METHODS: A cross-sectional study, using the 'Hospital Survey on Patient Safety Culture (HSOPSC)' questionnaire was carried out in 2018 in SGH. Random sampling was used to select a wide range of staff in SGH. A self-administered questionnaire was distributed to 500 hospital staff consisting of doctors, nurses, pharmacist and other clinical and non-clinical staff, conducted from March to April 2018. A total of 407 respondents successfully completed the questionnaire. Therefore, the final response rate for the survey was 81.4%. This study used SPSS 22.0 for Windows and Hospital Data Entry and Analysis Tool that works with Microsoft Excel developed by United States Agency for Healthcare Research and Quality (AHRQ) to perform statistical analysis on the survey data.
RESULTS: Majority of the respondents graded the overall patient safety as acceptable (63.1%) while only 3.4% graded as excellent. The overall patient safety score was 50.1% and most of the scores related to dimensions were lower than the benchmark scores (64.8%). Generally, the mean positive response rate for all the dimensions were lower than composite data of AHRQ, except for "Organizational Learning - Continuous Improvement", which is also the highest positive response rate (80%), higher than AHRQ data (73%). The result showed that SGH has a good opportunity to improve over time as it gains experience and accumulates knowledge. On the other hand, the lowest percentage of positive responses was "Non-punitive response to error" (18%), meaning that most of the staff perceived that they will be punished for medical error.
CONCLUSIONS: The level of patient safety culture in SGH is acceptable and most of the scores related to dimensions were lower than benchmark score. SGH as a learning organisation should also address the issues of staffing, improving handoff and transition and develop a non-punitive culture in response to error.
AIMS: The PEACH in Asia pilot study aimed to test the feasibility of a standardized protocol for investigating SCEs in anesthesia practices across Asia, evaluate the data acquisition processes, and determine the sample size for a main study.
METHODS: This multicenter pilot study involved ten institutions across nine Asian countries, including children from birth to 15 years undergoing diagnostic or surgical procedures. Data on SCEs were collected using standardized definitions. The study assessed the feasibility and estimated the sample size needed for the main study.
RESULTS: The pilot study enrolled 330 patients, with a SCE incidence of 12.4% (95% CI: 9.2-16.4%). Respiratory events were observed in 7.0% of cases, cardiovascular instability in 4.9%, and drug errors in 0.6%. Based on the SCE incidence observed in the pilot study, the estimated sample size required for the main study is at least 10 958 patients. The pilot study demonstrated the feasibility of the study protocol but identified several challenges, particularly in resource-limited settings. These challenges included a significant burden associated with data collection, technical issues with electronic case report forms (e-CRFs), variability in patient enrollment across institutions (ranging from 4 to 86 patients per site), and incomplete data acquisition (24.8% of height data and 9.7% of disposition data were missing).
CONCLUSIONS: The PEACH in Asia pilot study successfully validated a protocol for investigating SCEs in pediatric anesthesia across Asia. Addressing the challenges identified in the pilot study will be crucial for generating robust data to improve pediatric anesthesia safety in the region. Key issues to address include improving data collection methods, resolving e-CRF technical difficulties, and ensuring consistent institutional support.