• M van Beuzekom, F Boer, S Akerboom, and A Dahan.
• Department of Anaesthesiology, Leiden University Medical Centre, PO Box 9600, 2300 RC Leiden, The Netherlands. m.van_beuzekom@lumc.nl
• Br J Anaesth. 2013 Jan 1;110(1):107-14.

BackgroundCurrent thinking about patient safety emphasizes the relationship between organizational factors, that is, latent risk factors (LRFs) and patient safety. This study explores the influence of the operating theatre (OT), intensive care unit (ICU), and disciplines on ratings of LRFs. If we have an understanding of the contribution made by these factors, we can identify significant points from which we can promote a safe environment.MethodsStaff in four university hospitals were sent a survey relating to the state of LRFs, which included communication, planning and coordination, design, maintenance, equipment, teamwork, team instructions, housekeeping, situational awareness, hierarchy, and procedures.ResultsThe ICU staff had more favourable perceptions of training, communication, team instruction, and hierarchy. The OT staff had more favourable perceptions of technical LRFs. We found three profiles for disciplines: (i) anaesthetists and intensivists had more favourable perceptions of technical LRFs than surgeons and nurses. (ii) Anaesthetists, anaesthesia nurse-technicians, and recovery nurses had a poorer perception of non-technical skills. (iii) Anaesthesia nurse-technicians and recovery nurses had less favourable perceptions of procedures, housekeeping, and situational awareness than anaesthetists and intensivists.ConclusionsAs healthcare focuses its safety efforts towards system issues rather than towards the individual provider of care, attention has turned to organizational factors, known as LRFs. Understanding how LRFs affect safety should enable us to design more effective measures that will improve overall safety. Strategies for improving patient safety should be tailored specifically for various clinical areas and disciplines.

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