Employee and Patient Perceptions of Safety and Teamwork

New state legal requirements prompted the separation of all Intensive Care Units (ICUs) and intermediate rooms within OSF St. Francis Medical Center. Neurological, surgical and medical ICU rooms were all moved to the fourth floor of the hospital’s Gerlach building to comply with these standards. One new implication of these changes was that all ICU departments were required to share the same spaces. The change in staffing assignments prompted an educational effort to prepare medical staff across disciplines for interacting in the new environment.

Several core competency days occurred for the purpose of helping employees adjust to the new changes. This educational component of the transition incited the Employee and Patient Perceptions of Safety and Teamwork study. The study was designed to measure how both employees and patients processed and adjusted to new circumstances. The study sought to measure three main factors: employee perceptions of a safe working climate, patient perceptions of staff teamwork and a correlation between these two data points.

Two sets of surveys were utilized. The Patients’ Insights and Views Observing Teams (PIVOT) questionnaire was given to ICU patients before the ICU transition, one month into the transition and four months after the transition had taken effect. Clinicians were given the Safety Climate Survey three times according to the same timeframe as the patients’ questionnaire. Altogether, 65 PIVOT surveys and 90 Safety Climate Surveys were completed.

A high internal consistency was found for both surveys, and cross-examination of the two surveys revealed a very interesting trend. While patients overall perceived clinical staff to be highly coordinated in teamwork and communication, staff surveys indicated low perception of safety climate. Results indicate that patients’ ability to accurately perceive employee experience in a new environment is highly limited. This phenomenon may be replicated within organizational dynamics, especially between different levels of an organizational hierarchy. This study is complete in both data collection and analysis and is currently awaiting opportunities for publication.

Valuable discussion surrounds the results of this research project. Of primary interest was the identification of disconnect between the staff perceptions of safety and patient perspectives of teamwork; in this study, patient perceptions of teamwork positively increased in the midst of change while staff continued to survey their safety climate negatively. Another important element related to this project is the exploration of how such disconnects between staff and patient perception are communicated to the organization.  More discussion is encouraged to further explore these areas of interest.