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Improving safety culture on adult medical units through multidisciplinary teamwork and communication interventions: the TOPS Project
  1. M A Blegen1,
  2. N L Sehgal2,
  3. B K Alldredge3,
  4. S Gearhart1,
  5. A A Auerbach2,
  6. 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}


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.

  • Patient safety
  • healthcare quality improvement
  • quality of care
  • medication error
  • adverse event
  • safety culture
  • team training

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  • 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.