Hospital work environments affect the patient safety climate: A longitudinal follow-up using a logistic regression analysis model.

Kirsten Brubakk,Martin Veel Svendsen,Dag Hofoss,Ellen Tveter Deilkås,Ole Tjomsland,Paul Barach,Marcel Pikhart

doi:10.1371/journal.pone.0258471

Abstract

BackgroundOccupational worker wellness and safety climate are key determinants of healthcare organizations’ ability to reduce medical harm to patients while supporting their employees. We designed a longitudinal study to evaluate the association between work environment characteristics and the patient safety climate in hospital units.MethodsPrimary data were collected from Norwegian hospital staff from 970 clinical units in all 21 hospitals of the South-Eastern Norway Health Region using the validated Norwegian Work Environment Survey and the Norwegian version of the Safety Attitudes Questionnaire. Responses from 91,225 surveys were collected over a three year period. We calculated the factor mean score and a binary outcome to measure study outcomes. The relationship between the hospital unit characteristics and the observed changes in the safety climate was analyzed by linear and logistic regression models.ResultsA work environment conducive to safe incident reporting, innovation, and teamwork was found to be significant for positive changes in the safety climate. In addition, a work environment supportive of patient needs and staff commitment to their workplace was significant for maintaining a mature safety climate over time.ConclusionsA supportive work environment is essential for patient safety. The characteristics of the hospital units were significantly associated with the unit’s safety climate scores, hence improvements in working conditions are needed for enhancing patient safety.

Highlights

Providing high value, patient-centered, and quality care while preventing patient harm remains a worldwide challenge [1]
A supportive work environment is essential for patient safety
The characteristics of the hospital units were significantly associated with the unit’s safety climate scores, improvements in working conditions are needed for enhancing patient safety

Summary

Introduction

Patient-centered, and quality care while preventing patient harm remains a worldwide challenge [1]. Healthcare organizations must consider issues across whole systems, including organizational and cultural factors affecting the system in which care is provided if they are to improve their patient outcomes [4,5]. Addressing organizational culture is viewed as essential to health system transformation [9,10] and remains an important factor in the successful implementation and sustainability of quality improvement initiatives on the front lines of care [11]. Zhou et al captured this well, saying that “the safety culture of an organization can motivate workers to engage in safe behaviors and facilitate the translation of these behaviors into daily practice, and can influence the ability of staff to raise concerns regarding safety and the ability of managers to respond to those concerns” [13]. We designed a longitudinal study to evaluate the association between work environment characteristics and the patient safety climate in hospital units

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Methods

Conclusion