Measuring patient safety culture in Taiwan using the Hospital Survey on Patient Safety Culture (HSOPSC)

I-Chi Chen,Hung-Hui Li

doi:10.1186/1472-6963-10-152

Abstract

BackgroundPatient safety is a critical component to the quality of health care. As health care organizations endeavour to improve their quality of care, there is a growing recognition of the importance of establishing a culture of patient safety. In this research, the authors use the Hospital Survey on Patient Safety Culture (HSOPSC) questionnaire to assess the culture of patient safety in Taiwan and attempt to provide an explanation for some of the phenomena that are unique in Taiwan.MethodsThe authors used HSOPSC to measure the 12 dimensions of the patient safety culture from 42 hospitals in Taiwan. The survey received 788 respondents including physicians, nurses, and non-clinical staff. This study used SPSS 15.0 for Windows and Amos 7 software tools to perform the statistical analysis on the survey data, including descriptive statistics and confirmatory factor analysis of the structural equation model.ResultsThe overall average positive response rate for the 12 patient safety culture dimensions of the HSOPSC survey was 64%, slightly higher than the average positive response rate for the AHRQ data (61%). The results showed that hospital staff in Taiwan feel positively toward patient safety culture in their organization. The dimension that received the highest positive response rate was "Teamwork within units", similar to the results reported in the US. The dimension with the lowest percentage of positive responses was "Staffing". Statistical analysis showed discrepancies between Taiwan and the US in three dimensions, including "Feedback and communication about error", "Communication openness", and "Frequency of event reporting".ConclusionsThe HSOPSC measurement provides evidence for assessing patient safety culture in Taiwan. The results show that in general, hospital staffs in Taiwan feel positively toward patient safety culture within their organization. The existence of discrepancies between the US data and the Taiwanese data suggest that cultural uniqueness should be taken into consideration whenever safety culture measurement tools are applied in different cultural settings.

Highlights

Patient safety is a critical component to the quality of health care
According to Fleming [9], the reliability expressed as Cronbach's α for the AHRQ data ranged from 0.63 to 0.84, whereas for the data in this research, the Cronbach's α ranged from 0.51 to 0.84, slightly lower than the AHRQ data, which implied that the consistency of the responses on each survey item for the data in this study is less than for the AHRQ data
96.2% of the hospitals had their own patient safety reporting mechanism, and 87.6% of them had a specific department in charge with patient safety affairs

Summary

Introduction

As health care organizations endeavour to improve their quality of care, there is a growing recognition of the importance of establishing a culture of patient safety. According to the adverse event reports in Taiwan, there were 14,945 cases reported in 2007, and many of these accidents and deaths could have been prevented [1] Those accidents and failures were extremely costly both for the patients and for the health care system. As health care industries strive to improve, there is a growing recognition of the importance of establishing a culture of patient safety. Nieva & Sorra [4] defined patient safety culture as the product of individual and group values, attitudes, perceptions, competencies, and patterns of behaviour that determine the commitment to, and the style and proficiency of, an organization's safety management. An organization with a 'safety culture' is open and fair with staff when incidents occur, learns from mistakes, and rather than blaming individuals, looks at what went wrong in the system [3,4]

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