Assessment Of Safety Culture Research Articles

Existing perception of Patient safety among health personnel in operating room at CHICH (Children Hospital & Institute of Child Health, Lahore.

Background: Patient Safety is the key concept of every healthcare setup worldwide as it depicts the perception of health care personnel about patient safety and quality of care delivered to patients. The World Health Organization along with other major organizations has taken initiatives to deal with patient safety challenges. Objective: To assess the existing perception of patient safety among health personnel in operating rooms of tertiary care hospital in Pakistan. Study Design: Cross Sectional study. Setting: Children Hospital & Institute of Child Health Lahore. Period: July 2018 to December 2018. Material & Method: Participants were selected through proportionate simple random sampling. The WHO patient safety survey was used to assess perception of patient safety culture. Data was collected after taking consent. The data was entered in SPSS version 25 and analyzed by it. “Composite positive response rate” for the various dimensions were calculated. Reliability was checked by Cronabach alpha which was more than 0.7 (70%). Results: The overall response rate in the study was 100%. Average composite positive response percentage was 65.17% and it varied among different cadres of HCPs ranged from 51% to 88%. The dimensions “Personal attitude to Patient safety” and “Personal influence over safety” showed highest positive response among all cadres (88 % and 67 %) respectively. composite Positive percent response about patient safety culture varied among different cadres of health personnel, nurses showed highest positive response percentage of 71.2%. Conclusion: Safety culture assessment is a useful tool for evaluation of patient safety interventions, measuring organization’s safety culture and raising awareness. WHO patient safety study tool showed the average positive response rate of 65.17% but the dimension “Safety of health care system”, and “Error and patient safety” have least positive response which shifts the focus to organizational conditions that lead to adverse events and patient harm in healthcare organizations. The result also highlighted areas that required improvement, as perceived by health care workers.

Assessment of Patient Safety Culture at Intensive Care Units in Public Hospitals in Benghazi from The Health Care Professional`s Perspective

Assessment of Patient Safety Culture at Intensive Care Units in Public Hospitals in Benghazi from The Health Care Professional`s Perspective

Regulating nuclear safety through safety culture

The primary aim of this paper is to demonstrate that safety culture can be a relevant additional concept for regulating at-risk installations. In that purpose, we developed a three-level model aiming at guiding a safety culture assessment. In that framework, “coherence” (i.e. the level of alignment between principles and practices), “cooperation” (i.e. the mutual understanding between sub-cultures) and “consistency” (i.e. the capacity to change and to improve) have been considered as core issues for a regulatory body assessment of safety culture. These important dimensions are illustrated through two study cases related to two safety culture assessments of nuclear installations.

How to Measure Patient Safety Culture? a Literature Review of Instruments

Abstract Introduction: Patient safety culture is described as employees’ shared values, attitudes, and behaviours in a healthcare organization. Its main goal is to improve patient safety. Assessment of patient safety culture in the hospital environment is most often carried out using self-assessment tools. Although several of these tools have been developed, their comprehensive overview is lacking in literature. Aim: To provide an overview of instruments measuring patient safety culture in a hospital setting. Methods: The study has a character of a narrative literature review. The search was performed in the scientific databases Scopus, ProQuest, and PubMed in January 2021. The search produced a total of 1,767 studies and was limited to language (English). The search and the retrieval process reflected PRISMA’s recommendations. The content analysis method was used in the data synthesis. Results: We identified 24 tools for assessing the patient safety culture in a hospital setting, of which seven were developed for specific workplaces; others are considered general. Eighteen tools might be utilized by all healthcare professionals within the hospital setting and only three were designated explicitly for nurses. The most commonly used instruments were the Hospital Survey on Patient Culture and the Safety Attitudes Questionnaire. Conclusion: Assessing a patient safety culture is considered one of the strategies for improving patient safety while increasing care quality. An appropriate tool’s choice depends on the target population, the instrument’s validity and reliability, and other aspects. Awareness of the various assessment tools can help hospitals choose the one that best suits their circumstances.

