Psychometric properties of the full and short version Nursing Home Survey on Patient Safety Culture (NHSOPSC) instrument: a cross-sectional study assessing patient safety culture in Norwegian homecare services

Objectives: Measure patient safety culture in homecare services; test the psychometric properties of the Nursing Home Survey on Patient Safety Culture (NHSOPSC) instrument; and propose a short-version Homecare Services Survey on Patient Safety Culture instrument for use in homecare services. Design: Cross-sectional survey with psychometric testing. Setting: Twenty-seven publicly funded homecare units in eight municipalities (six counties) in Norway. Participants: Five-hundred and forty health personnel working in homecare services. Interventions: Not applicable. Primary and secondary outcome measures: Primary: Patient safety culture assessed using the NHSOPSC instrument. Secondary: Overall perception of service users’ safety, service safety and overall care. Methods: Psychometric testing of the NHSOPSC instrument using factor analysis and optimal test assembly with generalised partial credit model to develop a short-version instrument proposal. Results: Most healthcare personnel rated patient safety culture in homecare services positively. A 19-item short-version instrument for assessing patient safety culture had high internal consistency, and was considered to have sufficient concurrent and convergent validity. It explained a greater proportion of variance (59%) than the full version (50%). Short-version factors included safety improvement actions, teamwork, information flow and management support. Conclusion: This study provides a first proposal for a short-version Homecare Services Survey on Patient Safety Culture instrument to assess patient safety culture within homecare services. It needs further improvement, but provides a starting point for developing an improved valid and reliable short-version instrument as part of assessment of patient safety and quality improvement processes.publishedVersio

Exploring the role of leaders in enabling adaptive capacity in hospital teams – a multiple case study

Background Resilient healthcare research studies how healthcare systems and stakeholders adapt and cope with challenges and changes to enable high quality care. Team leaders are seen as central in coordinating clinical care, but research detailing their contributions in supporting adaptive capacity has been limited. This study aims to explore and describe how leaders enable adaptive capacity in hospital teams. Methods This article reports from a multiple embedded case study in two Norwegian hospitals. A case was defined as one hospital containing four different types of teams in a hospital setting. Data collection used triangulation of observation and interviews with leaders, followed by a qualitative content analysis. Results Leaders contribute in several ways to enhance their teams’ adaptive capacity. This study identified four key enablers; (1) building sufficient competence in the teams; (2) balancing workload, risk, and staff needs; (3) relational leadership; and (4) emphasising situational understanding and awareness through timely and relevant information. Conclusion Team leaders are key actors in everyday healthcare systems and facilitate organisational resilience by supporting adaptive capacity in hospital teams. We have developed a new framework of key leadership enablers that need to be integrated into leadership activities and approaches along with a strong relational and contextual understanding.publishedVersio

Prehospital Stressors: A Cross-sectional Study of Norwegian Helicopter Emergency Medical Physicians

Objective Personnel working in helicopter emergency medical services (HEMS) and search and rescue (SAR) are exposed to environmental stressors, which may impair performance. The aim of this survey was to study the extent HEMS and SAR physicians report the influence of specific danger-based and non–danger-based stressors. Methods The study was performed as a cross-sectional, anonymous, Web-based (Questback AS, Bogstadveien 54, 0366 Oslo, Norway) survey of Norwegian HEMS and SAR physicians between December 2, 2019, and February 25, 2020. Results Of the recipients, 119 (79.3%) responded. In helicopter operations, 33.6% (n = 40) reported involvement in a minor accident and 44.5% (n = 53) a near accident. In the rapid response car, 26.1% (n = 31) reported near accidents, whereas 26.9% (32) reported this in an ambulance. Of physicians, 20.2% (n = 24) received verbal abuse or threats during the last 12 months. When on call, 50.4% (n = 60) of physicians reported sometimes or often being influenced by fatigue. Conclusion This study shows that Norwegian HEMS and SAR physicians are exposed to several stressors of both a danger-based and non–danger-based nature, especially regarding accidents, threatening patient behavior, and fatigue. Very serious incidents appear to be seldom, and job satisfaction is high.publishedVersio

The effect of emergency department delays on 30-day mortality in Central Norway

publishedVersionPaid Open Acces

EDB-senteret som arbeidsplass : en intern spørreskjemaundersøkelse.

