Healthcare Organizational Culture Research Articles

Registered nurses' emotional responses to medication errors and perceived need for support: A qualitative descriptive analysis.

To identify the contributing factors behind the second victim phenomenon, describe the emotional responses of nurses after medication errors, assess the support received by them after errors and recognize the need for a suitable support program for second victims. Qualitative descriptive design. Eleven in-depth semi-structured interviews were conducted among registered nurses studying advanced degrees at a University in Finland during November 2021-April 2022. Data were analysed using thematic analysis. The study results revealed four themes with various sub-themes which included: contributing factors behind the second victim phenomenon; emotional responses of nurses after error; support received by nurses; and the desired need for a support program for second victims. The severity of the error and the negative work environment acted as catalysts for the second victim phenomenon among nurses. A "bitter aftermath" of emotions and a sense of insufficient support added further risk to already stressed and anxious nurses. This study identifies the early exploratory and enduring impact of memories associated with medication errors, some of them haunting nurses for long periods of time. Further, the need for support at different levels is highlighted to reduce the impact of negative emotions generated among nurses after medication errors. Through the lens of this study, it has been possible to identify contributing factors behind the second-victim phenomenon and enduring symptoms that make nurses vulnerable to becoming second victims of medication incidents. This study addresses the aftermath effect of medication errors from the perspective of nurses involved with such incidents. It provides valuable insights for healthcare managers and nurse leaders to establish a just and blame-free culture in healthcare organizations and help emotionally traumatized nurses cope effectively after error. The research adheres to Consolidated criteria for reporting qualitative research (COREQ) guidelines. No patient or public contribution.

Fostering path to a just culture in healthcare organizations: Influential factors and challenges

Fostering path to a just culture in healthcare organizations: Influential factors and challenges

The Impact of Leadership Styles on Healthcare Organizational Culture and Performance: (Review Artical)

The Impact of Leadership Styles on Healthcare Organizational Culture and Performance: (Review Artical)

A Study of the Influence of Healthcare Organization Culture on the Doctor-Patient Relationship

In the healthcare field, the doctor-patient relationship is an important factor in ensuring the quality of care and patient satisfaction. However, in the past, there have been problems of detachment and miscommunication between doctors and patients, which have negatively impacted medical outcomes and patient experience. Therefore, it has become particularly important to focus on building and improving the culture of healthcare organizations. The culture of a healthcare organization has a profound impact on the doctor-patient relationship, which includes aspects of trust and communication, doctor-patient collaboration and shared decision-making, respect, and empathy. By building a culture that promotes trust and communication, medical staff can build strong ties with patients and facilitate information exchange and shared decision-making. At the same time, healthcare organizations should develop cultural sensitivity and cross-cultural competence among medical staff to better understand and respect patients from different cultural backgrounds. Through these efforts, healthcare organizations can improve the doctor-patient relationship, enhance the quality of care, and achieve more satisfying medical outcomes.

Improving patient safety governance andsystems through learning from successes andfailures: qualitative surveys andinterviews with international experts.

Patient harm is a leading cause of global disease burden with considerable morbidity, mortality, and economic impacts for individuals, families, and wider society. Large bodies of evidence exist for strategies to improve safety and reduce harm. However, it is not clear which patient safety issues are being addressed globally, and which factors are the most (or least) important contributors to patient safety improvements. We aimed to explore the perspectives of international patient safety experts to identify: (1) the nature and range of patient safety issues being addressed, and (2) aspects of patient safety governance and systems that are perceived to provide value (or not) in improving patient outcomes. English-speaking Fellows and Experts of the International Society for Quality in Healthcare participated in a web-based survey and in-depth semistructured interview, discussing their experience in implementing interventions to improve patient safety. Data collection focused on understanding the elements of patient safety governance that influence outcomes. Demographic survey data were analysed descriptively. Qualitative data were coded, analysed thematically (inductive approach), and mapped deductively to the System-Theoretic Accident Model and Processes framework. Findings are presented as themes and a patient safety governance model. The study was approved by the University of South Australia Human Research Ethics Committee. Twenty-seven experts (59% female) participated. Most hailed from Africa (n = 6, 22%), Australasia, and the Middle East (n = 5, 19% each). The majority were employed in hospital settings (n = 23, 85%), and reported blended experience across healthcare improvement (89%), accreditation (76%), organizational operations (64%), and policy (60%). The number and range of patient safety issues within our sample varied widely with 14 topics being addressed. Thematically, 532 textual segments were grouped into 90 codes (n = 44 barriers, n = 46 facilitators) and used to identify and arrange key patient safety governance actors and factors as a 'system' within the System-Theoretic Accident Model and Processes framework. Four themes for improved patient safety governance were identified: (1) 'safety culture' in healthcare organizations, (2) 'policies and procedures' to investigate, implement, and demonstrate impact from patient safety initiatives, (3) 'supporting staff' to upskill and share learnings, and (4) 'patient engagement, experiences, and expectations'. For sustainable patient safety governance, experts highlighted the importance of safety culture in healthcare organizations, national patient safety policies and regulatory standards, continuing education for staff, and meaningful patient engagement approaches. Our proposed 'patient safety governance model' provides policymakers and researchers with a framework to develop data-driven patient safety policy.

