019 Apr 1;31(3):212-218. doi: 10.1093/intqhc/mzy126.