Building a safety culture in global health: lessons from Guatemala.

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Rice, Henry E

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Lou-Meda, Randall

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Saxton, Anthony T

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Johnston, Bria E

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Ramirez, Carla C

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Mendez, Sindy

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Rice, Eli N

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Aidar, Bernardo

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Taicher, Brad

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Baumgartner, Joy Noel

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Milne, Judy

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Frankel, Allan S

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Sexton, J Bryan

dc.date.accessioned

2019-11-01T13:36:51Z

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2019-11-01T13:36:51Z

dc.date.issued

2018-01

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2019-11-01T13:36:49Z

dc.description.abstract

Programmes to modify the safety culture have led to lasting improvements in patient safety and quality of care in high-income settings around the world, although their use in low-income and middle-income countries (LMICs) has been limited. This analysis explores (1) how to measure the safety culture using a health culture survey in an LMIC and (2) how to use survey data to develop targeted safety initiatives using a paediatric nephrology unit in Guatemala as a field test case. We used the Safety, Communication, Operational Reliability, and Engagement survey to assess staff views towards 13 health climate and engagement domains. Domains with low scores included personal burnout, local leadership, teamwork and work-life balance. We held a series of debriefings to implement interventions targeted towards areas of need as defined by the survey. Programmes included the use of morning briefings, expansion of staff break resources and use of teamwork tools. Implementation challenges included the need for education of leadership, limited resources and hierarchical work relationships. This report can serve as an operational guide for providers in LMICs for use of a health culture survey to promote a strong safety culture and to guide their quality improvement and safety programmes.

dc.identifier

bmjgh-2017-000630

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2059-7908

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2059-7908

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https://hdl.handle.net/10161/19454

dc.language

eng

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BMJ

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BMJ global health

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10.1136/bmjgh-2017-000630

dc.subject

global health

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health culture survey

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low- and middle-income countries

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safety

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safety culture

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Building a safety culture in global health: lessons from Guatemala.

dc.type

Journal article

duke.contributor.orcid

Rice, Henry E|0000-0001-8033-6687

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Taicher, Brad|0000-0001-9985-8637

duke.contributor.orcid

Sexton, J Bryan|0000-0002-0578-2924

pubs.begin-page

e000630

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2

pubs.organisational-group

School of Medicine

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Duke

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Duke Global Health Institute

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University Institutes and Centers

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Institutes and Provost's Academic Units

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Pediatrics

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Clinical Science Departments

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Surgery, Pediatric General Surgery

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Surgery

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Duke Institute for Brain Sciences

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Psychiatry & Behavioral Sciences, General Psychiatry

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Psychiatry & Behavioral Sciences

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Anesthesiology, Pediatrics

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Anesthesiology

pubs.publication-status

Published

pubs.volume

3

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