Evaluation Of Safety Culture Research Articles

The patient safety culture: a systematic review by characteristics of Hospital Survey on Patient Safety Culture dimensions.

To learn the weaknesses and strengths of safety culture as expressed by the dimensions measured by the Hospital Survey on Patient Safety Culture (HSOPSC) at hospitals in the various cultural contexts. The aim of this study was to identify studies that have used the HSOPSC to collect data on safety culture at hospitals; to survey their findings in the safety culture dimensions and possible contributions to improving the quality and safety of hospital care. Medline (via PubMed), Web of Science and Scopus were searched from 2005 to July 2016 in English, Portuguese and Spanish. Studies were identified using specific search terms and inclusion criteria. A total of 33 articles, reporting on 21 countries, was included. Scores were extracted by patient safety culture dimensions assessed by the HSOPSC. The quality of the studies was evaluated by the STROBE Statement. The dimensions that proved strongest were 'Teamwork within units' and 'Organisational learning-continuous improvement'. Particularly weak dimensions were 'Non-punitive response to error', 'Staffing', 'Handoffs and transitions' and 'Teamwork across units'. The studies revealed a predominance of hospital organisational cultures that were underdeveloped or weak as regards patient safety. For them to be effective, safety culture evaluation should be tied to strategies designed to develop safety culture hospital-wide.

Nurses' handoff and patient safety culture in perinatal care units

To examine nursing handoff, identify causes of handoff errors, evaluate current methods of handoff and determine the factors associated with handoff evaluation in delivery rooms and neonatal units of hospitals in South Korea. Handoff is a critical communication process in clinical settings. Less attention has been paid to the handoff practice to assure safe perinatal care in hospitals. This is a cross-sectional descriptive study. A total of 291 nurses participated in the study. They completed a set of self-reporting questionnaires containing five instruments that evaluated demographic data and current handoff strategies, experience of handoff error, causes of handoff error, perception of patient safety culture and handoff evaluation. The responses were analysed using descriptive statistics and stepwise regression modelling. Perception of patient safety culture was positively related to handoff evaluation, while experience and causes of handoff error were negatively related to handoff evaluation. A regression analysis showed that degree of cooperation among departments and units, reasonable communication and processes, and frequency of reported medical errors were positively related to handoff evaluation and the lack of documented guidelines or checklists was negatively associated with handoff evaluation. This study suggests that hospitals should develop a standardised handoff checklist according to documented guidelines, promote cooperation among hospital units and departments, enhance communication and clarify work processes to achieve safer care to create an affirmative culture that encourages reporting of errors to keep patients safe. This study highlights the importance of standardising handoff process and systems, promoting communication and cooperating with each other to foster patient safety culture in perinatal care units.

An evaluation of patient safety culture in a secondary care setting in Kuwait.

ObjectivesTo improve patient safety outcomes, it is considered essential to create a positive culture of patient safety. This study carried out an initial evaluation of the patient safety culture in a secondary care setting in Kuwait.MethodsThis cross-sectional questionnaire study was conducted in a general hospital medical department in Kuwait, using the Hospital Survey on Patient Safety Culture (HSPSC). Multiple linear regression analyses were used to identify patient safety culture predictors. Both an ANOVA and a Kruskal Wallis test were carried out to assess the differences between participants' total scores and the scores they achieved in each dimension, categorized by nationality.ResultsA total of 1008 completed questionnaires were received, yielding a response rate of 75.2%. Three dimensions of patient safety culture were found to be priority areas for improvement: non-punitive responses to errors, staffing, and communication openness. Teamwork within units and organizational learning with continuous improvement were identified as areas of strength. Respondents from Kuwait and the Gulf State countries had a less positive perception of the hospital's patient safety culture than did Asian respondents. A regression analysis showed that the respondents' countries of origin, professions, age, and patient safety course/lecture attendance were significantly correlated with their perceptions of the hospital's patient safety culture.ConclusionThis study demonstrates that patient safety is perceived differently by medical staff members from different countries of origin, professional groups, and age groups. These variables must be acknowledged and addressed when planning or evaluating patient safety initiatives.

The Evaluation of Safety Culture in Gas Stations in the City of Zanjan

The Evaluation of Safety Culture in Gas Stations in the City of Zanjan

Using Data Envelopment Analysis to Benchmark Safety Culture in Aviation Organizations

While organizations are increasingly encouraged to evaluate safety culture in the context of measurement of leading safety indicators within a safety management system, there remains no generally agreed upon means by which this should be accomplished. In fact, few tools exist that allow an operator to make such measurement with any substantial practical value. Data envelopment analysis (DEA) has been used extensively to compare organizational production efficiency, with techniques such as stochastic frontier analysis or the double-bootstrapped form of DEA infusing the process with a stochastic element. This study applies native DEA methodology toward the evaluation of safety culture and safety program effectiveness among similar organizations and proposes future research directions utilizing stochastic DEA methods toward achieving more reliable, generalizable results upon which statistical inferences may be based.

