BMJ Qual Saf doi:10.1136/bmjqs.2010.047605

Improving patient safety: the comparative views of patient-safety specialists, workforce staff and managers

  1. Philip Robinson6
  1. 1Centre for Clinical Governance Research, Faculty of Medicine, University of New South Wales, Sydney, Australia
  2. 2Australian Institute of Health Innovation, Faculty of Medicine, University of New South Wales, Sydney, Australia
  3. 3Quorus Consulting, Sydney, Australia
  4. 4Communio Pty Ltd, Sydney, Australia
  5. 5Safety and Quality Clinical Systems, Department of Health, Adelaide, South Australia
  6. 6Children, Youth and Women's Health Service, Department of Health, Adelaide, South Australia
  1. Correspondence to Professor Jeffrey Braithwaite, Australian Institute of Health Innovation, Faculty of Medicine, University of New South Wales, NSW 2052, Australia; j.braithwaite{at}
  • Accepted 8 December 2010
  • Published Online First 17 January 2011


Introduction Methods for improving patient safety are predicated on cooperation between healthcare groups, but are the views of health professionals involved in promoting safety shared by other healthcare workforce staff and managers?

Aim To compare patient-safety suggestions from health workforce managerial and staff groups with those of patient-safety specialists.

Method Samples of managers (424) and staff (1214) in the South Australian state health system and 131 Australian patient-safety specialists were asked to write suggestions for improving patient safety. Group responses were content analysed and compared.

Results Patient-safety specialists (83.2%) were more likely to make suggestions than were workforce managers (57.8%) or staff (44.1%). Workforce members from clinical professions were more likely than non-clinicians to tender suggestions. No relationship existed between the importance specialists and managers (ρ=−0.062, p=0.880) and specialists and staff (ρ=−0.046, p=0.912) attached to nine categories of suggestions. There was a high correlation between the importance that managers and non-managers attached to safety strategies (ρ=0.817, p=0.011). Among those who made suggestions, specialists were more likely to suggest implementing reviews and guidelines, and incident reporting. Workforce groups were more likely to recommend increased and improved staffing and staffing conditions, and better equipment and infrastructure. There were no significant differences in the proportions of group members recommending: improving management and leadership; increasing staff safety education and supervision; communication and teamwork; improved patient focus; or tackling specific safety projects.

Implications Differences between safety specialists' and workforce groups' beliefs about how to improve patient safety may impede the successful implementation of patient-safety programmes.


  • Funding JB receives funding for research into patient safety from the National Health and Medical Research Council. This research is supported in part by National Health and Medical Research Council Programme Grant 568612.

  • Competing interests None.

  • Ethics approval Ethics approval was provided by the South Australian Department of Health's Human Research Ethics Committee.

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

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