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Qual Saf Health Care 19:346-350 doi:10.1136/qshc.2008.031252
  • Education and training

Improving safety culture on adult medical units through multidisciplinary teamwork and communication interventions: the TOPS Project

  1. R M Wachter2
  1. 1School of Nursing, University of California, San Francisco, San Francisco, California, USA
  2. 2Division of Hospital Medicine, University of California, San Francisco, San Francisco, California, USA
  3. 3School of Pharmacy, University of California, San Francisco, San Francisco, California, USA
  1. Correspondence to Mary A Blegen, Community Health Systems Department, School of Nursing, University of California, San Francisco, 2 Koret Way, Box 0608, San Francisco, CA 94143, USA; mary.blegen{at}nursing.ucsf.edu

  1. Contributors The six authors listed for this article all contributed to the design of the study, the development of the team training intervention and the choice of tools for evaluating the impact. Their direction was also important in the analysis and reporting of results. In addition, the following persons are acknowledged for their contribution as site champions and support staff for this work: UCSF Medical Center champions were Thomas Bookwalter PharmD, Terri Evans, Michael Fox RN, Brian Sharpe MD, Arpana Vidyarthi MD; El Camino champions were Michael Podlone MD, Sue Schutt RN, Delphina Payer, Janie Lowe PharmD; Kaiser Permanent San Francisco champions were Rachel Mueller RN, Clarissa Johnston, MD, Paul Preston, MD.

  • Accepted 11 November 2009

Abstract

Aim The goal of this project was to improve unit-based safety culture through implementation of a multidisciplinary (pharmacy, nursing, medicine) teamwork and communication intervention.

Method The Agency for Healthcare Research and Quality Hospital Survey on Patient Safety Culture was used to determine the impact of the training with a before–after design.

Results Surveys were returned from 454 healthcare staff before the training and 368 staff 1 year later. Five of eleven safety culture subscales showed significant improvement. Nurses perceived a stronger safety culture than physicians or pharmacists.

Conclusion While it is difficult to isolate the effects of the team training intervention from other events occurring during the year between training and postevaluation, overall the intervention seems to have improved the safety culture on these medical units.

Footnotes

  • Funding The project was generously supported by the Gordon and Betty Moore Foundation.

  • Competing interests None.

  • Ethics approval This study was conducted with the approval of the Committee for Human Research at the University of California San Francisco.

  • Provenance and peer review Not commissioned; externally peer reviewed.