Errors and the Burden of Errors

Attitudes, Perceptions, and the Culture of Safety in Pediatric Cardiac Surgical Teams

Agnes Bognár, Paul Barach, Julie K. Johnson, Robert C. Duncan, David Birnbach, Donna Woods, Jane L. Holl, Emile A. Bacha

Research output: Contribution to journalArticle

81 Citations (Scopus)

Abstract

Background: The fear of committing clinical errors in perioperative care has a negative impact on the psychological well-being of surgical team members and ultimately on patient care. We assessed the perceptions and attitudes of surgical teams relative to committing errors, the impact of errors, and the culture of safety. Methods: Pediatric cardiac surgery team members at three academic hospitals were surveyed. The survey included scaled, open-ended questions and a clinical vignette. Respondents were asked about the safety climate, team climate, stress recognition, and the impact of error as they relate to making and the anticipation of making clinical errors. Results: The response rate was 69%. Safety attitudes were influenced by the work environment climate. Many respondents felt unable to express disagreement and had difficulty raising safety concerns. Staffing levels, equipment availability, production pressures, and hectic schedules were concerns. Respondents admitted that errors occurred repeatedly, and that guidelines and policies were often disregarded. Conclusions: A psychometrically sound teamwork culture tool was used and demonstrated that surgical teams are influenced by the recognition of medical errors and that these errors carry significant personal burden. The findings suggest that the safety attitudes among team members may impact their performance and need to be carefully taken into consideration. Providers' reluctance to share safety events with others, as well as the perceived powerlessness to prevent events, must be addressed as part of an overall strategy to improve patient care outcomes. The study points to the need to address teamwork culture in efforts to improve patient care.

Original languageEnglish
Pages (from-to)1374-1381
Number of pages8
JournalAnnals of Thoracic Surgery
Volume85
Issue number4
DOIs
StatePublished - Apr 1 2008

Fingerprint

Safety Management
Pediatrics
Safety
Climate
Patient Care
Perioperative Care
Medical Errors
Thoracic Surgery
Fear
Appointments and Schedules
Guidelines
Psychology
Pressure
Equipment and Supplies
Surveys and Questionnaires

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery

Cite this

Errors and the Burden of Errors : Attitudes, Perceptions, and the Culture of Safety in Pediatric Cardiac Surgical Teams. / Bognár, Agnes; Barach, Paul; Johnson, Julie K.; Duncan, Robert C.; Birnbach, David; Woods, Donna; Holl, Jane L.; Bacha, Emile A.

In: Annals of Thoracic Surgery, Vol. 85, No. 4, 01.04.2008, p. 1374-1381.

Research output: Contribution to journalArticle

Bognár, Agnes ; Barach, Paul ; Johnson, Julie K. ; Duncan, Robert C. ; Birnbach, David ; Woods, Donna ; Holl, Jane L. ; Bacha, Emile A. / Errors and the Burden of Errors : Attitudes, Perceptions, and the Culture of Safety in Pediatric Cardiac Surgical Teams. In: Annals of Thoracic Surgery. 2008 ; Vol. 85, No. 4. pp. 1374-1381.
@article{e4266394d53a462fa203580147e06571,
title = "Errors and the Burden of Errors: Attitudes, Perceptions, and the Culture of Safety in Pediatric Cardiac Surgical Teams",
abstract = "Background: The fear of committing clinical errors in perioperative care has a negative impact on the psychological well-being of surgical team members and ultimately on patient care. We assessed the perceptions and attitudes of surgical teams relative to committing errors, the impact of errors, and the culture of safety. Methods: Pediatric cardiac surgery team members at three academic hospitals were surveyed. The survey included scaled, open-ended questions and a clinical vignette. Respondents were asked about the safety climate, team climate, stress recognition, and the impact of error as they relate to making and the anticipation of making clinical errors. Results: The response rate was 69{\%}. Safety attitudes were influenced by the work environment climate. Many respondents felt unable to express disagreement and had difficulty raising safety concerns. Staffing levels, equipment availability, production pressures, and hectic schedules were concerns. Respondents admitted that errors occurred repeatedly, and that guidelines and policies were often disregarded. Conclusions: A psychometrically sound teamwork culture tool was used and demonstrated that surgical teams are influenced by the recognition of medical errors and that these errors carry significant personal burden. The findings suggest that the safety attitudes among team members may impact their performance and need to be carefully taken into consideration. Providers' reluctance to share safety events with others, as well as the perceived powerlessness to prevent events, must be addressed as part of an overall strategy to improve patient care outcomes. The study points to the need to address teamwork culture in efforts to improve patient care.",
author = "Agnes Bogn{\'a}r and Paul Barach and Johnson, {Julie K.} and Duncan, {Robert C.} and David Birnbach and Donna Woods and Holl, {Jane L.} and Bacha, {Emile A.}",
year = "2008",
month = "4",
day = "1",
doi = "10.1016/j.athoracsur.2007.11.024",
language = "English",
volume = "85",
pages = "1374--1381",
journal = "Annals of Thoracic Surgery",
issn = "0003-4975",
publisher = "Elsevier USA",
number = "4",

