%0 Journal Article
%T Interplay Between Quantifiable and Unquantifiable Safety Climate as Affected by Successful Systems Approach to Medication Safety Improvement:Primary Care Settings
%J American Journal of Medicine and Medical Sciences
%@ 2165-9036
%D 2013
%I 
%R 10.5923/j.ajmms.20130301.01
%X The authors examine interrelation of safety attitude constructs measured with an Ambulatory Safety Attitudes Questionnaire(SAQ-A) and a successful intervention designed to reduce medication errors. This paper responds to WHO All Expert Working Group¡¯s 2012 call to understand this interrelationship. Authors set out to measure safety attitude changes in relation to the changes in Adverse Drug Events using a cluster randomized trial in which 12 Upstate New York Practice-based Research Network practices were each randomized to one of 3 states(4 practices each):(1)Team resource management intervention based on FMEA approach;(2)Team resource management intervention with Practice Enhancement Assistants;(3) No intervention(comparison group). Combined pre- and post-intervention scores of the safety attitudes constructs were: (a)stress recognition: 62 vs 64.8, (b)perceptions of management:64.3 vs 61.5,(c)working conditions: 68.1 vs 63.9,(d) teamwork climate: 75.4 vs 72.9,(e) safety climate: 73.3 vs 75.2, and (f) job satisfaction: 78.4 vs 77.0. Despite anecdotal reports to the contrary, the efficacious TRM intervention appeared to have had no significant effects on measured safety attitudes.The authors describe limitations of the work and put forward a concept of context-sensitive culture of safety.
%K Ambulatory
%K Attitude
%K Culture
%K Failure Modes
%K Medication
%K Primary Care
%K Safety
%U http://article.sapub.org/10.5923.j.ajmms.20130301.01.html