A comprehensive obstetrics patient safety program improves safety climate and culture

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


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

Study design: 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.

Results: 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.

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

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Humans
  • Obstetrics / standards*
  • Organizational Culture
  • Patient Care Team / organization & administration
  • Quality Assurance, Health Care*
  • Safety Management / organization & administration*
  • Safety*
  • Surveys and Questionnaires