Patient Safety Research Report: Patient Safety Culture and Outcomes

This patient safety research report investigates a study that employed permuted block randomization to assign patients to experimental and control groups within an ICU setting. The research assessed the impact of an educational empowerment program on patient safety culture, measuring outcomes across various dimensions such as communication, teamwork, and the reduction of preventable harm. The report details the study's methodology, including the use of a globally recognized questionnaire, and analyzes the treatment effects, highlighting improvements in patient safety and a decrease in adverse events following the educational intervention. The findings are deemed applicable to the local population, emphasizing the potential to save lives and improve healthcare efficiency through enhanced staff training and coordinated patient care. The report concludes by underscoring the value of such research in terms of cost-effectiveness, considering the paramount importance of human life and the global efforts to reduce medication-related deaths.

PATIENT SAFETY REPORT 1
PATIENT SAFETY RESEARCH REPORT
Name of Student:
Name of Institution:
Date:
1. Whether or not patient assignment was a random process

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Yes, patients were assigned using a random process. Permuted block randomization was used
in for allocation. The ICU units to be classified as either experimental group (1, 3 & 6) or
control group (2, 4 & 5) were selected using a purely random process with no influence by
either the hospital management or the patients themselves. This approach helps to eliminate
bias and achieve balance across specific groups under consideration (Penstate Eberly College
of Science, 2019). Each block contains a pre-specified number of treatment assignments
picked in a random manner (Center for Health Disparities Research and the Department of
Public Health, Brody School of Medicine, East Carolina University, Physicians Quadrangle,
Greenville, NC 27858, USA, 2011). The random nature of this section process eliminates
bias. The probability of being assigned to any treatment group changes according to how
many participants have already been assigned to either of the treatment groups (Penstate
Eberly College of Science, 2019). Randomization when assigning patients to treatment
during this research helped to ensure that all groups of patients received each treatment. Also,
the process helped to ensure only individuals with similar characteristics were classified
under one unit (Broglio, 2018) thus making the findings more reliable. The sample chosen
using this approach is a true representation of the population. The process is unbiased and
inferences drawn represent the true picture as is depicted by the population in most cases.
2. Accountability for patients at the end of the training.
Yes, indeed all the sampled patients were accounted for by the researcher at the end of the
research period. After training and data analysis, the inferences derived are compared to the pre-
test findings. This can only happen statistically if the same data set is the same (Bacarea, n.d.).
For instance, the report shows that by the end of the training period, more signs of a safety
culture in patients were recorded for individuals in the experiment group. It was also higher than

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that of the control group. The means of a population or sample takes into consideration all the
individual components of the same or population under study. It is the central tendency of that
data set (“Data and statistics; Mean and median,” 2019). Patients were analyzed in either the
experimental or control groups to which they were randomized at the beginning of the study.
3. A test of similarity between groups at the beginning of the experiment
The groups were indeed homogenous when the experiment started. One fundamental
requirement of permuted randomization approach (which was used to classify patients) is that
the members of each treatment group should have similar characteristic (John P. Matts &
John M. Lachin, 2010). Permuted randomization approach is commonly used in randomized
clinical trials when such research work is done. Furthermore, the results obtained also
indicate that both the group subject to the experiment and the control group all had similar
characteristics when it comes to their age groups, gender, marital status, and occupational
rank. This is shown in Table 1 1(Amiri1, et al., 2018). All the data sets named above have a
p-value which exceeds 0.001 according to table 12 thus the difference isn’t significant
statistically. In essence, the researcher too necessary steps to ensure the feedback got was not
biased towards a particular gender, age group, marital status or position. If the members of
one group would be of different ages for instance, there exists a high likelihood that the
feedback obtained might be biased. This is particularly because different age groups are
likely to respond differently to medication. This, as a result, may lead to incorrect inferences
being made from the feedback provided.
1
2

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4. Was there a fair treatment between the groups other than interventions resulting from the
experiment?
It is true that the units were subjected to fair treatments away from the experimental
interventions. All Intensive Care Units (ICUs) were subject to similar Patient Safety Policies.
These are regulations that govern the patients as they undergo treatment in hospitals (Linda
Emanuel, et al., 2009). The Patient Safety Policies are divided into broad levels which
include health system, organizational, as well as the clinical practice (Hasegawa & Fujita,
2018). These policies dictate professional ethics under which patients and their affairs should
be managed. They capture the individual hospital policies and links them to the national and
global policies governing the same practice. This way, all patients in a hospital, irrespective
of which unit they are admitted are subject to similar policies at a times.
5. How large was the treatment effect
A globally recognized agency had come up with a globally accepted questionnaire
to be used for the data collection on patient safety culture whose reliability had been
proven. There are a total of 42 questions covering 12 dimensions. These dimensions are
the parameters used to gauge the impact of the educational empowerment program at the
end of the research period. Part of the feedback needed necessitated administering of a
separate item on the patient safety grading, which was the primary objective of the whole
experiment. The other 12 parameters were secondary outcomes for the purpose of
backing up the primary item. Respondents were required to give their general feedback
on this item by selecting one of the five possible options provided. The questions
administered in the questionnaire capture feedback on progressive organizational
learning, peoples opinion on patient safety, constant, transparent and efficient

