Safety attitudes and working climate after organizational change in a major emergency department in Sweden

Abstract

Background: Medically complex patients present challenges to the health care system, particularly in the emergency department (ED) setting. Specifically, teamwork is thought to affect staff safety climate, which in turn impacts patient safety.

Aim: This study aimed to evaluate the effect of organizational changes to interprofessional team assessment processes on staff perception of teamwork and safety attitudes in the ED.

Methods: This prospective observational study used cross-sectional design and measured ED staff perception of patient safety related domains at two time-points (before and after an organizational intervention), using the Safety Attitude Questionnaire.

Results: Statistically significant changes were seen among the overall sample (n = 112 at time point one and n = 121 at time point two) for the safety climate, working conditions, and stress recognition domains. Nurses and doctors showed different baseline attitudes and different responses to the intervention between the two time points.

Conclusion: The results reflect improved positive attitudes overall though there were differences in responses between the nursing and medical professions. The findings highlight opportunities to improve attitudes among ED team members through defined organizational change and learning from one another. Organizational change can affect staff perceptions of the safety climate and interprofessional teamwork, which may improve the ED working environment.

Keywords: Emergency department; Interprofessional; Patient safety; Safety attitude; Teamwork.