Investigation of multi-level safety culture in the Indian construction industry: a multi-level employees’ perception-based approach

Inadequate compliance with safety practices is a major hurdle in the construction industry, and a single-level source of input to assess safety culture is a major limitation of the literature. Therefore, this study aimed to capture multi-level employees’ (top management, middle management and workers) perceptions to assess multi-level safety culture (organizational level, project level and personnel level) in the construction industry. This study considered the Indian construction industry as the study area and used a questionnaire survey and interview technique as research instruments. In total, 184 responses were collected from multi-level employees. Data analysis was performed using a descriptive statistical method and hypothesis testing using the Mann–Whitney U test followed by the Kruskal–Wallis and post hoc tests. Findings highlighted inadequate safety compliances and significant (p < 0.05) perception differences among multi-level employees. Further, root cause analysis for observed perception differences was performed, and managerial implications were discussed from implementation perspectives.

Patient Safety Culture Assessment in Primary Care Settings in Greece.

Introduction: A positive safety culture is considered a pillar of safety in health organizations and the first crucial step for quality health services. In this context, the aim of this study was to set a reference evaluation for the patient safety culture in the primary health sector in Greece, based on health professionals’ perceptions. Methods: We used a cross-sectional survey with a 62% response rate (n = 459), conducted in primary care settings in Greece (February to May 2020). We utilized the “Medical Office Survey on Patient Safety Culture” survey tool from the Agency for Healthcare Research and Quality (AHRQ). The study participants were health professionals who interacted with patients from 12 primary care settings in Greece. Results: The most highly ranked domains were: “Teamwork” (82%), “Patient Care Tracking/Follow-up” (80% of positive scores), and “Organizational Learning” (80%); meanwhile, the lowest-ranked ones were: “Leadership Support for Patient Safety” (62%) and “Work Pressure and Pace” (46%). The other domains, such as “Overall Perceptions of Patient Safety and Quality” (77%), “Staff Training“ (70%), “Communication about Error” (70%), “Office Processes and Standardization” (67%), and “Communication Openness” (64%), ranked somewhere in between. Conclusions: A positive safety culture was identified in primary care settings in Greece, although weak areas concerning the safety culture should be addressed in order to improve patient safety.

Dimensions of safety culture: a systematic review of quantitative, qualitative and mixed methods for assessing safety culture in hospitals

BackgroundThe study of safety culture and its relationship to patient care have been challenged by variation in definition, dimensionality and methods of assessment. This systematic review aimed to map methods...

Variation in Perception of Safety Culture in Out-of-hours Family Medicine Service in Croatia.

IntroductionThe Safety Attitudes Questionnaire (SAQ) is among the most frequently cited tools for measuring safety culture in healthcare settings. Its ambulatory version was used in this study. The aim was to assess safety culture in out-of-hours (OOH) family medicine service and its variation across job positions, regions, and respondents’ demographic characteristic.MethodsA cross-sectional observational study was carried out targeting 358 health professionals working in the 29 largest Croatian healthcare centres providing out-of-hours family medicine service. The response rate was 51.7% (185 questionnaires). The questionnaire comprised 62 Likert items with 5 responses (fully disagree to fully agree). Scores of negatively worded items were reversed before analysis. Scores on the total scale and subscales were calculated as additive scores. The study included demographic data on gender, age, working experience, and job position. Repeated measurement analysis of variance was used to assess variation of Safety Attitudes Questionnaire – Ambulatory Version (SAQ-AV) sub-scales.ResultsNurses assessed safety culture higher than did physicians and residents. Teamwork climate had higher scores than Ambulatory process of care and Organizational climate. Stress recognition and Perceptions of workload had the lowest overall scores. Variation across gender, age, working experience, and region was not statistically significant.ConclusionsSAQ-AV can be used to identify areas for improvement in patient safety at OOH GPs. There is a need to improve staffing and support for OOH GP residents. Further research is needed in order to gain better understanding of factors influencing observed variations among job positions.