}

TY - JOUR

T1 - Errors and the Burden of Errors

T2 - Attitudes, Perceptions, and the Culture of Safety in Pediatric Cardiac Surgical Teams

AU - Bognár, Agnes

AU - Barach, Paul

AU - Johnson, Julie K.

AU - Duncan, Robert C.

AU - Birnbach, David

AU - Woods, Donna

AU - Holl, Jane L.

AU - Bacha, Emile A.

PY - 2008/4/1

Y1 - 2008/4/1

N2 - Background: The fear of committing clinical errors in perioperative care has a negative impact on the psychological well-being of surgical team members and ultimately on patient care. We assessed the perceptions and attitudes of surgical teams relative to committing errors, the impact of errors, and the culture of safety. Methods: Pediatric cardiac surgery team members at three academic hospitals were surveyed. The survey included scaled, open-ended questions and a clinical vignette. Respondents were asked about the safety climate, team climate, stress recognition, and the impact of error as they relate to making and the anticipation of making clinical errors. Results: The response rate was 69%. Safety attitudes were influenced by the work environment climate. Many respondents felt unable to express disagreement and had difficulty raising safety concerns. Staffing levels, equipment availability, production pressures, and hectic schedules were concerns. Respondents admitted that errors occurred repeatedly, and that guidelines and policies were often disregarded. Conclusions: A psychometrically sound teamwork culture tool was used and demonstrated that surgical teams are influenced by the recognition of medical errors and that these errors carry significant personal burden. The findings suggest that the safety attitudes among team members may impact their performance and need to be carefully taken into consideration. Providers' reluctance to share safety events with others, as well as the perceived powerlessness to prevent events, must be addressed as part of an overall strategy to improve patient care outcomes. The study points to the need to address teamwork culture in efforts to improve patient care.

AB - Background: The fear of committing clinical errors in perioperative care has a negative impact on the psychological well-being of surgical team members and ultimately on patient care. We assessed the perceptions and attitudes of surgical teams relative to committing errors, the impact of errors, and the culture of safety. Methods: Pediatric cardiac surgery team members at three academic hospitals were surveyed. The survey included scaled, open-ended questions and a clinical vignette. Respondents were asked about the safety climate, team climate, stress recognition, and the impact of error as they relate to making and the anticipation of making clinical errors. Results: The response rate was 69%. Safety attitudes were influenced by the work environment climate. Many respondents felt unable to express disagreement and had difficulty raising safety concerns. Staffing levels, equipment availability, production pressures, and hectic schedules were concerns. Respondents admitted that errors occurred repeatedly, and that guidelines and policies were often disregarded. Conclusions: A psychometrically sound teamwork culture tool was used and demonstrated that surgical teams are influenced by the recognition of medical errors and that these errors carry significant personal burden. The findings suggest that the safety attitudes among team members may impact their performance and need to be carefully taken into consideration. Providers' reluctance to share safety events with others, as well as the perceived powerlessness to prevent events, must be addressed as part of an overall strategy to improve patient care outcomes. The study points to the need to address teamwork culture in efforts to improve patient care.

UR - http://www.scopus.com/inward/record.url?scp=40849088215&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=40849088215&partnerID=8YFLogxK

U2 - 10.1016/j.athoracsur.2007.11.024

DO - 10.1016/j.athoracsur.2007.11.024

M3 - Article

VL - 85

SP - 1374

EP - 1381

JO - Annals of Thoracic Surgery

JF - Annals of Thoracic Surgery

SN - 0003-4975

IS - 4

ER -