A Safety Huddle Intervention in In-Patient Surgical Units: A Mixed-Methods Study

Open communication about patient safety concerns is necessary to enable a learning environment where lessons can be learned to improve patient safety, but nurses often hesitate to speak up even in situations where their patients may be at risk. One way to create a safe environment for speaking up is through the use of unit-level daily huddles. This study aimed to assess the effects of a 12-week huddle intervention on nine unit, nurse and patient care outcomes and describe nurses’ experiences with the intervention. We used a single group, pre- and post-test mixed-methods design, with a dominant quantitative thread, and a final sample of 89 staff nurses. The intervention was conducted in four surgical units in a tertiary teaching hospital in Seoul, Korea. The intervention included two educational workshops for huddle leaders, two workshops for staff nurses, and 12-week huddles with coaching visits. We collected quantitative data on nine outcomes using online surveys before and after the intervention and qualitative data on nurse experiences of the intervention after the intervention. Paired t-tests were used for quantitative data analysis, and content analysis was used for qualitative data. We examined four unit-level outcomes (organizational learning, situation monitoring, mutual support, and speaking-up climate), three nurse-level outcomes (promotive and prohibitive voice behaviors and job satisfaction), and two patient care outcomes (patient safety and quality of care). Significant improvements were found in six of the nine outcomes. Findings from the qualitative data confirmed the benefits of the intervention but also identified challenges to huddle participation. Patient safety huddles can contribute to a learning environment by flattening hierarchies and encouraging nurses to speak up regarding safety issues. Leadership is a key in role modelling and creating the foundation for a more collaborative patient safety culture in healthcare organizations, for example, through the use of daily huddles.

Relationship between Health Care Organizational Culture and Professional Nurses' Autonomy

Relationship between Health Care Organizational Culture and Professional Nurses' Autonomy

Status and Factors Affecting Patient Safety Culture at Dilla University Teaching Hospital: A Mixed-Method Cross-Sectional Study.

Patient safety culture is now at the forefront of the global health agenda and has been designated as a human right. Assessing safety culture is seen to be a prerequisite for improving safety culture in health-care organizations. However, no research has been conducted to examine the current study setup. Therefore, this study aims at assessing the status and factors influencing patient safety culture at Dilla University Teaching Hospital. This cross-sectional institutional-based study was conducted from February to March 2022 at Dilla University Hospital. The study used both qualitative and quantitative methods. A total of 272 health professionals were included in the survey. The qualitative data was collected using Key Informant Interviews and In-depth Interviews and 10 health professionals were selected purposively to meet the study objective. The overall composite positive patient safety culture response rate in the current study hospital was 37% (95% CI: 35.3, 38.8). Out of the 12 dimensions, teamwork within hospital units was the highest (75.3%), while frequency of event reporting was the lowest (20.7%) positive percentage response. Only two of the 12 dimensions scored above 50%. Factors affecting patient safety culture majorly at organizational and individual level were poor/low attitude of health professionals, poor documentation practice, and poor cooperation by clients, lack of training and continuous education, lack of standard operating procedure, Staff shortage and high work load. This study revealed that the overall composite positive patient safety culture response rate within the surveyed facility was alarmingly low compared to other hospitals in various countries. The results indicate that there is a need for improvement in areas such as event reporting, documentation, health-care workers' attitude, and staff training. Hospitals must prioritize patient safety by cultivating a strong safety culture through effective leadership, adequate staffing, and education to enhance overall patient care.

