Training health care professionals in root cause analysis: a cross-sectional study of post-training experiences, benefits and attitudes

BACKGROUND: Root cause analysis (RCA) originated in the manufacturing engineering sector but has been adapted for routine use in healthcare to investigate patient safety incidents and facilitate organizational learning. Despite the limitations of the RCA evidence base, healthcare authorities and decision makers in NHS Scotland – similar to those internationally - have invested heavily in developing training programmes to build local capacity and capability, and this is a cornerstone of many organizational policies for investigating safety-critical issues. However, to our knowledge there has been no systematic attempt to follow-up and evaluate post-training experiences of RCA-trained staff in Scotland. Given the significant investment in people, time and funding we aimed to capture and learn from the reported experiences, benefits and attitudes of RCA-trained staff and the perceived impact on healthcare systems and safety. METHODS: We adapted a questionnaire used in a published Australian research study to undertake a cross sectional online survey of health care professionals (e.g. nursing & midwifery, medical doctors and pharmacists) formally trained in RCA by a single territorial health board region in NHS Scotland. RESULTS: A total of 228/469 of invited staff completed the survey (48%). A majority of respondents had yet to participate in a post-training RCA investigation (n=127, 55.7%). Of RCA-experience staff, 71 had assumed a lead investigator role (70.3%) on one or more occasions. A clear majority indicated that their improvement recommendations were generally or partly implemented (82%). The top three barriers to RCA success were cited as: lack of time (54.6%), unwilling colleagues (34%) and inter-professional differences (31%). Differences in agreement levels between RCA-experienced and inexperienced respondents were noted on whether a follow-up session would be beneficial after conducting RCA (65.3% v 39.4%) and if peer feedback on RCA reports would be of educational value (83.2% v 37.0%). Comparisons with the previous research highlighted significant differences such as less reported difficulties within RCA teams (P<0.001) and a greater proportion of respondents taking on RCA leadership roles in this study (P<0.001). CONCLUSION: This study adds to our knowledge and understanding of the need to improve the effectiveness of RCA training and frontline practices in healthcare settings. The overall evidence points to a potential organisational learning need to provide RCA-trained staff with continuous development opportunities and performance feedback. Healthcare authorities may wish to look more critically at whom they train in RCA, and how this is delivered and supported educationally to maximize cost-benefits, organizational learning and safer patient care

Prospectus, October 12, 1977

TWO STUDENTS KILLED IN MISHAPS; Program for long-living begins year of courses; Early registration urged for health career applicants; Parkland Events; Staff opion: Some people are just dying to get your blood; PC posters: where do they come from?; Radio station meeting tomorrow; News in brief: Hundreds at art show; ORT program is accredited; Food service training-new course for this fall; Around the world in slides?; Reading courses offered; Music students to perform; \u27Who dances for the dancers?\u27: Dancer Beals delights large PC crowd; Female health concerns shown; Women\u27s News: Collette cancelled; Her Say News...; Gymnasium: Where\u27s that?; Disco sounds score big for big and small labels; Partial eclipse visible today...; ...and speaking of astronomy; Walt, how could you!?: PC teacher spends summer on tundra; Classifieds; God bless Horatii?; Personal Service Guide; Classic photos at U of I; McLean County seeks artists-in-residence; Cobras place 13th among 19 in golf; Women run volleyball record to 5-2 against Kankakee; Pritchett announces squad; Southern Cal upset is only Bennett miss; EI Jr. Varsity takes Parkland Invitationalhttps://spark.parkland.edu/prospectus_1977/1009/thumbnail.jp

Prospectus, April 5, 1978

ELECTIONS SATURDAY: SIX IN RUN FOR THREE BOARD SEATS; Letters to the editor: Disgruntled trackster chastises track coach, Stu-Go answers editorial: \u27Here\u27s what we\u27ve done\u27; Parkland College News in brief: Tom Kendall: Stoneware artisan to visit here Sunday, PC Faculty Wives to view new seasonal styles, Saturday hours for LRC, SIU to sponsor guest day there on April 8, ISU transfer day April 15, Kuhns announced as new Parkland nurse, Basic handy hints in womans workshop, George Williams College rep here; Performance at Parkland April 14th and 15th: King a crowning success; Haughty habiliment highlights BSA show; New exams schedule; Newsweek\u27s Bruno: \u27Press isn\u27t supposed to get along\u27; Brewer, DeShong win awards; Classifieds; If that referee looked familiar; Baseball Cobras split twin bill; Women start softball seasonhttps://spark.parkland.edu/prospectus_1978/1019/thumbnail.jp

