Medical engagement in organisation-wide safety and quality-improvement programmes: experience in the UK Safer Patients Initiative.
Despite the success of large-scale patient safety initiatives such as the Keystone ICU project, many institutions still struggle with engaging staff in new safety programs. This qualitative study of institutions enrolled in the United Kingdom's Safer Patients Initiative (SPI) identified several factors affecting institutions' ability to launch safety initiatives, including the organizational context and history, the design of specific initiatives, and the role of local and external expertise in guiding new initiatives. These factors are also important drivers of local safety culture. A prior report based on the SPI discusses the local impact of the program and factors that predicted success at the institutional level.