Open Access Research article

Residents' intentions and actions after patient safety education

José D Jansma12*, Cordula Wagner23 and Arnold B Bijnen14

Author Affiliations

1 Foreest Medical School, Medical Center Alkmaar, Wilhelminalaan 12, 1815JD Alkmaar, the Netherlands

2 EMGO Institute for Health and Care Research, VU University Medical Center, Van der Boechorststraat 7, 1081BT Amsterdam, the Netherlands

3 NIVEL Netherlands Institute for Health Services Research, Otterstraat 118 - 124, 3500BN Utrecht, the Netherlands

4 VU University Medical Center, Institute for Education and Training, Van der Boechorststraat 7, 1081BT Amsterdam, the Netherlands

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BMC Health Services Research 2010, 10:350  doi:10.1186/1472-6963-10-350

Published: 31 December 2010

Abstract

Background

Medical residents are key figures in delivering care and an important target group for patient safety education. The objective of this study was to assess residents' intentions and actions concerning patient safety improvement after patient safety education.

Methods

Four multi-specialty 2-day patient safety courses were organized, in which residents from five Dutch hospitals participated. At the end of these courses participants were asked to formulate an action point to improve patient safety. Three months later semi-structured interviews were conducted to reveal actions that were taken, factors that had influenced their behaviour and reactions concerning the education. An inductive theory approach was used to analyze transcriptions.

Results

Out of 71 participants, sixty-nine (97%) residents were interviewed. In total they had formulated 91 action points, which mainly focused on: 'Improving organization of own work/Follow policies' and 'Improving culture/Educating colleagues about patient safety'. Sixty-two (90%) residents declared to have taken action, and 50 (55%) action points were fully carried out. Most actions taken were at the level of the individual professional, rather than at the level of their social or organizational context. Results of actions included adjusting the structure of their own work, organizing patient safety education for colleagues, communicating more efficiently and in a more structured way with colleagues, and reporting incidents. Promoters for action included: 'Awareness of the importance of the action to be taken', 'Supportive attitude of colleagues' and 'Having received patient safety education'. Barriers included: 'Impeding attitude of colleagues', 'High work-pressure', 'Hierarchy' and 'Switching of work stations'.

Conclusions

After patient safety training, residents reported various intentions to contribute to patient safety improvement. Numerous actions were taken, but there still is a discrepancy between intentions and actual behaviour. To increase residents' participation in patient safety improvement, educational efforts should be supplemented with actions to remove experienced barriers, most of which are related to the residents' social and organizational context.