Who Wears Me? Bioimpedance as a Passive Biometric

Mobile and wearable systems for monitoring health are becoming common. If such an mHealth system knows the identity of its wearer, the system can properly label and store data collected by the system. Existing recognition schemes for such mobile applications and pervasive devices are not particularly usable – they require ıt active engagement with the person (e.g., the input of passwords), or they are too easy to fool (e.g., they depend on the presence of a device that is easily stolen or lost). \par We present a wearable sensor to passively recognize people. Our sensor uses the unique electrical properties of a person\u27s body to recognize their identity. More specifically, the sensor uses ıt bioimpedance – a measure of how the body\u27s tissues oppose a tiny applied alternating current – and learns how a person\u27s body uniquely responds to alternating current of different frequencies. In this paper we demonstrate the feasibility of our system by showing its effectiveness at accurately recognizing people in a household 90% of the time

Prospectus, February 22, 1978

IS ANNEXATION TO CHAMPAIGN INEVITABLE?; A real stew in Stu-Go; Letters to the editor: Laudations for lifespan workshop, More on saving PLATO; Parkland College News in Brief: Keep out of handicapped parking….Or else!; Black Woman\u27s workshop, Parkland serves unusual course; SSU rep. here Tues., Next CHI program: SIDS, Writers needed to publish, Long lifers 4th annual arts and crafts show; Speech team keeps on talking; Table tennis, anyone?: Parkland\u27s Phan takes second at U of I; Happy Birthington\u27s Washday, everyone!; MTD bus schedule changes affect Parkland commuters; Star-gazers glance back and foretell an icy future; Classifieds; Humane Society has no choice...: Unwanted, unloved...animals die by the thousands; March Madness just around the corner: Area roundballers down to the wire; Men\u27s team tops CIAC: Regular season over: 22-4!; IM basketball titles still up for grabs; Arkansas-Houston game is fooler; Women finish season with loss to Olney at sectional; Bouncing Bob Basketball Bonanzahttps://spark.parkland.edu/prospectus_1978/1024/thumbnail.jp

Prospectus, November 22, 1977

NOVEMBER BOARD MEETING: PLATO STAYS \u27TIL AUGUST; Senate votes tomorrow: More $$$ for Parkland; Pssst!! Here\u27s a hot tip for making lettuce; Who\u27s Who in American Junior Colleges: More PC students listed in college directory; Staff editorial: Has PLATO become just a PLAy TOy???; Letters to the editors: Let\u27s try it one more time: Ax; Canteen defended; Cycle schedule is now available; Administration posture on Canteen is one of \u27Let them eat cake\u27; Decision workshop given by counseling; Bio instructors sound off on DES reply; Special to Prospectus: Calculator gives interview; Beach Boys revisited; Poet\u27s Corner; Grid great grabs freight: \u27Picnic\u27 keeps the audience laughing; News in Brief: Volunteers are needed for programs; Lems performs here November 29; LWV will cater fancy goodies; Classifieds; Thanks, but no thanks: PC students reflect on holiday season; Chris tells Spaniards, \u27Turkeys is peacocks\u27; Freddy is loser in contest finale; second year in a row: K-Action takes football crown; Win opener, 86-59: Cobras fry Lynx; Molesters stampede Bulls in IM opener; Two local teams still running for state; Cobras take on Millikin tonight in home opener; Bills vs. Oui; Pool wizard here Tues.https://spark.parkland.edu/prospectus_1977/1003/thumbnail.jp

Prospectus, March 1, 1978

WPCD: ONE MONTH AFTER FLIPPING THE SWITCH; Nine new officers sworn in; The story behind low unemployment rates for Parkland grads; Student killed in accident; Letters to the editor: Apology to workshop participants necessary, WIRE official \u27appalled\u27 by women\u27s sports cartoon, New DES evidence from a familiar place; Some people just can\u27t tell their ice from a hole in the ground; Parkland College News in brief: Opera house goes country, CHI tips for better, calmer living, Basic reading courses set, Passover to be shown Tues. by Fellowship, Health interests new WPCD show Thur., Two electronic classes will begin March 13th, Print workshop; Blind students find way; Welcome to the new Champaign Library; 1.5 million sign petition: Californians to fight high land tax; \u27Lincoln\u27 music in concert; U. of I. womens conference schedule; Not so Blue...Ladyhouse a treasure; Child care tax break; Classifieds; It\u27s official: March Madness is upon us!!; State finals in Danville for Region IV b-ball; End best season ever: Danville dumps Cobras, 86-83; Three tracksters are set for national meets; Perfect 12-for-12 wins antepenultimate contest; Bouncing Bob Basketball Bonanza; Women\u27s tryouts for softballhttps://spark.parkland.edu/prospectus_1978/1023/thumbnail.jp