An Assessment of Safety Culture in Building Construction Project (A Case Study of Federal Secretariat Construction and Management Office, Sano Gaucharan, Kathmandu)

The construction industry is a very dangerous industry. Safe and healthy working condition in construction is created with safety practices. Safety is one of the major performance indicators of any construction project. The overall objective of the research was to assess safety culture in building construction project undertaken by Federal Secretariat Construction and Management Office, Sano Gaucharan, Kathmandu. To meet the objective, primary data were collected. Questionnaire survey and field observations were done to collect primary data. Data were analyzed using MS Excel and SPSS and results were analyzed and discussed. From this research, it was found that knowledge of workers about safety practice was satisfactory. However they were found to be unaware about contractual provision about safety. Basic safety culture like provision of drinking water, first aid kits, etc. was found to be well practiced. However safety culture provision likesafety training, safety meeting and appointment of safety engineer were not found to be practiced. Workers safety responsibilities, use of PPE, good house keeping, increment of budget on safety facilities, arrangement of safety training and education, enforcement of safety regulations, appointment of safety engineer, equipment and tool inspection, inspection of safety provision before commencement of works, construction safety plan, construction safety meeting and incident investigation significantly contribute for prevention and control of accidents.

P.116 Assessment of patient safety culture in the theatre unit of an Irish tertiary maternity hospital

Introduction: The practice of obstetrics requires effective multidisciplinary teamwork and systems to achieve optimal patient outcomes in high stress situations. Patient safety culture (PSC) is a core contributor to teamwork and communication. The Safety Attitudes Questionnaire (SAQ) has been validated to measure PSC. High scores in this questionnaire are associated with reduced staff turnover, infection rates and mortality. [1] Pronovost PJ, Miller MR, Wachter RM. Tracking progress in patient safety: an elusive target. JAMA. 2006;296:696-9. Google Scholar

Cross-cultural Adaptation and Validation of Patient Safety Culture Assessment Tool for Clinical Staff in Kazakhstan

BACKGROUND: Modern healthcare systems lack empirical models and appropriate tools to evaluate the safety culture, which encourages the need for their development. The national healthcare system of Kazakhstan has no empirically tested robust tools to evaluate the safety culture. AIM: The present paper aims at performing translation, cross-cultural adaptation, and validation of the “Patient safety culture” tool (from here – the tool) as a means for evaluating safety culture in healthcare establishments of the Republic of Kazakhstan. METHODS: The study design was cross-sectional. The original “Patient safety culture” tool is an integrated evaluation framework consisting of 7 scales and 62 items (6 general questions and 56 targeted questions) and reflecting different aspects of risk-related components of safety culture. The Cronbach’s alpha coefficient ranging from 0.0 to 1.0 was used to measure the internal consistency of the tool. To evaluate the tool’s reproducibility, we performed a test-retest assessment after 15 days and evaluated it using Pearson’s correlation coefficient. RESULTS: The overall Cronbach’s alpha for different scales ranged from 0.27 to 0.75. Subscales “Safety procedures” and “Safety Training” had the lowest coefficients. At test-retest, the Pearson’s correlation coefficient ranged from 0.934 to 0.969 among the scales. CONCLUSION: The study is dedicated to cross-cultural adaptation and validation of the “Patient safety culture” tool and describes the development of a translation protocol with subsequent cognitive debriefing and field testing. The field testing helped to confirm good validity, reliability, and reproducibility. The tool might undergo additional modification after further testing.

Assessment of Patient Safety Culture in a Pediatric Department.

