Accident and Emergency Care Made High Reliable: Perception of Staff on Factors Affecting Application of High-Reliability Organization Principles in Accident Emergency Units

K K Malavige (Mbbs, Msc, Mba),Dr Samiddhi Samarakoon (Mbbs, Md-Medical Administration),Dr Nelum Samaruthilake (Mbbs, Md -Community Medicine),Dr Sathasivam Sridharan (Mbbs, Md-Medical Administration), Mba,I R Malawige (B.Sc (Hons.) In Mit, Mba),Dr G S K Dharmaratne (Mbbs, Md-Medical Administration)

doi:10.22158/rem.v6n3p20

K K Malavige (Mbbs, Msc, Mba), Dr Samiddhi Samarakoon (Mbbs, Md-Medical Administration) + Show 4 more

Open Access

https://doi.org/10.22158/rem.v6n3p20

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Journal: Research in Economics and Management	Publication Date: Aug 13, 2021
License type: CC BY 4.0

Abstract

There is a growing concern regarding patient safety and high reliability which made more intense with this ongoing pandemic.Aim of this study is to assess the organizational factors affecting the practice of High-Reliability Organization (HRO) Principles as perceived by staff in selected Accident and Emergency Units. Methodology: A hospital based cross-sectional study in three Accident and Emergency care setting, among healthcare staff, conducted using a self-administered questionnaire.Results: Out of the five factors affecting HRO practices as perceived by staff, “Organizational Safety Culture” (Mean-4.27., SD-0.49) has the highest mean value followed by Leadership (Mean: 3.96, SD: 0.44) and Teamwork (Mean: 3.95, SD: 0.5). “Work Environment” (Mean: 3.94, SD: 0.46) has the lowest score. All independent and dependent variables have a significant positive correlation with HRO principles (Correlation is significant at the 0.01 level-1-tailed). Multivariate analysis was carried out to assess the proportion variability of the dependent variable. The linear regression model explains 22% of the variability of the HRO practices (dependent variable) by factors affecting HRO practices (independent variables) if all the factors operate together.The distribution of Coefficients, Standardized B value is 0.29 (significant at the 0.01 level), showing if “Organizational Safety Culture” operates together with the other four independent variables 29% of the variability of the HRO practices (dependent variable) can be explained by Organizational Safety Culture.Conclusion: Organizational safety culture shows significant (< 0.01) effect on determining HRO practices.

Highlights

There is a growing concern regarding Patient safety, due to the potentially catastrophic nature of medical errors
This is a descriptive cross-sectional study carried out to assess the factors affecting implementation of High-Reliability Organization (HRO) principles as perceived by staff working in level one A & E units in three main Sri Lankan Teaching hospitals, among doctors and nursing staff
Out of the five factors affecting HRO practices as perceived by staff, “Organizational Safety Culture” (Mean-4.27., standard deviation (SD)-0.49) has the highest mean value followed by Leadership (Mean: 3.96, SD: 0.44) and Teamwork (Mean: 3.95, SD: 0.5)

Summary

Introduction

There is a growing concern regarding Patient safety, due to the potentially catastrophic nature of medical errors. Weick and Sutcliffe studied diverse organizations, where the potential for disaster can lead to catastrophic event in the instance itself They found that HROs have a unique structure but and it acts differently from other organizations. Due to the catastrophic nature of medical errors, healthcare systems started adopting principles of High-Reliability Organizations (HROs). HRO in Accident and emergency care: Factors affecting the implementation of HRO principles need to be identified in all selected Accident and Emergency Care Units in Tertiary Care Hospitals (A and E Units), due to the fact errors in A and E Units has the potential for catastrophic consequences.

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