Prospectus, November 16, 1977

PC PLACES 13 IN YEARBOOK; Finals just a month away; SWAMP meets; Bio talk Dec. 1st; Air Force rep here next week; MSOE rep here; Male health is next CHI topic; Parkland Events; Letters to the editors: Canteen flayed, Quatrain query, Cartoon condemned, ...and defended, Should students drive vehicles?; Carolers sought for kids\u27 party; Nutrition course starts in Jan.; \u27Anne Sexton\u27 tomorrow night; State museum features three new art exhibits; PC art gallery may be a permanent addition; Madwoman of Chaillot: as a parable of Europe, ...as an amusing play; WILL Women\u27s Week specials; Women\u27s Conference hears girls\u27 arguments; Watch repairing wide open field, says Parkland grad; Last winter killed much wildlife: Hunting may be thin this fall; Only 40 spending days \u27til Christmas; Personal Service Guide; Numbers A Woman May Need; Hygienists out on own?; Sorority rush; Moraine Valley takes Women\u27s State Tourney; Attics high on insulation list; Doc says \u27Mason\u27s got it all together\u27; ...Lex says \u27Mason/Loggins remnants of former selves; Final exam schedule; Suppose Custer hadn\u27t died at Little Big Horn; Classifieds; Area teams still vying for state championship; NBC presents new basketball format; Ivy League revisited: Two tie in Freddy Forecast; One more Freddy; Women\u27s basketball tryouts this week; It\u27s basketball time again: Cobras short but accurate this season, State community college teams look to good seasons, Parkland Basketball Roster, Opener tonight at Lincoln pits young Cobras vs. Lynx; IM basketballhttps://spark.parkland.edu/prospectus_1977/1004/thumbnail.jp

Prospectus, October 19, 1977

WPCD GOES ON AIR JANUARY \u2778: KELLY; Security stymies petrol pilferers; Propeck resigns as Stu-Go secretary; Thompson vetoes House community college bill; Canteen hit again; Parkland Events; \u27Who\u27s Who… candidates due; Letters to the editor: Some thoughts on a lost friend..., Head Start Follow Up Program needs tutors, ...\u27why headlined?\u27, On student directories - \u27not hired to correct\u27; Thompson seeks candidates for national awards; ACT Test Oct. 27; Phone line available for disabled; Blood drive is \u27successful\u27; Student Directory problem brought before Stu-Go; Have any suggestions?; CCWAR begins training; Danville DJ not quite ready for funny farm; Art group meets tonight; U.S. goes hosteling; Fear of dentists extracted by psych project; CHI, Women\u27s Program sponsor workshop Oct. 27; Don\u27t buy the book: How to save money through the mail; Tours this fall for U. of I.\u27s IMPE; Classifieds; Trout not pleased with women\u27s 8-5 record; K-Action continues winning ways in IM; Halloween activities on October 27; Art students are working for spring show; A review: Moliere adaptation Scapino was \u27zany\u27; Graphic Art competitions at U. of I.; Upsets cause trouble 10-for-12 Freddy; Indoor tracksters are balanced team; Fast Freddy Football Forecast; Danville drives for CIAC title, Parkland second?; Three run best ever at DuPage; Golfers 14th of 20 at Lincoln Landhttps://spark.parkland.edu/prospectus_1977/1008/thumbnail.jp

Prospectus, September 14, 1977

TWO VIE FOR VEEP POST: STUDENT GOVERNMENT ELECTIONS TODAY; Elections scheduled today and tomorrow; District 505 entitled to minimum credit grants; Activities postponed; Unopposed; Shiloh\u27s and Sonshine Circle to perform; Survival of democratic society topic at forum; Vets must go by book; \u27Self Defense\u27 is under attack; Youngest brew master is nun; Warners, women battle over \u27Jump On It\u27; Male prostitute makes history; News From \u27Her Say\u27: Ten women earn wings; UAW asks Congress for maternity benefits \u27as soon as possible\u27; Career Awareness Course for women Wednesday eve.; Instructors earn high grades from PC students; Back orders on home insulation cause woes; Blowing of the shofar means Rosh Hashanah, start of 5,738 New Year; Springfield news: senior citizens, equal language; The gas man cometh...; Holograph exhibit at PC tomorrow; Letting out some Slack...: Answers for queries on PC; Chicago painter displays at KCPA; Prospectus Pigskin Preview: Cobra Grid Schedule, Parkland Roster, Fight on Cobras; Alaskan wilderness is summer home to Basler; Parkland Learning Laboratory: Early help available to students; Stu-Go explores check cashing for PC people; PC music groups have many openings; Jumers: German touch; \u27Elite\u27 women to get public house; Home care topic to be presented; Classifieds; X-country opens Saturday; Spikettes look good; Sports shorts; Bio instructor Cox wins Fast Freddy; Intramural sign up closing; The continuing battle for Number 1; Parkland to host nationalshttps://spark.parkland.edu/prospectus_1977/1013/thumbnail.jp