BackgroundAn assessment of the prevalent culture needs to be the first step when building patient safety programs in healthcare organizations to achieve high-quality health care.ObjectiveTo conduct a baseline assessment of patient safety culture, to provide insight into the factors that contribute to patient safety, and to use the information to make improvements. MethodsThe Hospital Survey on Patient Safety Culture (PSC) questionnaire was conducted from October through December 2020 at the Brookdale Hospital Medical Center (BHMC) Pediatric departments (Pediatric Inpatient Unit, Neonatal Intensive Care Unit [NICU], Pediatric Intensive Care Unit [PICU], and Pediatric Emergency Department) and four community-based ambulatory pediatric practices (Brookdale Family Care Centers [BFCC]). The percentages of positive responses on the 12 patient-safety dimensions and the summation of PSC and two outcomes (overall patient safety grade and adverse events reported in the past year) were assessed. Factors associated with PSC aggregate score were analyzed.ResultsFrom the 385 emails that were sent, 136 surveys were considered for analysis. This gives us a response rate of 35.3%. Most of the participants were nurses (58%) with direct contact with patients (94.2%). Most respondents did not report any events (60.7%), whereas 30.3% reported 1-2 events in the past year. The patient safety composites with the highest positive scores were teamwork within units (78%), supervisor/manager expectations and actions promoting patient safety (71.2%), and organizational learning--continuous improvement (66.8%). The composites with the lowest scores were non-punitive response to error (35.9%) and staffing (38%).ConclusionsAll of our composite measures, with the exception of teamwork within units, appear to be low, which means that all the other composite measures require interventions for improvement of overall safety culture. In order for healthcare leaders and policymakers to establish a culture of safety and improvement, they must create a climate of open communication, continuous learning, and eliminate the fear of blame and punitive feedback.

Assessment of Safety Culture at a Veterinary Teaching Hospital in the United States.

This study assessed the fidelity of an existing questionnaire regarding attitudes toward safety culture in an academic veterinary hospital setting and gathered baseline data on these attitudes in a local population. A cross-sectional study design was used to evaluate perceptions held by veterinary teaching hospital employees. An established veterinary safety culture survey was modified and administered as a confidential online survey to faculty, house officers, and professional staff of a veterinary teaching hospital in the United States. Confirmatory and exploratory factor analysis were conducted to compare the adapted survey to the established version. Descriptive statistics were used to characterize baseline safety culture. The adapted survey exhibited factor groupings that were mostly in agreement with, but slightly different from, the original instrument. In general, survey respondents outlined positive attitudes toward the various domains of safety culture, though we identified opportunities for improvement in some areas. An adapted veterinary safety culture survey can be applied to a veterinary teaching hospital in the United States to assess baseline data surrounding the culture of safety and to identify opportunities for focused improvement efforts.

Research of security and safety culture within an organization. The case study within the Slovak Republic

Security and safety culture is an increasingly important term in assessing the security and safety of organizations. It is an internal security and safety factor of an organization that can directly influence its overall security and safety. In many cases, however, organizations do not know, nor do they have a way of assessing the level of their security and safety culture. It is therefore necessary to know the content, elements, and sectors in which it can be identified in order to gain a deeper knowledge of security and safety culture in more detail and be able to examine it. Firstly, we focused on creating a model for evaluating the safety and safety culture and its application in selected organizations. Secondly, we devoted to the description and design of an organization’s security and safety culture assessment model. The proposed model is based on the identification of subsectors and indicators of security and safety culture that will gain their value by using information obtained from combining the four proposed methods. Accordingly, six security and safety culture sectors were defined for the purposes of security and safety culture assessment in selected organizations. These were compared to each other to determine their mutual weight. Finally, using these research methods, security and safety culture indicators were also identified and included in the defined security and safety culture sectors. The research needed to design a security and safety culture assessment model was realized in six selected organizations, which wanted to participate in the research. These were divided according to the size of the organization into two small, two medium, and two large organizations. Crucial element in our research was data collection conducted by means of controlled interviews and questionnaire surveys in these organizations. Based on this survey, indicators of security and safety culture could be identified. As a result of this, security and safety culture values are determined for all analyzed organizations. The conclusions will point up the possible way of evaluating security and safety culture in organizations and it also contains a specific example of their usage in the practice. Thus, by using the resulting values, it is possible to decide the further direction for the organizations, focusing on the sectors of the security and safety culture, which yielded unsatisfactory results.