EDB-senteret har vært plaget med en ustabil personalsituasjon i det siste. Denne undersøkelsen tar sikte på å kartlegge årsakene til dette og foreslå tiltak for å bedre stabiliteten. bedring av terminalarbeidsplassene og den interne kommunikasjonen kolleger imellom samt omorganisering av kontakten med brukerne er tiltak som de ansatte prioriterer. Lønn og avansemuligheter er imidlertid fortsatt viktige faktorer for å holde på arbeidskraften

Patient characteristics in sepsis-related deaths: prevalence of advanced frailty, comorbidity, and age in a Norwegian hospital trust

Objective - To examine the prevalence of advanced frailty, comorbidity, and age among sepsis-related deaths in an adult hospital population. Methods - Retrospective chart reviews of deceased adults within a Norwegian hospital trust, with a diagnosis of infection, over 2 years (2018–2019). The likelihood of sepsis-related death was evaluated by clinicians as sepsis-related, possibly sepsis-related, or not sepsis-related. Results - Of 633 hospital deaths, 179 (28%) were sepsis-related, and 136 (21%) were possibly sepsis-related. Among these 315 patients whose deaths were sepsis-related or possibly sepsis-related, close to three in four patients (73%) were either 85 years or older, living with severe frailty (Clinical Frailty Scale, CFS, score of 7 or more), or an end-stage condition prior to the admission. Among the remaining 27%, 15% were either 80–84 years old, living with frailty corresponding to a CFS score of 6, or severe comorbidity, defined as 5 points or more on the Charlson Comorbidity Index (CCI). The last 12% constituted the presumably healthiest cluster, but in this group as well, the majority died with limitations of care due to their premorbid functional status and/ or comorbidity. Findings remained stable if the population was limited to sepsis-related deaths on clinicians’ reviews or those fulfilling the Sepsis-3 criteria. Conclusions - Advanced frailty, comorbidity, and age were predominant in hospital fatalities where infection contributed to death, with or without sepsis. This is of importance when considering sepsis-related mortality in similar populations, the applicability of study results to everyday clinical work, and future study designs

Psychometric properties of the full and short version Nursing Home Survey on Patient Safety Culture (NHSOPSC) instrument: a cross-sectional study assessing patient safety culture in Norwegian homecare services

Objectives: Measure patient safety culture in homecare services; test the psychometric properties of the Nursing Home Survey on Patient Safety Culture (NHSOPSC) instrument; and propose a short-version Homecare Services Survey on Patient Safety Culture instrument for use in homecare services. Design: Cross-sectional survey with psychometric testing. Setting: Twenty-seven publicly funded homecare units in eight municipalities (six counties) in Norway. Participants: Five-hundred and forty health personnel working in homecare services. Interventions: Not applicable. Primary and secondary outcome measures: Primary: Patient safety culture assessed using the NHSOPSC instrument. Secondary: Overall perception of service users’ safety, service safety and overall care. Methods: Psychometric testing of the NHSOPSC instrument using factor analysis and optimal test assembly with generalised partial credit model to develop a short-version instrument proposal. Results: Most healthcare personnel rated patient safety culture in homecare services positively. A 19-item short-version instrument for assessing patient safety culture had high internal consistency, and was considered to have sufficient concurrent and convergent validity. It explained a greater proportion of variance (59%) than the full version (50%). Short-version factors included safety improvement actions, teamwork, information flow and management support. Conclusion: This study provides a first proposal for a short-version Homecare Services Survey on Patient Safety Culture instrument to assess patient safety culture within homecare services. It needs further improvement, but provides a starting point for developing an improved valid and reliable short-version instrument as part of assessment of patient safety and quality improvement processes

Psychometric properties of the full and short version Nursing Home Survey on Patient Safety Culture (NHSOPSC) instrument: a cross-sectional study assessing patient safety culture in Norwegian homecare services

