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Clinical Trial Details — Status: Not yet recruiting

Administrative data

NCT number NCT06398860
Other study ID # 2022-00404
Secondary ID 2022-00404
Status Not yet recruiting
Phase N/A
First received
Last updated
Start date August 2024
Est. completion date December 2025

Study information

Verified date April 2024
Source Region Västmanland
Contact Malin Lohela Karlsson, Associate professor
Phone 0046214818537
Email malin.lohela.karlsson@regionvastmanland.se
Is FDA regulated No
Health authority
Study type Interventional

Clinical Trial Summary

The evidence unequivocally supports the association between work environment and patient safety. The negative impact of working conditions on both employee health and quality of care highlights the potential benefits of integrating these areas. It is therefore suggested that integrated systematic occupational health and patient safety management are crucial in managing the challenges faced by healthcare services today. The project aims to assess the effectiveness and cost-effectiveness of a structured method for systematic and integrated occupational safety and health and patient safety management systems (SIOHPS). A process evaluation will be conducted alongside the main study to determine the intervention's specific outcomes and provide transferable guidance to a wider context. The intervention is designed to support both systematic occupational health and patient safety management systems using a Safety II-perspective. The intervention is comprised of several core components, including education to staff, support-functions and management, daily team reflections; as well as audit and feedback. A stepped wedge cluster-controlled design (SWD) will be used, with workplaces as clusters. The SWD will consist of three steps, with four clusters crossing over from the control to the intervention group at each step. All clusters will start as controls. At least twelve healthcare units with at least thirty employees per workplace from two different regions in Sweden will participate in the intervention. Workplaces that provide round-the-clock care are invited to participate in the study. Exclusion criteria are units with plans to implement any other occupational health and/or patient safety improvement work during the project period. At the individual level, inclusion criteria for employees include at least 50% of full-time work at the workplace. The SIOHPS project will contribute to the existing theory on safety culture interventions by considering the integration of these areas. The goal is to contribute to a safe environment for both employees and patients.


Description:

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Study Design


Intervention

Procedure:
SIOHPS
The intervention is comprised of several core components such as targeted education, daily team reflections and support for systematic management. First, a two hour education will be conducted for management, HCW involved in patient safety work, safety representatives and intervention facilitators. The second core component is a short daily team reflection conducted by HCW at the unit in connection to the end of work shifts. These are standardized to support identification of situations at work related to both Safety I and II perspective for both occupational health and patient safety as well as learning. The third component includes risk assessment, planning and implementation of appropriate measures, follow up and evaluation, based in information identified in the second component. The steps in this component targets the management and should be conducted in close collaboration with HCW involved in patient safety work and the safety representatives.
Wait-list
No intervention

Locations

Country Name City State
n/a

Sponsors (6)

Lead Sponsor Collaborator
Region Västmanland Karolinska Institutet, Sormland County Council, Sweden, University of Gavle, Uppsala County Council, Sweden, Uppsala University

Outcome

Type Measure Description Time frame Safety issue
Primary Sick leave Total number of sick leave days after intervention start. Register data. 12 months
Primary Quality of care Readmission rate within 30-days of discharge. Register data. 12 months
Secondary Job demands Change in perceived job demands at 4 and 8 months after intervention start. Consists of the domains quantitative demands, work pace and emotional demands. Questionnaire data. 4, 8 months
Secondary Job resources Change in perceived job resources at 4 and 8 months after intervention start. Job resources includes local leadership, teamwork climate, horizontal trust, meaningful work, influence at work. Questionnaire data. 4, 8 months
Secondary Learning environment Change in perceived learning at 4 and 8 months after intervention start. Questionnaire data. 4, 8 months
Secondary Safety climate Change in perceived safety climate at 4 and 8 months after intervention start. Includes both occupational health and safety climate as well as patient safety climate. Questionnaire data. 4, 8 months
Secondary Work environment Change in perception of the work environment at 4 and 8 months after intervention start. Questionnaire data. 4, 8 months
Secondary Work Engagement Change in work engagement at 4 and 8 months after intervention start. Questionnaire data. 4, 8 months
Secondary Productivity loss Change in lost productivity at 4 and 8 months after intervention start. Defined as productivity loss related to work environment- and health-related problems. Questionnaire data. 4, 8 months
Secondary Health Change in perceived health status of the employees at 4 and 8 months after intervention start. Health is measured as general health, sleep problems, stress, health- and work environment-related problems, exhaustion. Questionnaire data. 4, 8 months
Secondary Short-term sick leave Total number of short-term sick leave days after intervention start. Register data. 12 months
Secondary Quality of care Change in perceived quality of care at 4 and 8 months after intervention start. Questionnaire data. 4, 8 months
Secondary Patient Safety Change in perceived patient safety at 4 and 8 months after intervention start. Questionnaire data. 4, 8 months
Secondary Incremental cost effectiveness ratios (ICER): Sick leave and Quality of care Evaluation of cost-effectiveness by using calculated costs related to intervention primary outcomes. 4 months before first intervention enrollment to 8 months after last intervention enrollment
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