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Advancing measurement of patient safety culture.

https://arctichealth.org/en/permalink/ahliterature154948
Source
Health Serv Res. 2009 Feb;44(1):205-24
Publication Type
Article
Date
Feb-2009
Author
Liane Ginsburg
Debra Gilin
Deborah Tregunno
Peter G Norton
Ward Flemons
Mark Fleming
Author Affiliation
School of Health Policy and Management, Faculty of Health, York University, HNES Building 413, 4700 Keele Street, Toronto, ON, Canada M3J 1P3. lgins@yorku.ca
Source
Health Serv Res. 2009 Feb;44(1):205-24
Date
Feb-2009
Language
English
Publication Type
Article
Keywords
Canada
Cross-Sectional Studies
Factor Analysis, Statistical
Humans
Leadership
Medical Errors - prevention & control
Nursing Staff, Hospital - education - organization & administration
Organizational Culture
Psychometrics
Quality Assurance, Health Care - methods
Questionnaires
Reproducibility of Results
Safety Management - organization & administration
Abstract
To examine the psychometric and unit of analysis/strength of culture issues in patient safety culture (PSC) measurement.
Two cross-sectional surveys of health care staff in 10 Canadian health care organizations totaling 11,586 respondents.
A cross-validation study of a measure of PSC using survey data gathered using the Modified Stanford PSC survey (MSI-2005 and MSI-2006); a within-group agreement analysis of MSI-2006 data. Extraction Methods. Exploratory factor analyses (EFA) of the MSI-05 survey data and confirmatory factor analysis (CFA) of the MSI-06 survey data; Rwg coefficients of homogeneity were calculated for 37 units and six organizations in the MSI-06 data set to examine within-group agreement.
The CFA did not yield acceptable levels of fit. EFA and reliability analysis of MSI-06 data suggest two reliable dimensions of PSC: Organization leadership for safety (alpha=0.88) and Unit leadership for safety (alpha=0.81). Within-group agreement analysis shows stronger within-unit agreement than within-organization agreement on assessed PSC dimensions.
The field of PSC measurement has not been able to meet strict requirements for sound measurement using conventional approaches of CFA. Additional work is needed to identify and soundly measure key dimensions of PSC. The field would also benefit from further attention to strength of culture/unit of analysis issues.
Notes
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Erratum In: Health Serv Res. 2009 Feb;44(1):321
PubMed ID
18823446 View in PubMed
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An educational intervention to enhance nurse leaders' perceptions of patient safety culture.

https://arctichealth.org/en/permalink/ahliterature173724
Source
Health Serv Res. 2005 Aug;40(4):997-1020
Publication Type
Article
Date
Aug-2005
Author
Liane Ginsburg
Peter G Norton
Ann Casebeer
Steven Lewis
Author Affiliation
School of Health Policy and Management, York University, Toronto, ON, Canada.
Source
Health Serv Res. 2005 Aug;40(4):997-1020
Date
Aug-2005
Language
English
Publication Type
Article
Keywords
Adult
Analysis of Variance
Canada
Factor Analysis, Statistical
Female
Humans
Inservice training
Leadership
Male
Medical Errors - prevention & control
Middle Aged
Nursing Staff, Hospital - education - organization & administration
Organizational Culture
Quality Assurance, Health Care - methods
Regression Analysis
Safety Management - organization & administration
Abstract
To design a training intervention and then test its effect on nurse leaders' perceptions of patient safety culture.
Three hundred and fifty-six nurses in clinical leadership roles (nurse managers and educators/CNSs) in two Canadian multi-site teaching hospitals (study and control).
A prospective evaluation of a patient safety training intervention using a quasi-experimental untreated control group design with pretest and posttest. Nurses in clinical leadership roles in the study group were invited to participate in two patient safety workshops over a 6-month period. Individuals in the study and control groups completed surveys measuring patient safety culture and leadership for improvement prior to training and 4 months following the second workshop.
Individual nurse clinical leaders were the unit of analysis. Exploratory factor analysis of the safety culture items was conducted; repeated-measures analysis of variance and paired t-tests were used to evaluate the effect of the training intervention on perceived safety culture (three factors). Hierarchical regression analyses looked at the influence of demographics, leadership for improvement, and the training intervention on nurse leaders' perceptions of safety culture.
A statistically significant improvement in one of three safety culture measures was shown for the study group (p
Notes
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PubMed ID
16033489 View in PubMed
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Referral and use of heart failure clinics: what factors are related to use?

