Culture of Patient Safety Lacking in Some Orthopaedic Environments

Eighteen percent of nearly 400 orthopaedic surgeons responding to an 89-question survey about patient safety said they do not perceive a positive climate for patient safety in their organizations. In the July 15, 2015 JBJS, authors Janssen et al. call that percentage “high when compared with the [10%] threshold for highly reliable organizations.” Perceptions of patient safety were higher among men, surgeons in non-teaching hospitals, and those working in hospitals with a safety program already in place.

The authors surmise that the perception of a better patient-safety climate in non-teaching hospitals may be attributable to less complex care requirements that permit “a more structured approach,” and to typically smaller institution sizes in which care providers are “more adapted to each other and work more as a team.”

The respondents said that orthopaedic surgeons themselves are mainly responsible for preventing wrong-site surgery and retained foreign bodies. The most commonly cited strategies for improving patient safety overall were:

  • Making safety everyone’s responsibility
  • Improving communication, and
  • Standardizing procedures, equipment, and supplies.

Interestingly, surgeons who received salaries not linked to procedure volume were more enthusiastic about safety programs than those who received fee-for-service compensation. Janssen et al. conclude that “knowledge of the variation in perceived safety and the enthusiasm for specific strategies to improve safety among surgeons can serve as a starting point for necessary cultural change.”

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