Patient safety culture in Norwegian primary care: A study in out-of-hours casualty clinics and GP practices

Abstract

Objective. This study aimed to investigate patient safety attitudes amongst health care providers in Norwegian primary care by using the Safety Attitudes Questionnaire, in both out-of-hours (OOH) casualty clinics and GP practices. The questionnaire identifies five major patient safety factors: Teamwork climate, Safety climate, Job satisfaction, Perceptions of management, and Working conditions. Design. Cross-sectional study. Statistical analysis included multiple linear regression and independent samples t-tests. Setting. Seven OOH casualty clinics and 17 GP practices in Norway. Subjects. In October and November 2012, 510 primary health care providers working in OOH casualty clinics and GP practices (316 doctors and 194 nurses) were invited to participate anonymously. Main outcome measures. To study whether patterns in patient safety attitudes were related to professional background, gender, age, and clinical setting. Results. The overall response rate was 52%; 72% of the nurses and 39% of the doctors answered the questionnaire. In the OOH clinics, nurses scored significantly higher than doctors on Safety climate and Job satisfaction. Older health care providers scored significantly higher than younger on Safety climate and Working conditions. In GP practices, male health professionals scored significantly higher than female on Teamwork climate, Safety climate, Perceptions of management and Working conditions. Health care providers in GP practices had significant higher mean scores on the factors Safety climate and Working conditions, compared with those working in the OOH clinics. Conclusion. Our study showed that nurses scored higher than doctors, older health professionals scored higher than younger, male GPs scored higher than female GPs, and health professionals in GP practices scored higher than those in OOH clinics – on several patient safety factors.

Key Words::

• Adverse events
• general practice
• medical errors
• Norway
• out-of-hours
• patient safety culture
• primary care
• Safety Attitudes Questionnaire

Acknowledgements

The authors would like to thank the health care providers in the seven OOH casualty clinics and 17 GP practices for participating in the study.

Contributors

GTB was responsible for designing the study, developing the Norwegian version of the SAQ-AV questionnaire, data collection, analysis and interpretation of data, and writing the manuscript.

DH participated in developing the Norwegian SAQ-AV questionnaire, and was responsible for the statistical analysis and interpretation of results, in addition to revising the manuscript critically.

EHH participated in designing the study, developing the Norwegian SAQ-AV questionnaire, data collection, and revising the manuscript critically.

ECTD participated in designing the study, developing the Norwegian SAQ-AV questionnaire, data analyses and interpretation, and writing the manuscript.

All authors read and approved the final manuscript.

Funding

The study was funded by the National Centre for Emergency Primary Health Care, Uni Research Health, Bergen, Norway and the Norwegian Knowledge Centre for the Health Services, Norway.

Declaration of interest

There are no conflicts of interest in connection with the paper. The authors alone are responsible for the content and writing of the paper.