Design of the safety climate thermometer to promote team dialogue in surgical teams, using a thematic literature review and international expert panel study

Introduction A safe work climate benefits patients and healthcare professionals. Most instruments for evaluating safety climate are lengthy questionnaires focusing on either measuring and benchmarking, or identifying areas for improvement. We aimed to design a communication instrument promoting team discussion about safety in surgical teams: the safety climate thermometer (SCT). Method First, a literature study was conducted to identify important safety themes, which were then organized into eight safety climate themes. Behavior-based assessment statements were drafted per theme. Second, an expert panel study with international experts was conducted, soliciting feedback on our initial SCT design. Their feedback led to a redesign into the SCT prototype presented in this study. Results The literature search yielded twelve existing instruments and three reviews. Twenty-two experts participated in the panel study. The final SCT prototype framed eight safety climate themes and is organized into two parts. In Part I, team members individually and anonymously evaluate team performance per theme by responding to a single statement to quickly assess global perceptions of that theme. Based on their collective scores, the team chooses one safety climate area to investigate further by scoring one set of eight in-depth statements. In Part II, a structured interdisciplinary team discussion takes place aiming to pinpoint a work floor issue and set actionable goals for improvement. Discussion/conclusion The SCT is a communication instrument for surgical teams that first focuses on identifying opportunities for improvement, and then structuring team discussion and follow-up, aiming to improve safety climate.