Important factors for effective patient safety governance auditing: a questionnaire survey

van Gelderen, Saskia C.; Zegers, Marieke; Robben, Paul B.; Boeijen, Wilma; Westert, Gert P.; Wollersheim, Hub C.

doi:10.1186/s12913-018-3577-9

BMC Health Services Research

Table 3 Importance of factors amongst subgroups

From: Important factors for effective patient safety governance auditing: a questionnaire survey

Factor	Board of directors (n = 22)	Chief of medical staff (n = 35)	Nursing officer (n = 40)	Medical department head (n = 55)	Director of quality and patient safety (n = 59)	Overall (n = 211)
Category: board positioning of audits
Audit as an improvement tool as well as a control tool	100	100	100	100	100	100
Spreading the purpose and value of audit by board of directors	94	91	95	87	94	93
Departments receive support during improvement actions after audit	67*^R	91*	92*	100	78	88
Audit results are embedded in the planning and control cycle of the hospital	94	100	97	98	97	98
Board of directors addresses departments when follow-up on auditing results is not going according to plan	94	87	97	87	90	91
Dissemination of audit results to all personnel	94	100	97	98	95	97
Follow-up on auditing results by head of department	100	100	97	100	98	99
Category: organisation and content of audits
Department is aware of audit purpose	100	100	97	98	100	99
Audit is adjusted fit to individual departments	78*^R	97	92	100	97*	95
Department knows that the audit team is coming	67	77	59*^R	81*	80*	75
Extensive and detailed audit report	44	53	72	57	NA	59
Audit also focuses on health care pathways	100	97	97	94	100	98
There is room soft signals, not only facts, in the audit report	83	97*	90	89	75*^R	86
Audit also focuses on care provided by healthcare professionals and adverse events	78	82	83	97	NA	81
Patients as an information source during audits	94	89	95*	72^R	86	85
Auditors get a tunnel vision on department because of selective information during preparations	69*^R	94*	92*	84	88	87
Category: competences and composition of audit team
Patients as auditors	67	74	78*	57	55*^R	64
Patients are not suited to be an auditor because they are not objective	22*^R	29	33	50*	45	39
Patients are not suited to be an auditor because they do not have sufficient knowledge regarding healthcare guidelines	17*^R	41	41	47*	43	41
Patients are not suited to be an auditor because confidentiality cannot be secured.	17*^R	41	33	44	51*	41
Quality of the auditors	94	100	97	94	100	98
Evaluation of individual auditors	83*^R	94	90	98	98*	95
Multidisciplinary audit team	94	94	100	94	86	93
Medical specialist on the audit team	78	88*	79	92*	61*^R	79
Chairman of the audit team is a high-profile employee	50	68	53	59	51	56
The department to be audited influences the composition of the audit team	17*	29	13*	48*^R	15*	26
Auditors coming from other hospitals taking part in the audit team	94	97	95	90	91	93
Only employees with a (para)medical education should be auditors	39	30*	46	56* ^R	19*	37
Category: cultural factors and attitudes towards auditing
Staff sees added value of audit	89	91*^R	69^*	82	67*	78
Presence of head of department on audit day	94	94	80*	96*^R	93	92
Time investment	72	83	72*	90*^R	83	82
Staff feel that audit contributes to patient safety	94	97	90	96	97	95
Quality is ‘part of the job’	67*	74	71*	90*^R	66*	75
Importance of audit outcomes	78	62	70	56	69	66
Learning culture at department	100	100	100	100	100	100

*Subgroups differ significantly (p < 0.05) with the reference group (^R)

Back to article page

ISSN: 1472-6963

Contact us

General enquiries: journalsubmissions@springernature.com