Evaluation of Patient Safety Culture in Community Pharmacies.

Medication errors are common in community pharmacies. Safety culture is considered a factor for medication safety but has not been measured in this setting. The objectives of this study were to describe safety culture measured using the Agency for Healthcare Research and Quality (AHRQ) Community Pharmacy Survey on Patient Safety Culture and to assess predictors of overall patient safety. This is a cross-sectional survey of community pharmacists practicing in Wisconsin measuring safety culture. Demographic variables collected included pharmacist and pharmacy characteristics. Data were analyzed using descriptive statistics, χ, and multivariate logistic regression analyses. A total of 445 surveys were completed (response rate, 82%). Safety culture was positively associated with the following: an independent pharmacy (adjusted odds ratio [AOR], 1.69; 95% confidence interval [CI], 1.11-2.57), a health maintenance organization or clinic (AOR, 2.25; 95% CI, 1.34-3.78), being somewhat familiar with patients (AOR, 3.35; 95% CI, 1.82-6.19), or very/extremely familiar with patients (AOR, 8.8; 95% CI, 4.68-16.59). Five of the composite scores differed significantly from the results of the AHRQ pilot study (response to mistakes, communication openness, organizational learning-continuous improvement, communication about prescriptions across shifts, and overall patient safety). Consistent with the AHRQ pilot study, the composite describing staffing, work pressure, and pace had the lowest score (37.6%). Understanding the safety culture of community pharmacies can help identify areas of strength and those that require improvement. Improvement efforts that focus on staffing, work pressure, and pace in community pharmacies may lead to better safety culture.

Patient Safety in Surgery in Sub-Saharan Africa: A Multi-Method Evaluation of Perioperative Practice and Safety Culture at AaResource-Poor Rural Hospital

Patient Safety in Surgery in Sub-Saharan Africa: A Multi-Method Evaluation of Perioperative Practice and Safety Culture at AaResource-Poor Rural Hospital

Development of Nuclear Safety Culture evaluation method for an operation team based on the probabilistic approach

The aim of this study is to propose a new quantitative evaluation method for Nuclear Safety Culture (NSC) in Nuclear Power Plant (NPP) operation teams based on the probabilistic approach. Various NSC evaluation methods have been developed, and the Korea NPP utility company has conducted the NSC assessment according to international practice. However, most of methods are conducted by interviews, observations, and the self-assessment. Consequently, the results are often qualitative, subjective, and mainly dependent on evaluator’s judgement, so the assessment results can be interpreted from different perspectives. To resolve limitations of present evaluation methods, the concept of Safety Culture Healthiness was suggested to produce quantitative results and provide faster evaluation process.This paper presents Probabilistic Safety Culture Healthiness Evaluation Method (Pro-SCHEMe) to generate quantitative inputs for Human Reliability Assessment (HRA) in Probabilistic Safety Assessment (PSA). Evaluation items which correspond to a basic event in PSA are derived in the first part of the paper through the literature survey; mostly from nuclear-related organizations such as the International Atomic Energy Agency (IAEA), the United States Nuclear Regulatory Commission (U.S.NRC), and the Institute of Nuclear Power Operations (INPO). Event trees (ETs) and fault trees (FTs) are devised to apply evaluation items to PSA based on the relationships among such items. The Modeling Guidelines are also suggested to classify and calculate NSC characteristics of respective NPPs. Probability of the fault tree top event, namely safety culture healthiness, is automatically calculated to determine the state of NSC healthiness of operation teams. Validation of the suggested method performed by case studies using training video of NPP operators.According to the validation results, a positive relationship between ‘success’ states of safety culture and human performance was found, the safety culture state probability profile of each team represents the team characteristic, and the cut-set analysis of the proposed method provides not only the root causes but also the latent causes of failure. Pro-SCHEMe showed possibility to apply NSC to NPP system safety analysis judging by the results of the case study. Further case studies will be conducted to meet the statistical requirement of the results.