Contribution of PCA/K-means methods to the mixed assessment of patient safety culture

PurposeThe assessment of patient safety culture (PSC) is a major priority for healthcare providers. It is often realized using quantitative approaches (questionnaires) separately from qualitative ones (patient safety culture maturity model (PSCMM)). These approaches suffer from certain major limits. Therefore, the aim of the present study is to overcome these limits and to propose a novel approach to PSC assessment.Design/methodology/approachThe proposed approach consists of evaluating PSC in a set of healthcare establishments (HEs) using the HSOPSC questionnaire. After that, principal component analysis (PCA) and K-means algorithm were applied on PSC dimensional scores in order to aggregate them into macro dimensions. The latter were used to overcome the limits of PSC dimensional assessment and to propose a quantitative PSCMM.FindingsPSC dimensions are grouped into three macro dimensions. Their capitalization permits their association with safety actors related to PSC promotion. Consequently, a quantitative PSC maturity matrix was proposed. Problematic PSC dimensions for the studied HEs are “Non-punitive response to error”, “Staffing”, “Communication openness”. Their PSC maturity level was found underdeveloped due to a managerial style that favors a “blame culture”.Originality/valueA combined quali-quantitative assessment framework for PSC was proposed in the present study as recommended by a number of researchers but, to the best of our knowledge, few or no studies were devoted to it. The results can be projected for improvement and accreditation purposes, where different PSC stakeholders can be implicated as suggested by international standards.

Assessment of Patient Safety Culture Among Doctors, Nurses, and Midwives in a Public Hospital in Afghanistan.

IntroductionThe first step to improve the safety of patients in hospitals is to evaluate safety culture. Therefore, the patient safety culture in doctors, nurses and midwives should be reviewed regularly. The aim of the study was to determine the current state of patient safety culture among physicians, nurses and midwives at the Estiqlal Hospital in Kabul to promote an effective safety culture.MethodsThis cross-sectional descriptive study was conducted from January to March 2020 among doctors, nurses, and midwives at the Esteqlal Specialized Hospital in Kabul. In that study, the data were collected through a survey of hospital. Among the 267 employees invited to participate, 267 (100%) completed the surveys. Descriptive statistics have been used to adjust frequency distribution tables and inferential statistics to identify differences in variable relationships. The independent sample T-test and one-way ‘ANOVA ‘ were used to check variations between groups, and SPSS version 25 was used for data analysis.ResultsThe findings of this study have shown that organizational learning and non-punitive response to errors have had the highest and lowest scores. Eight out of 12 dimensions of patient safety culture scored lower. Four dimensions of patient safety culture scored the highest. Overall, patient safety culture dimensions were low and poor (44%). This means the patient safety culture at the hospital was poor.ConclusionThe safety culture of the patients at the hospital was inappropriate, particularly in the eight dimensions of the patient safety culture, immediate intervention was necessary. The study emphasizes the creation of a desirable organizational climate, the need for staff involvement in various levels of decision-making, the creation of a culture of error reporting and recognizing the causing factors, and promoting a patient safety culture.

Road towards promoting patient safety practices among hospital pharmacists: Hospital-based baseline patient safety culture assessment cross-sectional survey.

