Speaking Out for Patient Safety and the Associated Factors Among Anaesthesia Trainees in Kenya

Abstract

Background: Voicing Out Patient safety apprehensions is key to avoid errors being transmitted to the patient and is fundamental in improving the culture of teamwork and safety. Research done in various organizations demonstrates that individuals frequently select the innocuous response of silence, withholding feedback that could be beneficial to others. Objectives: To determine the speaking out behavior and safety climate among anesthesia trainees (Masters and Higher diploma in Anesthesia students) as well as the perceived barriers to speaking out among these trainees. Study design: A prospective cross-sectional study design. Study participants: Anesthesiology residents in the university of Nairobi school of from year 1 to year 4 and students taking higher diploma in Anesthesia at the Kenya Medical Training College in year 1 and year 2. Data collection tool: Speaking up about patient safety questionnaire (SUPS-Q)’ which was developed by the Swiss Patient Safety. Data analysis: Data obtained was entered into excel sheets and analyzed using descriptive statistics. The participant responses were then classified according to the framework of Okuyama. Research findings: The prevalence of speaking out behavior was 80.2 and 83.2% among KMTC and UON residents. The speaking out environment for the anesthesia trainees is favorable, as majority of the respondents reported psychological safety and an encouraging environment. Withholding voice behavior was common in our study population, with the withholding information that could benefit the patient being statistically significant P < 0.05. The top 3 barriers to speaking out for patient safety were: Perceived consequences of speaking up (43.8%), individual factors (31.7%) and the perceived efficacy of speaking up.

Conclusion: Our study demonstrates high prevalence of speaking up. Withholding voice is common despite the favorable safety climate. The most commonly identified barrier to speaking up for patient safety was the perceived consequences of speaking up.