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communication systems in hospitals, appropriate and timely feedback on errors
encountered, coordination between units, how regular patient safety reports are recorded,
and non-punitive response to faults (Agency for Healthcare Research and Quality, 2018).
Mean scores for collaborations among individual units, consistent learnings and
improvement for the staff members, transparent and effective communication,
expectations from managers that prompt them to participate in patient safety and handoffs
and transitions, recorded notable improvements when new questionnaires were
administered after the workshop period had elapsed (Amiri1, et al., 2018). After the
educational workshop, fewer patients were exposed to preventable harm. This is because
the nurses become more vigilant to patient feedback and there was a smoother flow of
information within the hospital. An example is a case where a patient responds negatively
to a particular medication and requires the attention of the doctor. If the nurse in charge
was part of the workshop, there is a high probability that she would swiftly and more
conveniently reach out to the most available doctor on duty and have the patient attended
to. This particular patient would, therefore, be saved, a scenario that would otherwise
have been unlikely should there have been no educational workshop.
6. Application of the research findings the local population
Yes, these research findings can indeed be used for the local population. Approximately 2.6
million patients die annually due to unsafe care globally (“Patient Safety,” 2018). The same
report indicates that one out of four patients is harmed when receiving primary and secondary
healthcare. With these kinds of statistics, it is very likely that there are a number of deaths
recorded annually within the locality that result from preventable harms. This research
particularly made it conclusive that education empowerment programs can largely be used to

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mitigate deaths that are as a result of preventable harms. The hospital within which the research
was conducted is a representative sample of the local population. The ratios of men to women,
between the different age groups and the ratio between the singe and married people, represent
the actual statistics of the local community.
Consequently, implementation of the research findings in local hospitals would have a great
effect on helping secures more lives. When we have more knowledgeable nurses handling
patients in hospitals, more lives are likely to be saved. With teamwork and coordination among
the different units, constant training for staff members, timely communication and response to
errors noticed by nurses and doctors on duty among others, the efficiency in service delivery in
hospitals can greatly be improved. The patients and the general public within the locality would
greatly benefit from this training. Based on the facts and benefits mentioned in this paragraph,
the findings of this research are therefore very suitable for the local context. If properly
implemented, the ripple effect would be a safer society, fewer deaths from preventable errors and
generally a happy society living in harmony.
7. Was there value for money at the conclusion of the research?
God created man in his own image (New International Version, n.d.). This implies that the value
of life cannot be quoted in monetary terms. Any cost incurred in an attempt to save a life is worth
it. The research might have involved a lot of investments ranging from time, human capital,
finances, and management. However, nothing is worth more than the life of a human being. With
the high numbers of people dying annually according to the World Bank report quoted earlier, it
is recommendable that public health payers should have a coordinated public health response to
contain this disastrous vice. In 2017, the World Bank launched a campaign to reduce medication-
related deaths by half globally. This initiative can only be achieved if more effort would be put in

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educating health practitioners on the best ways to reduce such deaths. Prevention is a primary
measure, therefore less costly.
It is even recommendable that more funds should be allocated for more similar exercises across
hospitals. The more awareness is created among the health practitioners, the lesser deaths are
likely to be reported as a result of errors that would otherwise have been recorded.

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References
Agency for Healthcare Research and Quality, 2018. National Healthcare Quality and Disparities
Report, Rockville, MD 20857 : s.n.
Amiri1, M., Khademian, Z. & Nikandis, R., 2018. The effect of nurse empowerment educational
program on patient safety culture: a randomized controlled trial. Results, p. 5.
Bacarea, M. M. V., n.d. Comparing groups for statistical differences: how to choose the right
statistical test?. Biochemia Medica, 20(1).
Broglio, K., 2018. JAMA Guide to Statistics and Methods. Randomization in Clinical Trials;
Permuted Blocks and Stratification, Issue doi:10.1001/jama.2018.6360.
Center for Health Disparities Research and the Department of Public Health, Brody School of
Medicine, East Carolina University, Physicians Quadrangle, Greenville, NC 27858, USA, 2011.
Blocked Randomization with Randomly Selected Block Sizes, s.l.: Online.
Hasegawa, T. & Fujita, S., 2018. Patient Safety Policies ‒ Experiences, Effects and Priorities;
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[Accessed 30 April 2019].

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Linda Emanuel, M. P. et al., 2009. Advances in Patient Safety: New Directions and Alternative
Approaches (Vol. 1: Assessment)., s.l.: Agency for Healthcare Research and Quality.
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Penstate Eberly College of Science, 2019. Home » Lesson 8.2: Treatment Allocation and
Randomization. [Online]
Available at: https://newonlinecourses.science.psu.edu/stat509/node/64/
[Accessed 30 April 2019].
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