Interprofessional collaboration and organizational culture in healthcare organizations

No abstract available

Evaluation of patient safety culture in community pharmacies

BackgroundThe majority of medical mistakes risking patient safety have been related to medication. Numerous international health organizations support assessing safety culture in healthcare organizations as a successful tactic for long-term safety development. ObjectiveThis study aimed to assess patient safety culture, investigate determinants of patient safety in community pharmacies and identify strengths and possible improvements concerning patient safety in the Lebanese community. MethodAn observational descriptive cross-sectional study was conducted using the Pharmacy Survey on Patient Safety Culture (PSOPSC). It was distributed among Lebanese community pharmacists. ResultsOne hundred forty-five community pharmacists completed the survey. High percent positive response (PPR) was seen in the domains of patient counseling (86.4%) and teamwork (83.9%). “Staffing, Work Pressure, and Pace” composite scored 41.2%. Female pharmacists were shown to be more dedicated to patient safety culture, namely in patient counseling skills (P < 0.05). Working for 32 to 40 h per week (β = 19.305), and for >40 h per week (β = 18.315) were significantly associated with increased patient safety score. ConclusionAn overall positive perception towards patient safety culture was seen among Lebanese community pharmacists.

Fostering a just culture in healthcare organizations: experiences in practice

BackgroundA just culture is regarded as vital for learning from errors and fostering patient safety. Key to a just culture after incidents is a focus on learning rather than blaming. Existing research on just culture is mostly theoretical in nature.AimThis study aims to explore requirements and challenges for fostering a just culture within healthcare organizations.MethodsWe examined initiatives to foster the development of a just culture in five healthcare organizations in the Netherlands. Data were collected through interviews with stakeholders and observations of project group meetings in the organizations.ResultsAccording to healthcare professionals, open communication is particularly important, paying attention to different perspectives on an incident. A challenge related to open communication is how to address individual responsibility and accountability. Next, room for emotions is regarded as crucial. Emotions are related to the direct consequences of incidents, but also to the response of the outside world, including the media and the health inspectorate.ConclusionsA challenge in relation to emotions is how to combine attention for emotions with focusing on facts, both within and outside the organization. Finally, healthcare professionals attach importance to commitment and exemplary behavior of management. A challenge as a manager here is how to keep distance while also showing commitment. Another challenge is how to combine openness with privacy of the parties involved, and how to deal with less nuanced views in other layers of the organization and in the outside world. Organizing reflection on the experienced tensions may help to find the right balance.

Relation between Health Care Organizational Culture and Workplace Violence

Relation between Health Care Organizational Culture and Workplace Violence

Exploring the relationship between midwives’ work environment, women's safety culture, and intent to stay

BackgroundThe shortage of midwives is a concern for healthcare systems as it compromises the quality maternity care. Various studies argue that a favorable work environment increases nurses’ job satisfaction and intention to continue working at their current workplace. AimTo analyze the work environment and its relationship with women’s clinical safety culture and midwives’ intention to stay in their current job and the midwifery profession. MethodsA cross-sectional, correlational study was performed on N = 218 midwives working in Spain. Standardized instruments were used, including The Practice Environment Scale of the Nursing Work Index (PES-NWI) and the Hospital Survey on Patient Safety Culture (HSOPSC). Descriptive and bivariable statistics were used. The study followed the STROBE guidelines. ResultsThe work environment in the labor wards was mixed, according to the PES-NWI classification. The mean total score of the PES-NWI significantly and positively correlated with the mean total score of the HSOPSC (rs = 0.498, p < 0.001), indicating that as the quality of midwives’ work environment increased, women’s clinical safety increased. Significant correlations were observed between the midwives’ intent to stay in the hospital where they work and features of women’s safety culture. ConclusionThe results of this study showed significant relationships between the work environment, women’s safety culture, and midwives’ intentions to leave their job/profession. Creating a favorable working environment could be a potentially effective strategy that encourages improvement in the women’s safety culture in healthcare organizations and greater intention of midwives to stay at their current job.

