Patient safety and human factors: Action on safety culture
Culture can determine the success and sustainability of patient safety initiatives (Dixon-Woods 2012). Tools exist to support healthcare organisations looking to capture a sense of how the safety culture is perceived by staff.
Tools and interventions: MaPSaF Manchester Patient Safety Assessment Framework
The MaPSaF framework supports organisations in assessing progress in developing a safety culture. By answering questions about ten dimensions of patient safety (e.g. recording incidents and best practice, communication about patient safety issues etc.) teams can identify strengths and weaknesses in their organisation's approach.
When answering the questions staff assess how safety conscious they believe their organisation to be. They are asked to rank their organisation against statements linked to five levels. The five levels describe five distinct safety cultures, from least (pathological) to most mature (generative) in terms of the perceived attitude to safety issues.
Pathological: organisations with a prevailing attitude of ‘why waste our time on safety’ and, as such, there is little or no investment in improving safety.
- Reactive: organisations that only think about safety after an incident has occurred.
- Bureaucratic: organisations that are very paper-based and safety involves ticking boxes to prove to auditors and assessors that they are focused on safety.
- Proactive: organisations that place a high value on improving safety, actively invest in continuous safety improvements and reward staff who raise safety related issues.
- Generative: the nirvana of all safety organisations in which safety is an integral part of everything that they do. In a generative organisation, safety is truly in the hearts and minds of everyone, from senior managers to frontline staff.
(University of Manchester 2006).
The NPSA did not endorse using MaPSaF for performance management purposes but states that it "is a tool for self-reflection and educating healthcare staff about what a safety culture looks and feels like" (University of Manchester 2006, p.6).
The tool has been adapted for use in a number of settings including acute, mental health and primary care trusts.
References
These resources were last accessed on 25 March 2013. Some of them are in PDF format - see how to access PDF files.
Dixon-Woods M et al (2012) Ten challenges in improving quality in healthcare: lessons from the Health Foundation's programme evaluations and relevant literature. BMJ Quality and Safety 21(10) October, pp.876-884, doi: 10.1136/bmjqs-2011-000760.
University of Manchester (2006) Manchester Patient Safety Framework (MaPSaF) Facilitator Guidance. Version 1, London: National Patient Safety Agency.
Go to: Human factors - safety culture.
See also information about other human factors and interventions.