Assessment of Patient and Occupational Safety Culture in Hospitals: Development of a Questionnaire with Comparable Dimensions and Results of a Feasibility Study in a German University Hospital.

Martina Michaelis,Edwin Luntz,Anke Wagner,Constanze Lessing,Andrea Wittich,Monika Rieger,Matthias Schrappe

doi:10.3390/ijerph15122625

Abstract

(1) Background: Both patient and occupational safety cultures should be considered when promoting safety culture. To our knowledge, there are no studies that capture patient safety culture (PSC) and occupational safety culture (OSC) in hospitals while using a common questionnaire. The aim of this feasibility study in a German university hospital was to develop a questionnaire to assess both issues analogously. In addition to feasibility outcomes, we report results of PSC-OSC comparisons. (2) Methods: To assess PSC, we used the existing Hospital Survey on Patient Safety Culture (HSPSC) questionnaire. Developing new OSC “twin items” for certain parts of the HSPSC was supported by a previous literature review. Additionally, we developed multiple choice questions to examine knowledge and competencies regarding specific PS/OS aspects. (3) Results: Developing and implementing a combined PSC and OSC assessment instrument was feasible. The overall response rate was 33% (407 nurses, 140 physicians). In general, the statistical reliability of almost all scales was sufficient. Positive PSC perceptions (agreement rates 46–87%) were found in 16 out of 18 scales. Of the four twin scales, the PSC values were significantly better. Individual PS- and OS-related knowledge and competencies were lower than expected. (4) Conclusion: The comparative investigation of patient and occupational safety in a large hospital is a promising approach and can be recommended for further studies. We used our experiences that are presented here in an ongoing bicentric study on the associations between working conditions, occupational safety culture, patient safety culture, and patient safety outcomes (WorkSafeMed).

Highlights

In recent years, there has been increasing discussion about safety culture in the healthcare sector.A well-known definition of safety culture, which can be adapted to the healthcare sector, is provided by the Advisory Committee on the Safety of Nuclear Installations
The lack of correlation of the further Occupational Safety Culture (OSC) dimensions, which we considered to be suitable for the measurement of occupational safety culture, limits the quality of the self-developed instrument
The results of the ABSK study presented here indicate that the comparative investigation of patient safety and occupational safety in hospitals within a multi-aspect approach addressing culture, knowledge, and competencies might be promising with regard to how such a study could be performed well

Summary

Introduction

A well-known definition of safety culture, which can be adapted to the healthcare sector, is provided by the Advisory Committee on the Safety of Nuclear Installations. Organizations with a positive safety culture are characterized by communications founded on mutual trust, by shared perceptions of the importance of safety and by confidence in the efficacy of preventive measures” [1]. According to this definition, safety culture can be seen as part of an organizational culture. Organizational culture “represents the shared beliefs, values, attitudes, norms of behaviour of people in an organization and the established organizational routines, traditions, ceremonies and reward systems” [2]

Methods

Results

Discussion

Conclusion