Patient Safety Culture Change over Time-Health Care Staffs’ Perceptions

Anna Nordin,Gun Nordström,Anders Hallberg,Kersti Theander,Bodil Wilde-Larsson

doi:10.4236/ojn.2020.103022

Abstract

Rationale and Aim: Patient safety is of great interest in health care organisations, worldwide. In Sweden, a national patient safety initiative was launched in 2011. The aim of this study was to examine and compare patient safety culture change over time from health care staffs’ perspective. A further aim was to examine factors that have had an effect on patient safety culture. Methods: Patient safety culture was assessed in 2009, 2011 and 2013 using the Swedish version of the Hospital Survey of Patient Safety Culture. Respondents in this study were registered nurses (n = 2149), enrolled nurses (n = 959), physicians (n = 355) and managers (n = 159) working in three health care divisions in a Swedish county council. Results: Patient safety culture decreased significantly over time for all but two dimensions. The dimension “Information to Patients/Relatives” was the only dimension to increase significantly over time. Health care staffs’ profession and health care division belonging had significant main effects on 14 and 8 dimensions, respectively. Managers and enrolled nurses scored patient safety culture significantly higher than registered nurses and physicians. Health care staff working in a mixed medical-surgical health care division scored significantly higher than those working in medical or surgical divisions did. Conclusions: Despite efforts for patient safety work in the county council, health care staffs’ perceptions of patient safety culture decreased over time. To improve hospital patient safety culture, managers and staff groups must meet and communicate with each other in order to create a common view of patient safety.

Highlights

Since the early 1990s, international studies have shown that on average 3% - 17% of all hospital patients will experience some form of harm as a result of their hospital stay [1]-[9]
The foremost result of this study shows that health care staffs’ perception of patient safety culture significantly decreased over time for all dimensions except two
The factor staff group showed a main effect on all patient safety culture dimensions, and managers scored higher for all dimensions in comparison to registered nurses (RNs), enrolled nurses (ENs), and physicians

Summary

Introduction

Since the early 1990s, international studies have shown that on average 3% - 17% of all hospital patients will experience some form of harm as a result of their hospital stay [1]-[9]. In response to figures like these, many countries have set up interventions to improve patient outcomes by means of reducing adverse events. In 2011, the Swedish government and the Swedish Association of Local Authorities and Regions (SALAR) reached an agreement for improved patient safety. The agreement aimed to encourage, strengthen, and intensify patient safety work within all county councils in Sweden [12]. Important parts of the initiative included reducing adverse events, striving towards a culture of safety, preventive work, and comparisons of efforts and results. The Swedish government allocated 59 million euros to be distributed to those county councils fulfilling the basic demands of the agreement, e.g. establishing an annual patient safety report in accordance with the Patient Safety Act [13] and undertaking at least one patient safety culture measurement

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