Differences in safety climate among hospital anesthesia departments and the effect of a realistic simulation-based training program.

Safety culture measurement is an important part of monitoring and improving safety at the organizational level. Several surveys are used to measure safety, but recent research has demonstrated that safety culture measurements may vary across units within a hospital. Teamwork training, such as crew resource management (CRM), is a method of improving safety culture that is being widely implemented in a variety of clinical settings. In this study, the investigators analyzed safety culture before and after anesthesia staff underwent a CRM training program. Wide variations in overall safety culture perception—and specific dimensions of safety—were found even before clinicians underwent teamwork training, and faculty, nurse anesthetists, and residents had widely differing opinions of the safety climate. The CRM program did not result in sustained improvement in safety climate at any of the participating hospitals. The authors discuss their findings in the context of what is currently known about safety culture measurement, and the implications for designing future teamwork training programs.