Triangulation and the importance of establishing valid methods for food safety culture evaluation

The research evaluates maturity of food safety culture in five multi-national food companies using method triangulation, specifically self-assessment scale, performance documents, and semi-structured interviews. Weaknesses associated with each individual method are known but there are few studies in food safety where a method triangulation approach is used for both data collection and data analysis. Significantly, this research shows that individual results taken in isolation can lead to wrong conclusions, resulting in potentially failing tactics and wasted investments. However, by applying method triangulation and reviewing results from a range of culture measurement tools it is possible to better direct investments and interventions. The findings add to the food safety culture paradigm beyond a single evaluation of food safety culture using generic culture surveys.

Development and validation of a scale to capture social desirability in food safety culture

The evaluation of food safety culture in a food company is influenced by human factors such as employees' tendency to respond to social desirability – a reflection of respondents' tendency to answer questions in a manner that will be viewed favorably by others. Building on previous research a self-assessment scale consisting of 18-statements (FSDRS) was developed to capture desirable responding in food safety. Statistical analyses of data collected from 816 North-American food manufacturing professionals revealed that a shortened 14-item version of the FSDRS scale provides a reliable and valid measurement of the extent to which employees deceive themselves. It is concluded that the proposed FSDRS will enrich food safety culture measurement and food safety performance.

Comparative analysis of existing food safety culture evaluation systems

The purpose of the research was firstly, to analyze existing culture evaluation systems for commonalities and differences in research quality, applied validation strategies, and content. Secondly, to suggest a simple structure of food safety cultural dimensions to help unify the culture evaluation field. To achieve these goals, a comparison of eight culture evaluation models applied to varing degrees in the food industry was conducted. The systems were found to vary significantly in applied validation strategies but through deductive, textual data analysis, five dimensions were identified that cover elements present in all the models. Transparency is needed when using applied research methodologies to continually increase quality and trustworthiness of culture research in the food safety domain and this field would benefit from both further commonality of approach to validation strategy and structure and adoption of an overarching structural framework.

Formal Safety versus Real Safety: Quantitative and Qualitative Approaches to Safety Culture – Evidence from Estonia

Abstract This paper examines differences between formal safety and real safety in Estonian small and medium-sized enterprises. The results reveal key issues in safety culture assessment. Statistical analysis of safety culture questionnaires showed many organisations with an outstanding safety culture and positive safety attitudes. However, qualitative data indicated some important safety weaknesses and aspects that should be included in the process of evaluation of safety culture in organisations.

Evaluation of Patient Safety Culture and Organizational Culture as a Step in Patient Safety Improvement in a Hospital in Jakarta, Indonesia

Introduction: Establishment of patient safety culture is the first step in the improvement of patient safety. As such, assessment of patient safety culture in hospitals is of paramount importance. Patient safety culture is an inherent component of organizational culture, so that the study of organizational culture is required in developing patient safety. This study aimed to evaluate patient safety culture among the clinical staff of a hospital in Jakarta, Indonesia and identify organizational culture profile. Materials and Methods: This cross-sectional, descriptive, qualitative study was conducted in a hospital in Jakarta, Indonesia in 2014. Sample population consisted of nurses, midwives, physicians, pediatricians, obstetrics and gynecology specialists, laboratory personnel, and pharmacy staff (n=152). Data were collected using the Hospital Survey on Patient Safety Culture developed by the Agency for Healthcare Research and Quality (AHRQ) and Organizational Culture Assessment Instrument (OCAI). Results: Teamwork within units” was the strongest dimension of patient safety culture (91.7%), while “staffing” and “non-punitive response to error” were the weakest dimensions (22.7%). Moreover, clan culture was the most dominant type of organizational culture in the studied hospital. This culture serves as a guide for the changes in the healthcare organization, especially in the development of patient safety culture. Conclusion: According to the results of this study, healthcare providers were positively inclined toward the patient safety culture within the organization. As such, the action plan was designed through consensus decision-making and deemed effective in articulating patient safety in the vision and mission of the organization.

Evaluation of patient safety culture among Malaysian retail pharmacists: results of a self-reported survey.