https://arctichealth.org/en/permalink/ahliterature126685
Source
Can J Cardiol. 2012 Jul-Aug;28(4):483-9
Publication Type
Article
Author
Shannon Gravely
Liane Ginsburg
Donna E Stewart
Susanna Mak
Sherry L Grace
Author Affiliation
York University, Faculty of Health, Toronto, Ontario, Canada.
Source
Can J Cardiol. 2012 Jul-Aug;28(4):483-9
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Cohort Studies
Female
Health Services Needs and Demand - utilization
Heart Failure - epidemiology - rehabilitation
Humans
Male
Middle Aged
Odds Ratio
Ontario
Prospective Studies
Referral and Consultation - statistics & numerical data
Rehabilitation Centers - utilization
Risk factors
Utilization Review - statistics & numerical data
Abstract
Heart failure (HF) clinics have been shown to reduce hospital readmissions and generally have favourable effects on quality of life, survival, and care costs. This study investigated the rates of referral and use of HF clinics and examined factors related to program use.
This study represents a secondary analysis of a larger prospective cohort study conducted in Ontario. In hospital, 474 HF inpatients from 11 hospitals across Ontario completed a survey that examined predisposing, enabling, and need factors affecting HF clinic use. Then 1 year later, 271 HF patients completed a mailed survey that assessed referral to and use of HF clinics.
Forty-one patients (15.2%) self-reported referral, and 35 (13%) self-reported attending an HF clinic. Generalized estimating equations showed that factors related to greater program use were having an HF clinic at the site of hospital recruitment (odds ratio [OR] = 8.40; P = 0.04), referral to other disease management programs (OR = 4.87; P = 0.04), higher education (OR = 4.61; P = 0.02), lower stress (OR = 0.93; P = 0.03), and lower functional status (OR = 0.97; P = 0.03).
Similar to previous research, only one-seventh of HF patients were referred to and used an HF clinic. Both patient-level and health-system factors were related to HF clinic use. Given the benefits of HF clinics, more research examining how equitable access can be increased is needed. Also, the appropriateness and cost repercussions of use of multiple disease management programs should be investigated.
PubMed ID
22366509 View in PubMed
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What, why, and how care protocols are implemented in Ontario nursing homes.

https://arctichealth.org/en/permalink/ahliterature115441
Source
Can J Aging. 2013 Mar;32(1):73-85
Publication Type
Article
Date
Mar-2013
Author
Whitney Berta
Liane Ginsburg
Erin Gilbart
Louise Lemieux-Charles
Dave Davis
Author Affiliation
Institute of Health Policy, Management and Evaluation, University of Toronto, ON. whit.berta@utoronto.ca
Source
Can J Aging. 2013 Mar;32(1):73-85
Date
Mar-2013
Language
English
Publication Type
Article
Keywords
Aged
Aging
Clinical Protocols
Evidence-Based Medicine
Focus Groups
Guideline Adherence
Guidelines as Topic
Health Care Surveys
Homes for the Aged - standards
Humans
Long-Term Care - standards
Nursing Homes - standards
Ontario
Patient Care Planning - standards
Program Evaluation
Questionnaires
Rural Population
Skin Diseases - prevention & control
Urban Population
Abstract
The aim of this study was to better understand care protocol implementation, including the influence of organizational-contextual factors on implementation approaches, in long-term care homes operating in Ontario. We surveyed directors of care employed in all 547 Ontario LTC homes, and combined survey data with secondary organizational data on rural/urban location, nursing home size, chain membership, type of ownership, and accreditation status. Motivations for the use/selection of care protocols in nursing homes primarily derived from beliefs in continuous improvement and in evidence-based care. Protocol selection was largely participative, involving management and staff. External information sources were important for protocol implementation, and in-service education was the chief means of training and educating staff. Significant differences in approaches to implementation were evident in association with differences in ownership. Three key success factors for implementation were identified: contextualizing the practice change, adequately resourcing for implementation, and demonstrating connections between practice change and outcomes.
PubMed ID
23507344 View in PubMed
Less detail