Evidence map›Paper›PMID 42786463›Full record

Observational studyBMC health services research2026

No effect of learning from excellence on patient safety culture in a postanaesthesia care unit: a longitudinal quasi-experimental study.

Gørill Birkeli, Owen Matthew Truscott Thomas, Randi Ballangrud, Ellen Catharina Tveter Deilkås, Anne Karin Lindahl

Registry-linked trialAbstract readObservational Study
In one paragraph

Observational study in BMC health services research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05794490 (Continuous Learning to Increase Patient Safety - A Multi-method Study), which is not on this map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT05794490 completednot on this map

Continuous Learning to Increase Patient Safety - A Multi-method Study

TypeobservationalSponsorUniversity Hospital, AkershusRan2022 to 2024Enrolled24ConditionsHealth Personnel, Resilience, Patient Safety, LearningArmsLearning from excellence
3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Gørill BirkeliDivision of Surgery, Akershus University Hospital, Sykehusveien 25, Lørenskog, 1478, Norway. gobi@ahus.no.ORCID http://orcid.org/0000-0003-4212-3802
Owen Matthew Truscott ThomasHealth Services Research Unit, Akershus University Hospital, Sykehusveien 25, Lørenskog, 1478, Norway.ORCID https://orcid.org/0000-0001-5199-4269
Randi BallangrudFaculty of Medicine and Health Sciences, Department of Health Sciences in Gjøvik, Norwegian University of Science and Technology, Teknologivegen 22, Gjøvik, 2815, Norway.ORCID http://orcid.org/0000-0003-0403-0509
Ellen Catharina Tveter DeilkåsHealth Services Research Unit, Akershus University Hospital, Sykehusveien 25, Lørenskog, 1478, Norway.ORCID http://orcid.org/0000-0001-6527-5636
Anne Karin LindahlDivision of Surgery, Akershus University Hospital, Sykehusveien 25, Lørenskog, 1478, Norway.ORCID http://orcid.org/0000-0001-5148-0639

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe prevailing strategy for combating surgically related adverse events (AEs) is to anticipate and prevent them by learning from adverse events (Safety-I). However, not all AEs can be anticipated or prevented in complex systems. This requires more focus on how daily work succeeds, that is, resilient and adaptive behaviour (Safety-II). Learning from success and promoting a positive patient safety culture (PSC) are key global strategies for eliminating preventable AEs. As a patient safety initiative, Learning from Excellence (LfE) captures episodes of successful everyday work and is thus, a system for applying a Safety-II perspective. However, its effect on PSC has not been evaluated. This study aimed to explore whether the implementation of LfE in a postanaesthesia care unit over a 16-month period changed the nurses' perceptions of the measurable PSC dimensions 'work engagement', 'teamwork climate', 'working conditions' and 'safety climate'.

methodsThis longitudinal two-group, controlled quasi-experimental study used an annual 'Hospital Staff Survey' to measure PSC factors before (2021-2022) and after (2023-2024) the implementation of LfE. The study included nurses from the surgical department of a Norwegian university hospital working in units specialised in postoperative care (intervention unit) and intensive care (comparison unit). The primary outcomes were binarised versions of individuals' positive responses to Likert-type statements regarding 'work engagement', 'teamwork climate', 'working conditions' and 'safety climate'. The data were analysed using logistic regression methods.

resultsRelative to the changes in the comparison unit, the results within the intervention unit indicated non-significant small positive changes in 'work engagement', 'teamwork climate' and 'working conditions' and a non-significant small negative change in 'safety climate'.

conclusionsLfE did not have a significant effect on PSC after 16 months implementation. Further longitudinal experimental studies are needed to measure the effect of LfE on PSC. Future research should focus on the role of psychological safety in LfE and assess whether reflexive spaces add value to LfE.

trial registrationClinicalTrials.gov NCT05794490; registered date: 4 March 2023.

Indexed as

Nursing Staff, HospitalPatient SafetySafety ManagementAdultAttitude of Health PersonnelFemaleHumansLongitudinal StudiesMaleOrganizational CultureSurveys and QuestionnairesWorking ConditionsFormative feedbackLearning health systemNon-randomised controlled trialsNursesOrganisational culturePatient safetyPositive psychologyPostoperative carePsychologicalResilienceRisk management

Identifiers

PMID42786463
PMCPMC13613599

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.