What Has Been the Impact of Covid-19 on Safety Culture? (preprint)

ABSTRACT

Introduction Covid-19 has placed an unprecedented demand on healthcare systems worldwide. A positive safety culture is associated with improved patient safety and in turn patient outcomes. To date, no study has evaluated the impact of Covid-19 on safety culture. Methods The Safety Attitudes Questionnaire (SAQ) was used to investigate safety culture during Covid-19 at a large UK teaching hospital. Findings were compared with baseline data from 2017. Incident reporting from the year preceding the pandemic was also examined. Results Significant increases were seen in SAQ score for doctors and AHPs (p value) from baseline (p value). A decrease in SAQ was found in the nursing group. Largely due to perception of management and safety climate subscales. During Covid-19, on univariate regression analysis, female gender (p<0.001), age 40-49 years (p<0.01), non-white ethnicity (p<0.001), nursing job role (p<0.001) were all associated with lower SAQ scores. Training (p<0.001) and support (p<0.001) for redeployment were associated with higher SAQ scores. On multivariate analysis, non-disclosed gender (-0.13, -0.26-0.00), non-disclosed ethnicity (-0.11, -0.22-0.00), nursing role (-0.15, -0.24-0.06), and support (0.24, 0.07-0.4) persisted to significance. A significant decrease (p<0.003) was seen in error reporting after the onset of the Covid-19 pandemic. Discussion Differences in reported safety culture may reflect perception of risk due to occupational exposure, job function, or access to support services. Reductions in incident reporting may be due to increased workload, change in nature of work, or changing safety attitudes. Targeted high-quality support for redeployed staff may help improve safety during future pandemics.