Durable improvement in patient safety culture over 5 years with use of high-volume incident learning system

Abstract Purpose Incident learning systems (ILSs) require substantial time and effort to maintain, risking staff burnout and ILS disuse. Herein, we assess the durability of ILS-associated safety culture improvements and ILS engagement at 5 years. Methods and materials A validated survey assessing safety culture was administered to all staff of an academic radiation oncology department before starting ILS and annually thereafter for 5 years. The survey consists of 70 questions assessing key cultural domains, overall patient safety grade, and barriers to incident reporting. A χ 2 test was used to compare baseline scores before starting the ILS (pre-ILS) with the aggregate 5 years during which ILS was in use (with ILS). ILS engagement was measured by the self-reported number of ILS entries submitted in the previous 12 months. Results The survey response rate was ≥68% each year (range, 68%-80%). High-volume event reporting was sustained (4673 reports; average of 0.9 ILS entries per treatment course). ILS engagement increased, with 43% of respondents submitting reports during the 12 months pre-ILS compared with 64% with ILS in use ( P P P P Conclusions Comprehensive incident learning was sustained over 5 years and is associated with significant durable improvements in metrics of patient safety culture.