Objectives: Measure patient safety culture in homecare services; test the psychometric properties of the Nursing Home Survey on Patient Safety Culture (NHSOPSC) instrument; and propose a short-version Homecare Services Survey on Patient Safety Culture instrument for use in homecare services. Design: Cross-sectional survey with psychometric testing. Setting: Twenty-seven publicly funded homecare units in eight municipalities (six counties) in Norway. Participants: Five-hundred and forty health personnel working in homecare services. Interventions: Not applicable. Primary and secondary outcome measures: Primary: Patient safety culture assessed using the NHSOPSC instrument. Secondary: Overall perception of service users’ safety, service safety and overall care. Methods: Psychometric testing of the NHSOPSC instrument using factor analysis and optimal test assembly with generalised partial credit model to develop a short-version instrument proposal. Results: Most healthcare personnel rated patient safety culture in homecare services positively. A 19-item short-version instrument for assessing patient safety culture had high internal consistency, and was considered to have sufficient concurrent and convergent validity. It explained a greater proportion of variance (59%) than the full version (50%). Short-version factors included safety improvement actions, teamwork, information flow and management support. Conclusion: This study provides a first proposal for a short-version Homecare Services Survey on Patient Safety Culture instrument to assess patient safety culture within homecare services. It needs further improvement, but provides a starting point for developing an improved valid and reliable short-version instrument as part of assessment of patient safety and quality improvement processes

Pasienttilstrømming i et akuttmottak i påvente av covid-19-pandemien

BAKGRUNN Akuttmottaket i Trondheim har forberedt seg på storinnrykk av pasienter smittet med sars-CoV-2-virus. I en studie sammenlignet vi pasienter i akuttmottaket de første ukene av pandemien i Norge (uke 11 og uke 12) med gjennomsnittlig pasienttilstrømming. MATERIALE OG METODE Data fra pasienter i akuttmottaket ved St. Olavs hospital i perioden 6.1.2020–22.3.2020 ble innhentet fra akuttmottakets database. Logistiske pasientdata som omhandlet pasientantall, medisinsk problemstilling, liggetid i akuttmottaket, hastegrad, smitteisolering og behandlingsnivå ble analysert. RESULTATER I uke 12 ble 331 pasienter henvist til akuttmottaket, i motsetning til gjennomsnittet på 541 pasienter i uke 2–10, en reduksjon på 39 %. Det var en generell reduksjon av alle pasientgrupper, men spesielt for poliklinisk håndterte pasienter. I uke 12 var det 56 flere isolerte pasienter med mistenkt/potensielt smittsom infeksjonssykdom (187 %) sammenlignet med gjennomsnittet for uke 2–10, og liggetiden for smitteisolerte pasienter var nesten to timer lenger enn for andre pasienter. FORTOLKNING Det var en reduksjon av pasienttilstrømming til akuttmottaket de første ukene av pandemien. Andelen smitteisolerte pasienter økte, og liggetiden for isolerte pasienter var høyere enn for andre pasienter. Det forventes at reduksjonen i pasienttilstrømmingen er midlertidig, og akuttmottaket ved St. Olavs hospital venter på storinnrykk av pasienter med mistenkt covid-19-sykdom

Exploring the role of leaders in enabling adaptive capacity in hospital teams – a multiple case study

Background Resilient healthcare research studies how healthcare systems and stakeholders adapt and cope with challenges and changes to enable high quality care. Team leaders are seen as central in coordinating clinical care, but research detailing their contributions in supporting adaptive capacity has been limited. This study aims to explore and describe how leaders enable adaptive capacity in hospital teams. Methods This article reports from a multiple embedded case study in two Norwegian hospitals. A case was defined as one hospital containing four different types of teams in a hospital setting. Data collection used triangulation of observation and interviews with leaders, followed by a qualitative content analysis. Results Leaders contribute in several ways to enhance their teams’ adaptive capacity. This study identified four key enablers; (1) building sufficient competence in the teams; (2) balancing workload, risk, and staff needs; (3) relational leadership; and (4) emphasising situational understanding and awareness through timely and relevant information. Conclusion Team leaders are key actors in everyday healthcare systems and facilitate organisational resilience by supporting adaptive capacity in hospital teams. We have developed a new framework of key leadership enablers that need to be integrated into leadership activities and approaches along with a strong relational and contextual understanding