Exploring patient safety culture in primary care

Objective. To explore perceptions of safety culture in nine different types of primary care professions and to study possible differences. Design. Cross-sectional survey. Setting. Three hundred and thirteen practices from nine types of primary care profession groups in the Netherlands. Participants. Professional staff from primary care practices. Nine professions participated: dental care, dietetics, exercise therapy, physiotherapy, occupational therapy, midwifery, anticoagulation clinics, skin therapy and speech therapy. Main Outcome Measure(s). Perceptions of seven patient safety culture dimensions were measured: 'open communication and learning from error', 'handover and teamwork', 'adequate procedures and working conditions', 'patient safety management', 'support and fellowship', 'intention to report events' and 'organizational learning'. Dimension means per profession were presented, and multilevel analyses were used to assess differences between professions. Also the so-called patient safety grade was self-reported. Results. Five hundred and nineteen practices responded (response rate: 24%) of which 313 (625 individual questionnaires) were included for analysis. Overall, patient safety culture was perceived as being positive. Occupational therapy and anticoagulation therapy deviated most from other professions in a negative way, whereas physiotherapy deviated the most in a positive way. In addition, most professions graded their patient safety as positive (mean = 4.03 on a five-point scale). Conclusions. This study showed that patient safety culture in Dutch primary care professions on average is perceived positively. Also, it revealed variety between professions, indicating that a customized approach per profession group might contribute to successful implementation of safety strategies.