Healthcare professional's perception of patient safety assessed by the hospital survey on patient safety culture in Taiwan: a systematic review

PurposeSafety activities have been initiated in healthcare organizations in Taiwan, but little is known about the performance and trends of safety culture on a timely basis. This study aims to comprehensively review the articles that have conducted two worldwide patient safety culture instruments (HSPSC and SAQ) in Taiwan to provide the extent of existing knowledge about healthcare professionals' perception related to patient safety.Design/methodology/approachThe Web of Science, Medline (Pubmed) and Embas were used as the database to search papers related to the patient safety culture in Taiwan from 2008 to June 30, 2019.FindingsTwenty-four relative articles in total were found and further investigations confirmed that the regular assessment of patient safety culture among hospital staff is essentially important for healthcare organizations to reduce the rates of medical errors and malpractice. Moreover, the elements influencing patient safety culture may vary due to the difference in job positions, age, experience in organization and cultural settings.Research limitations/implicationsThe summary of findings enables healthcare administrators and practitioners to understand key components of patient safety culture for continuous improvement in medical quality.Originality/valueAssessing the safety culture in healthcare organizations is a foundation to achieve excellent medical quality and service. The implications of this study could be useful for hospitals to establish a safer environment for patients.

Patient Safety Culture in Primary Healthcare Centers in the Eastern Province of Saudi Arabia.

PurposeThis study aimed to explore health-care workers’ perceptions of patient safety culture (PSC) at primary health-care centers (PHCs) in the Eastern Province of Saudi Arabia and the factors that influence them. An additional aim was to identify the challenges of adopting PSCs in the PHCs of this region.MethodsThis is a cross-sectional study that adopted a PSC questionnaire from the Agency for Healthcare Research and Quality (AHRQ). The questionnaire was administered online and onsite targeted health-care workers at private, governmental, and quasi-governmental PHCs in the Eastern Province of Saudi Arabia, with 310 participants completing the survey.ResultsThe overall positive response rate of participants to the survey areas was 43.5% which is lower than the average for the AHRQ data in general. Teamwork scored the highest positive response (68.8%) while Number of Events and non-punitive Response to Error scored the lowest at 10.6% and 30.7%, respectively. In addition, ANOVA and t-tests were used to determine the bivariate associations for the parametric variables. The study reveals statistically significant differences between all demographic variables and overall PSC score, except by age.ConclusionThe findings highlight a number of areas for improvement, particularly in relation to event reporting, non-punitive responses, and openness in communication. Consequently, establishing a safety culture in health-care organizations necessitates the elimination of three crucial elements regarding errors: blame, fear, and silence. Error reporting should not just be considered a means of learning from mistakes; it should also be considered the first step towards preventing injury and improving patient safety.

Governance for Patient Safety: A Framework of Strategy Domains for Risk Management.

Adverse events in healthcare are primarily due to system failures rather than individuals. Risk reduction strategies should therefore focus on strengthening systems, bringing about improvements in governance, and targeting individual practices or products. The purpose of this study was to conduct a scoping review to develop a global framework of management strategies for sustaining a safety-oriented culture in healthcare organizations, focusing on patient safety and the adoption of good safety-related practices. We conducted a search on safety-related strategies in 2 steps. The first involved a search in the PubMed database to identify effective, broadly framed, cross-sector domains relevant to clinical risk management strategies in healthcare systems. In the second step, we then examined the strategies adopted by running a scoping review for each domain. Our search identified 8 strategy domains relevant to patient safety: transformational leadership, patient engagement, human resources management quality, innovation technology, skills certification, education in patient safety, teamwork, and effective communication. This scoping review explores management strategies key to healthcare systems' efforts to create safety-oriented organizations. Improvement efforts should focus particularly on the domains identified: combined together, they would nurture an overall safety-oriented culture and have an impact on preventable adverse events.