BackgroundPatient safety is a major public health issue, and the knowledge, skills, and experience of health professionals are very much essential for improving patient safety. Patient safety and medication error are very much associated. Pharmacists play a significant role in patient safety. The function of pharmacists in the medication use process is very different from medical and nursing colleagues. Medication dispensing accuracy is a vital element to ensure the safety and quality of medication use.ObjectiveTo evaluate the attitude and perception of the pharmacist toward patient safety in retail pharmacies setup in Malaysia.MethodsA Pharmacy Survey on Patient Safety Culture questionnaire was used to assess patient safety culture, developed by the Agency for Healthcare Research and Quality, and the convenience sampling method was adopted.ResultsThe overall positive response rate ranged from 31.20% to 87.43%, and the average positive response rate was found to be 67%. Among all the eleven domains pertaining to patient safety culture, the scores of “staff training and skills” were less. Communication openness, and patient counseling are common, but not practiced regularly in the Malaysian retail pharmacy setup compared with those in USA. The overall perception of patient safety of an acceptable level in the current retail pharmacy setup.ConclusionThe study revealed that staff training, skills, communication in patient counseling, and communication across shifts and about mistakes are less in current retail pharmacy setup. The overall perception of patient safety should be improved by educating the pharmacists about the significance and essential of patient safety.

Suggestions for More Reliable Measurement of Korean Nuclear Power Industry Safety Culture

Objective: The aim of this study is to suggest some improvement ideas based on the validity and the reliability analyses of the current safety culture measurement method applied to the Korean nuclear power industry. Background: Wrong safety culture is known as one of the major causes of the disasters such as the space shuttle Columbia disaster or the Fukushima Nuclear Power Plant accident. Assessment of safety culture of an organization is important to build a safer organizational environment as well as to identify the risks hidden in the organization. Method: A face validity of the current safety culture measurement method was analyzed by comparison of the key factors of safety culture in the Korean nuclear power industry with those factors reviewed in the previous studies. The current interview method was analyzed to identify the problems which degrade the consistency of evaluation. Results: Most safety culture factors reviewed in the literatures are covered in the list of the Korean nuclear power industry safety culture factors. However the unstructured questions used in the interview may result in inconsistency of safety culture evaluation among interviewers. Conclusion: This study suggests some examples which might improve the consistency of interviewers evaluation on safety culture such as a post interview evaluation form. Application: An extended post interview evaluation form might help to increase the accuracy of the interviewing method for Korean nuclear industry safety culture evaluation.

Subjective Predictors of Safe and Risky Behaviours. Presentation of Selected Results of the Studies Among Workers in Non-Traditional Forms of Employment

The paper presents selected results of the studies carried out among Polish workers in non-traditional forms of employment, using the Occupational Safety Culture Scale (Milczarek, 2000) consisting of 6 sub-scales: management commitment and participation; OSH training and analysis of accidents; values; relations between employees and affiliation to the company; responsibility and awareness; safe behaviours. All groups of the nine examined forms of flexible employment have declared the evaluation of occupational safety culture at the average level of 5-6 Sten, which shapes its following features. The paper presents selected results of the Author’s own broader research project on a sample of workers in non-traditional forms of employment

Method for quantitative assessment of safety culture

Many events with catastrophic consequences occurred over past decades. One of them was the disaster in Bhopal. A weak safety culture is mentioned as a one of the causes of this tragic event. It is a generally accepted fact that the level of safety culture has to be continuously evaluated and improved to avoid the occurrence of such situations in the future. This paper introduces a new method – Assessment Tree Method (ATM) allowing for quantitative estimation of the level of safety culture in an organization.The ATM enables the determination and quantification of the key aspects of safety culture on the basis of assessment trees. The structure of the trees is analogical to fault tree, a commonly used tool for the analysis of accidents. The assessment process is based on the guided interviews. As a result, a deeper insight is gained and effective identification and elimination of weak points in safety culture enabled. Next, the level of safety culture is calculated taking into account the results obtained for key safety aspects specific for a given organisation as well as their weights of importance.The ATM was tested for the evaluation of safety culture at the university department. There were twenty students, and three staff members responsible for safety, participating in the study. The six key aspects of safety culture were identified: knowledge & skills; awareness; flow of information; monitoring & control & supervision; management commitment and continuous improvement. On the basis of the obtained results it was concluded that the level of safety culture is high and some recommendations were given to make it even better.The most important advantages of the proposed method are quantification and simplicity enabling assessment of a broad scope of the specific aspects of safety culture. The proposed method could be used for the standardised benchmarking of the different organisations.

Comparative Evaluation of Pharmacy Patient Safety Culture in all Levels of Health Care Delivery in Delta State, Nigeria

In health care, there is a move towards a patient safety culture as a means of ensuring sustainable positive patient care outcomes. This study evaluated the safety cultures in the health institutions in Delta State, Nigeria. An adapted form of the Agency for Healthcare Research and Quality Questionnaire on Pharmacy Safety was administered to 118 pharmacy personnel in 10 hospitals spread across the 3 senatorial districts. Data was analyzed with SPSS.20. The number of pharmacists was inadequate; pharmacy organization at the secondary and tertiary levels was better than the primary level; At all three levels, the safety cultures of Staff Training and Skills, Teamwork, Communication Openness, and Patient Counseling were generally positively rated. Highly significant differences existed in the safety culture of documenting mistakes in the pharmacy. There were significant differences in most culture composites between the three levels of care. The general trend was Tertiary>Secondary>Primary in positivity. On the overall Rating of Patient Safety, all levels were rated Very Good / Excellent. However, there were isolated lapses in safety culture composites requiring attention; pharmacy managers, in particular, are therefore enjoined to re-evaluate the safety cultures in their domain to identify areas of systemic failure.

