Safety culture, error reporting and medical innovation: comparing a survey taken during COVID-19 to the 2019 national staff survey

Abstract

Background/Aims Times of crisis can lead to great innovations. Since the outbreak of COVID-19, rapid changes have been made in the NHS, warranting safety evaluation. This study assessed changes in safety culture, professionalism and staff morale during COVID-19, compared to the year before the crisis. Methods A survey of 205 staff at an acute district general hospital was carried out during summer 2020. Questions were taken directly from the 2019 National Staff Survey, the results of which were used as a baseline. Novel questions were also added to the 2020 survey to explore staff morale, professionalism and innovation. Datix reports made from March-June 2020 were also compared to those made during the same period in 2019. Results Reporting of errors using traditional methods decreased following the outbreak of COVID-19, with the number of staff stating that they would report an error they witnessed decreasing from 95% before March 2020 to 87%. The number of Datix reports made decreased from 2805 before the crisis to 1798 during. However, 81% of staff reported greater psychological safety during the pandemic, compared to 69% in the 2019 survey. Respondents cited several facilitators of innovation, with desire to improve patient care scoring the highest. Conclusions The health service has the capacity for incredible innovation and agility with the correct mindset. Innovations need to be documented for organisational learning. Error reporting and learning systems that are appropriate for times of extreme pressure and crisis need to be developed.