The Relationship between Healthcare Organizational Culture and Nurses' Empowerment

Background: Nowadays, healthcare organizations are affected by changes and reforms, thus new challenges arise for nurses. Nurses need to have the power to achieve their personal and organizational goals. Furthermore, healthcare organizational culture shapes the organization and provides a complex understanding of crucial organizational factors that affect nurses' empowerment.Aim: Identify the relationship between healthcare organizational culture and nurses' empowerment at hospital setting.Methods: Descriptive correlational research design was used. A convenient sample of 225 nurses was recruited from University Hospital in the Delta of Egypt. Denison Organizational Culture Survey (DOCS), the Condition of Work Effectiveness Questionnaire (CWEQ-II), the Psychological Empowerment Instrument were used to collect data for the current study. Results: There were a strong healthcare organizational culture among study sample, moderate level of structure empowerment, and moderate level of psychological empowerment. Conclusion: There were positive correlations between healthcare organizational culture, structural, and psychological empowerment. There was a positive correlation between structure and psychological empowerment. Only gender that did not vary with psychological empowerment. Sustaining a strong healthcare organizational culture enhances structure and psychological empowerment among nurses.

Instrument for Measuring Patient Safety Culture: Literature Review

The implementation of safe and quality care with attention to patient safety, requires organization’s effort to create and cultivating patient safety culture. The purpose of this article was to map the instruments used in measuring patient safety culture in healthcare organizations. The method used integrated literature review from various sources of research articles published from 2015 to 2020. The article included if it was available in full text and open access as well as articles described the instruments of patient safety culture or measurement of patient safety culture using one of the instruments of measurement of patient safety culture. The results of the literature review unravel the findings of three instruments such as HSOPSC (Hospital Survey on Patient Safety Culture), MaPSaF (Manchester Patient Safety Assessment Framework) and SAQ (Safety Attitudes Questionnaire). We concluded all three instruments contained four dimensions of patient safety culture, namely open culture, just culture, reporting culture and learning culture and were widely used to measure patient safety culture in hospitals, primary health facilities and other health facilities.

The Impacts of Disclosure and a Proactive Compensation Offer on Chinese Patients' Actions After Medical Errors.

This study aims to obtain evidence of the impacts of error disclosure and the impacts of a proactive compensation offer on Chinese patients' actions after medical errors. A total of 915 responses were collected from a questionnaire survey. Two fictitious cases (entailed moderate and severe harm) that involved error disclosure were described. One of 5 disclosure and compensation types was randomly provided to each participant. The 5 types were combinations of 3 disclosure types (no disclosure, partial disclosure, and full disclosure) and 2 proactive compensation offer categories (no offer and an offer), with the exception of no disclosure but a proactive compensation offer. The respondents were asked about their willingness to take actions if they were the affected patient. The generalized ordinal logit regression model showed that error disclosure did not increase the likelihood of the patients taking action, such as changing physicians, complaining, or filing lawsuits. A proactive compensation offer decreased the patients' willingness to file lawsuits but had no significant influence on the other action choices. In addition, the patients' actions were affected by other factors, such as the severity of the error, age, sex, education level, being religious, prior error experience, and health insurance. We suggest that "disclosure and compensation" programs are developed in China. To ensure their implementation, it is recommended that appropriate training is provided and that the disclosure culture in health care organizations is improved. Furthermore, laws or regulations are required that govern error disclosure and provide support for health care professionals and organizations.

EFFECT OF DIFFERENT DIMENSIONS OF ORGANIZATIONAL CULTURE ON JOB SATISFACTION OF NURSES WORKING IN RURAL AREAS OF PUNJAB, PAKISTAN

Purpose of the study: The current study has explored the effect of different dimensions of organizational culture on the job satisfaction of nurses working in the rural areas of Punjab, Pakistan.&#x0D; Methodology: Present study used a cross-sectional, face-to-face approach. The researcher collected data from 452 nurses working at tehsil headquarter hospitals and rural health centres across Punjab with the help of an interview schedule. The effect of culture on the job satisfaction level of nurses Investigated with the help of Multiple regression techniques.&#x0D; Main Findings: The analysis showed a 52% variation in job satisfaction because of the culture. Values and belief systems, feedback systems, innovation, growth and development opportunities, relationship patterns, autonomy, work environment were the significant determinants of job satisfaction. Whereas the facilities, communication, and vision were the nonsignificant determinants of job satisfaction in the present study.&#x0D; Application of this study: The current research will be helpful to understand the prevailing culture of health care organizations. That will help the administrators and policymakers to understand the different factors which are responsible for low productivity.&#x0D; Novelty /originality of this study: The study is novel in organizational studies because it adopts a holistic approach to consider all the significant components of culture.