Patient safety is a fundamental aspect of a healthcare system. The aim of this study was to assess the perception and determinants of the patient safety culture of pharmacists in hospitals, in Riyadh, Saudi Arabia.A survey was conducted with pharmacists in the pharmacies of governmental, /military and private hospitals in Riyadh, Saudi Arabia. The pharmacy survey on patient safety culture questionnaire developed by Agency for Healthcare Research and Qualtity, a hard copy was distriuted to the pharmacists. The positive response rate (RR) was calculated and compared across hospitals using a chi-square test. The predictors of patient safety grades were identified using the generalized estimating equation. The data was analyzed using SAS.A total of 538 questionnaires were distributed, of which 411 responded (RR 76.4%). Of the participants, 229 (56%) were females. The majority 255 (62%) were in the 18 to 34 years age range, and 361 (88%) had a bachelor's degree. The majority of the sample 376 (92%) was a pharmacist. The Positive RR (PRR) ranged between (25.6%–74%). The highest PRR was observed in teamwork (74.4%), followed by ‘staff, training and skills’ (68%), and ‘organizational learning continuous improvement’ (66%). The lowest PRR was observed in ‘staffing, work pressure, and pace’ (25.5%). Comparing the PPR of the various healthcare sectors, the governmental hospitals scored the highest in all patient safety domains. Generalized Estimating Equation analysis showed that with increase in scores of all patient safety culture domains increased the likelihood of reporting a better patient safety grade, whereas respondents’ demographic characteristics had no effect except the working experience years 6 years and above had odds of poor reporting of the patient safety grade (odds ratio = 2.54, 95% confience interval (1.543, 4.194), (P = .0003).The grades achieved in the various domains of patient safety culture by pharmacists in Riyadh are below the expected standard. The highest scores were achieved in teamwork, with the lowest scores in staffing, work pressure and pace. Overall, pharmacists in government hospital settings have a better perception of patient safety than their peers in other settings. These results provide the baseline evidence for developing future interventional studies aiming at improving patient safety culture in hospital pharmacy settings.

Adaptation and validation of a Korean-language version of the revised hospital survey on patient safety culture (K-HSOPSC 2.0)

BackgroundTo date, there has been no universal and validated tool for measuring safety culture in Korea. The Hospital Survey on Patient Safety Culture (HSOPSC), version 2.0 was released by the Agency for Healthcare Research and Quality in 2019, but it had not yet been translated and assessed for use in Korea. The aim of this study was to assess the content validity and other psychometric properties of the Korean-language version of the HSOPSC 2.0.MethodsInstrument adaptation was performed using a committee-based translation, cognitive interviews, and expert panel reviews. Confirmatory factor analysis was conducted on data obtained through an online survey from 526 registered nurses who worked on medical-surgical units in three teaching hospitals in South Korea.ResultsOne item was dropped during the translation and adaption phase of the study as being a poor fit for the Korean healthcare context, resulting in excellent content validity. Confirmatory factor analysis supported the factorial structure of the K-HSOPSC 2.0. Correlations with an overall measure of patient safety provided further evidence of construct validity. Additionally, in comparing the results of this current study to those from U.S. research using the HSOPSC 2.0, it was found that Korean nurses assigned less positive scores to all dimensions of patient safety culture.ConclusionOur findings provide evidence of the content validity, reliability, and construct validity of the K-HOSPSC 2.0 for measuring patient safety culture in South Korean hospitals.Hospital administrators can use this tool to assess safety culture and identify areas for improvement to enhance patient safety and quality of care.

Proposal of a Novel Approach to the Assessment of Patient Safety Culture

The assessment of Patient Safety Culture (PSC) is often conducted using a quantitative approach based on questionnaires or a qualitative one focused on the deployment of Patient Safety Culture Maturity Models (PSCMM). These two approaches suffer from a number of limitations and their resolution is only possible by exploiting the possible complementarity that exists between them. Indeed, to overcome their inherent limits, it is imperative to merge the two PSC approaches in a single approach called quali-quantitative evaluation of PSC. This article fits into this context and aims to materialise the merger of PSC approaches through their co-deployment. This will make it possible to capitalise the scores of the HSOPSC dimensions in terms of PSC maturity levels.

Proposal of a novel approach to the assessment of patient safety culture

Proposal of a novel approach to the assessment of patient safety culture