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Factors influencing the implementation of a hospitalwide intervention to promote professionalism and build a safety culture: a qualitative study
journal contribution
posted on 2019-10-01, 00:00 authored by L N McKenzie, L Shaw, J E Jordan, M Alexander, M O'Brien, S J Singer, Elizabeth ManiasElizabeth ManiasBackground: There is widespread recognition that creating a safety culture supports high-quality health care. However, the complex factors affecting cultural change interventions are not well understood. This study examines factors influencing the implementation of an intervention to promote professionalism and build a safety culture at an Australian hospital. Methods: The study was completed midway into the three-year intervention and involved collecting qualitative data from two sources. First, face-to-face interviews were conducted pre- and mid-intervention with a purposely selected sample. Second, a survey with three open-ended questions was completed one year into the intervention by clinical and patient support staff. Data from interviews and survey questions were analyzed using a combination of inductive and deductive approaches. Results: A total of 25 participants completed preintervention interviews, and 24 took part mid-intervention. Of the 2,047 staff who completed the survey (61% response rate), 59.1% of respondents answered at least one open-ended question. Multiple interrelated factors were identified as enhancing intervention implementation. These include sustaining a favorable implementation climate, leaders consistently demonstrating behaviors that support a safety culture, increasing compatibility of working conditions with intervention aims, building confidence in systems to address unprofessional behaviors, and responding to evolving needs. Conclusion: Strengthening safety culture remains an enduring challenge, but this study yields valuable insights into factors influencing implementation of a multifaceted behavior change intervention. The findings provide a basis for practical strategies that health care leaders seeking cultural improvements can employ to enhance the delivery of similar interventions and address potential impediments to success.
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Journal
Joint commission journal on quality and patient safetyVolume
45Issue
10Pagination
694 - 705Publisher
ElsevierLocation
Amsterdam, The NetherlandsPublisher DOI
ISSN
1553-7250Language
engPublication classification
C1 Refereed article in a scholarly journalCopyright notice
2019, The Joint CommissionUsage metrics
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