Browsing Theses and Dissertations by Subject "Graduate medical education"
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The Impact of Introducing Resident Physicians in the ICU: Perceptions of Safety Culture Change by Staff and Residents in the ICU Following the Introduction of Residency Training Programs in a New Teaching HospitalStudies indicate the third leading cause of death in the United States is medical error, and up to 21% of admitted patients are affected by a medical error during their hospital stay. Efforts to reduce patient error have led many hospitals to adopt systems and processes to encourage a culture where the staff and providers feel comfortable to report errors. Residents in training programs are an important part of the safety culture of the hospital but are not often included in patient safety and quality improvement initiatives. The impact that residents have on the safety culture of the hospital is infrequently studied. This study evaluated data from safety culture surveys in a new community teaching hospital and compared ICU staff and resident perceptions pre- and post-start of residency. ICU staff completed the Safety Culture Index as part of an annual employee engagement survey in 2018-2021, providing data for 12 months prior to residency training to two years after the start of residency programs. Residents completed the Safety Attitudes Questionnaire at intervals during residency of 0 through 25 months of residency. Mean scores indicate that ICU staff safety culture perceptions showed an overall positive increase from one year prior to residents starting to two years after start. Resident perceptions at the start of residency training were in the “Strongly Agree” range when starting residency then declined to the “Agree” or “Neutral” range at the one-year point. The mean value of resident scores after one year of residency training met the average responses from the staff survey in the same period and scores from both groups increased between the first and second year of residency training. This study demonstrates the impact that residents can have to improve safety culture in the ICUs of a new teaching hospital. Results from this study can assist hospital leaders to better understand the impact of residents on safety culture and support initiatives to start residency programs in community hospitals. Existing residency programs may be encouraged by the results of this study to integrate residents into hospital patient safety and quality improvement initiatives to improve patient care.