Survey on patient safety climate in public hospitals in China.

Ping Zhou,M Kate Bundorf,Di Xue,Jianjun Gu,Xiaoyan He

doi:10.1186/s12913-015-0710-x

Ping Zhou, M Kate Bundorf + Show 3 more

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https://doi.org/10.1186/s12913-015-0710-x

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Abstract

BackgroundPatient safety climate has been recognized as a core determinant for improving safety in hospitals. Describing workforce perceptions of patient safety climate is an important part of safety climate management. This study aimed to describe staff’s perceptions of patient safety climate in public hospitals in Shanghai, China and to determine how perceptions of patient safety climate differ between different types of workers in the U.S. and China.MethodsSurvey of employees of 6 secondary, general public hospitals in Shanghai conducted during 2013 using a modified version of the U.S. Patient Safety Climate in Health Care Organizations (PSCHO) tool. The percentage of “problematic responses” (PPRs) was used to measure safety climate, and the PPRs were compared among employees with different job types, using χ2 tests and multivariate regression models.ResultsPerceptions of patient safety climate were relatively positive among hospital employees and similar to those of employees in U.S. hospitals along most dimensions. For workers in Chinese hospitals, the scales of “fear of blame” and “fear of shame” had the highest PPRs, whereas in the United States the scale of “fear of shame” had among the lowest PPRs. As in the United States, hospital managers in China perceived a more positive patient safety climate overall than other types of personnel.Conclusions“Fear of shame” and “fear of blame” may be important barriers to improvement of patient safety in Chinese hospitals. Research on the effect of patient safety climate on outcomes is necessary to implement effective polices to improve patient safety and quality outcomes in China.Electronic supplementary materialThe online version of this article (doi:10.1186/s12913-015-0710-x) contains supplementary material, which is available to authorized users.

Highlights

Patient safety climate has been recognized as a core determinant for improving safety in hospitals
We surveyed each of the six secondary general public hospitals in Pudong new area, four in the northern urban area and two in the southern rural area
When calculating the weights and analyzing the percentage of “problematic responses” (PPRs) by job type, we classified as “managers” those who worked in administrative offices rather than in direct patient care

Summary

Introduction

Patient safety climate has been recognized as a core determinant for improving safety in hospitals. The report highlighted the role of an organization’s safety culture as a determinant of risks to patients care. Patient safety culture can refer to “the product of individual and group values, attitudes, competencies and patterns of behavior that determine the commitment to, and the style and proficiency of, an organization’s health. Patient safety has taken on particular importance in China due to the deteriorating relationship between physicians and patients. The Chinese government and hospitals have carried out a series of initiatives to prevent medical errors, including encouraging the development of safety culture [15,16,17,18]. As clinicians and policy makers place more emphasis on patient safety, assessing patient safety climate has taken on greater importance

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