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Am J Obstet Gynecol. 2011 Mar;204(3):216.e1-6. doi: 10.1016/j.ajog.2010.11.004.

A comprehensive obstetrics patient safety program improves safety climate and culture.

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  • 1Department of Obstetrics, Gynecology, and Reproductive Sciences, Yale University School of Medicine, New Haven, CT, USA.



The purpose of this study was to determine the effect of an obstetrics patient safety program on staff safety culture.


We implemented (1) obstetrics patient safety nurse, (2) protocol-based standardization of practice, (3) crew resource management training, (4) oversight by a patient safety committee, (5) 24-hour obstetrics hospitalist, and (6) an anonymous event reporting system. We administered the Safety Attitude Questionnaire on 4 occasions over 5 years (2004-2009) to all staff members that assessed teamwork and safety cultures, job satisfaction, working conditions, stress recognition, and perceptions of management.


We observed significant improvements in the proportion of staff members with favorable perceptions of teamwork culture (39% in 2004 to 63% in 2009), safety culture (33% to 63%), job satisfaction (39% to 53%), and management (10% to 37%). Individual roles (obstetrics providers, residents, and nurses) also experienced improvements in safety and teamwork, with significantly better congruence between doctors and nurses.


Safety programs can improve workforce perceptions of safety and an improved safety climate.

Copyright © 2011 Mosby, Inc. All rights reserved.

[PubMed - indexed for MEDLINE]
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