Predictive Effect of Implicit Safety Attitudes on Safety Performance in Aviation Safety Culture

The fundamental feature of safety culture is represented by safety attitudes. In terms of measuring safety cultures, many researchers have mainly focused on explicit safety attitudes and generally relied on specific survey instruments. It is questionable, however, whether self-report measures can capture all aspects of organizational safety culture. Instead of getting direct answers, it is necessary to introduce implicit measures and the implicit safety attitudes test into safety culture evaluation. The basic hypothesis of this study was that while various enterprises share different safety culture, the structure and intensity of implicit and explicit safety attitudes differ for employees. The present study was aimed at investigating the complete model of aviation safety culture and the importance of implicit safety attitudes by detecting the relationship between explicit and implicit safety attitudes as well as the prediction effect of implicit safety attitudes.The Flight Management Attitudes Questionnaire(FMAQ 2.0, international version) was adopted in this study which was based on the work characteristics of modern airlines pilots. With the purpose of evaluating explicit safety attitudes under the background of aviation safety culture, FMAQ 2.0 is comprised of three subscales, including basic organizational attitudes, cockpit work attitudes, and flight automation attitudes. Moreover, Evaluative Implicit Association Test and Affective Implicit Association Test were developed for aviatic implicit safety attitudes test. 134 pilots were involved in the investigation, 126 valid cases were obtained. Safety performance were obtained from airline company on four dimensions, including safety regulation, flight style, flight skill and organizational management was applied for validity criterion. The results showed that(1) IAT of aviation safety attitudes indicated a high effect value, aviation safety led to more positive evaluation and feelings while flight risk and adventure were more connected with negative evaluation and emotion.(2) Implicit and explicit safety attitudes were both relevant and relative separation. There was a positive relation between evaluative implicit safety attitudes and cockpit work attitudes. Affective implicit safety attitudes showed significant positive correlation with cockpit work attitudes and flight automation attitudes. And the model data showed that implicit and explicit safety attitudes were separation structure.(3) Both the flight management attitudes and implicit safety attitudes were able to predict safety performance. The former were doing better on predicting flight style, flight skill and organizational management, while the latter had higher prediction rate on safety regulation. The common prediction model fitted well. The study demonstrated a high intensity of aviation safety attitudes. IAT can be used as an effective evaluation tool for implicit safety attitudes. Explicit and implicit safety attitudes are both unified and separated structure. The explicit safety attitudes, implicit safety attitudes and safety performance together constitute a complete model of aviation safety culture. And in this model, the outer layer is aviation safety performance, the middle layer is explicit safety attitudes which can be measured directly, the inner layer is implicit safety attitudes which can be evaluated by indirect measurement methods.

Assessment of patient safety culture in clinical laboratories in the Spanish National Health System.

IntroductionThere is increasing awareness of the importance of transforming organisational culture in order to raise safety standards. This paper describes the results obtained from an evaluation of patient safety culture in a sample of clinical laboratories in public hospitals in the Spanish National Health System.Material and methodsA descriptive cross-sectional study was conducted among health workers employed in the clinical laboratories of 27 public hospitals in 2012. The participants were recruited by the heads of service at each of the participating centers. Stratified analyses were performed to assess the mean score, standardized to a base of 100, of the six survey factors, together with the overall patient safety score.Results740 completed questionnaires were received (88% of the 840 issued). The highest standardized scores were obtained in Area 1 (individual, social and cultural) with a mean value of 77 (95%CI: 76-78), and the lowest ones, in Area 3 (equipment and resources), with a mean value of 58 (95%CI: 57-59). In all areas, a greater perception of patient safety was reported by the heads of service than by other staff.ConclusionsWe present the first multicentre study to evaluate the culture of clinical safety in public hospital laboratories in Spain. The results obtained evidence a culture in which high regard is paid to safety, probably due to the pattern of continuous quality improvement. Nevertheless, much remains to be done, as reflected by the weaknesses detected, which identify areas and strategies for improvement.