Patient Safety Climate In Hospitals Research Articles

Patient Safety Climate, Quality of Care, and Intention of Nursing Professionals to Remain in Their Job During the COVID-19 Pandemic.

This study aimed to examine the relationship between patient safety climate, quality of care, and intention of nursing professionals to remain in their job. A cross-sectional study was carried out in a teaching hospital in Brazil wherein nursing professionals were surveyed. The Brazilian version of the Patient Safety Climate in Healthcare Organizations tool was applied to measure the patient safety climate. Spearman correlation coefficient and multiple linear regression models were applied for the analysis. A high percentage of problematic response was observed for most dimensions, except for fear of shame. Quality of care resulted in a strong correlation with organizational resources for safety and with overall emphasis on patient safety, and the nurse-perceived staffing adequacy was strongly correlated with organizational resources for safety. The multiple linear regression model showed higher scores in quality of care in dimensions related to organizational, work unit, and interpersonal aspects as well as in the adequacy of the number of professionals. A higher score in intention to stay in one's job was also found in the dimensions of fear of blame and punishment, provision of safe care, and adequacy of the number of professionals. The organizational and work unit aspects can lead to a better perception of the quality of care. Improving interpersonal relationships and increasing the number of professionals on staff were found to increase nurses' intention to remain in their jobs. Assessing a hospital's patient safety climate will enable improvement in the provision of safe and harm-free health care assistance.

Association between nurses' burnout, hospital patient safety climate and quality of nursing care

Aim: To evaluate the associations between nurse burnout, the hospital patient safety climate, the patient safety grade, and adverse events. Design: Cross-sectional. Methods: 117 nurses completed the Copenhagen Burnout Inventory and the Hospital Survey on patient safety culture. Pearson correlation and linear regression analysis was conducted to assess associations between variables. Results: Higher level of burnout significantly met with lower grade of patient safety, overall perception of patient safety, higher frequency of adverse events recorded, and medication errors. The overall perception of safety was positively related to teamwork within hospital units and non-punitive responses to error. The frequency of recorded events was significantly negatively associated with hospital management support and supervisors’ activities, and positively with feedback. Medication errors correlated positively with organizational learning and continuous safety improvement and negatively with staffing. Significant relationships have been identified between management support, non-punitive responses to error, teamwork within hospital units, and selected adverse events. Conclusion: Enhancement of the patient safety climate and nurses’ mental health are important patient safety improvements in healthcare organisations.

Patient Safety Climate in General Public Hospitals in China: A Multiregion Study.

This study aimed to analyze the potential difference in patient safety climate by region (Shanghai vs Hubei Province vs Gansu Province) and general public hospital level (tertiary vs secondary) in China. Using a stratified sampling method, employees from 54 public general hospitals in Shanghai, Hubei Province, and Gansu Province in China were surveyed in 2015. The Patient Safety Climate in Health Care Organizations tool and the percentage of "problematic responses" (PPRs) were used to measure and analyze the patient safety climate. A χ2 test and hierarchical linear modeling were applied for the analysis. In the study, 4121 valid questionnaires were collected. The psychometric analysis supported the validity and reliability of our Chinese version of the Patient Safety Climate in Health Care Organizations. The overall patient safety climate was relatively good and exhibited no significant differences among the surveyed hospitals by various regions (Shanghai vs Hubei Province vs Gansu Province) and diverse hospital levels (tertiary vs secondary) using hierarchical linear models. "Fear of blame and punishment" and "fear of shame" had the highest PPRs and were prevalent in various types of hospitals. "Provision of safe care" and "organizational resources for safety" also had notably high PPRs. There were 4 dimensions varied by region and hospital level in this survey. Fear of shame and fear of blame are the most important barriers to the improvement of patient safety in the hospitals of China. Facility characteristics contributed somewhat to hospital patient safety climate in some dimensions. The initiatives to improve hospital patient safety climate are necessary and its implementation strategies needs to be shared.

Perceptions of Hospital Safety Climate and Incidence of Readmission

To define the relationship between hospital patient safety climate (a measure of hospitals' organizational culture as related to patient safety) and hospitals' rates of rehospitalization within 30 days of discharge. A safety climate survey administered to a random sample of hospital employees (n=36,375) in 2006-2007 and risk-standardized hospital readmission rates from 2008. Cross-sectional study of 67 hospitals. Robust multiple regressions used 30-day risk-standardized readmission rates as dependent variables in separate disease-specific models (acute myocardial infarction [AMI], heart failure [HF], pneumonia), and measures of safety climate as independent variables. We estimated separate models for all hospital staff as well as physicians, nurses, hospital senior managers, and frontline staff. There was a significant positive association between lower safety climate and higher readmission rates for AMI and HF (p ≤ .05 for both models). Frontline staff perceptions of safety climate were associated with readmission rates (p ≤ .01), but senior management perceptions were not. Physician and nurse perceptions related to AMI and HF readmissions, respectively. Our findings indicate that hospital patient safety climate is associated with readmission outcomes for AMI and HF and those associations were management level and discipline specific.

Patient Safety Climate in Hospitals: Act Locally on Variation Across Units

An appreciation of how human factors affect patient safety has led to development of safety climate surveys and recommendations that hospitals regularly assess safety attitudes among caregivers. A better understanding of variation in patient safety climate across units within hospitals would facilitate internal efforts to improve safety climate. A study was conducted to assess the extent and nature of variation in safety climate across units within an academic medical center. The Agency for Healthcare Research and Quality (AHRQ) Hospital Survey of Patient Safety was administered in 2008 to all nurses and attending physicians (N=4283) in a 900-bed acute care hospital (overall response rate, 69% [n=2961]). Responses were analyzed from the 2,163 physicians and nurses (73% of respondents) who could be assigned to one specific clinical unit. Results were examined for 57 units, categorized into six types. Ratings of various safety climate domains differed markedly across the 57 units, with the percentage reporting a safety grade of excellent ranging from 0% to 50%. The overall percentage of positive ratings was lower for the operating and emergency unit types than for inpatient medical and other clinical units. Even within the six unit types, substantial variation across individual units was evident. Unlike previous findings, physicians reported more negative ratings than nurses for some safety climate dimensions. Safety climate may vary markedly within hospitals. Assessments of safety climate and educational and other interventions should anticipate considerable variation across units within individual hospitals. Furthermore, clinicians at individual hospitals may offer different relative perceptions of the safety climate than their professional peers at other hospitals.

Identifying Organizational Cultures That Promote Patient Safety

Background Safety climate refers to shared perceptions of what an organization is like with regard to safety, whereas safety culture refers to employees' fundamental ideology and orientation and explains why safety is pursued in the manner exhibited within a particular organization. Although research has sought to identify opportunities for improving safety outcomes by studying patterns of variation in safety climate, few empirical studies have examined the impact of organizational characteristics such as culture on hospital safety climate. Purpose This study explored how aspects of general organizational culture relate to hospital patient safety climate. Methodology In a stratified sample of 92 U.S. hospitals, we sampled 100% of senior managers and physicians and 10% of other hospital workers. The Patient Safety Climate in Healthcare Organizations and the Zammuto and Krakower organizational culture surveys measured safety climate and group, entrepreneurial, hierarchical, and production orientation of hospitals' culture, respectively. We administered safety climate surveys to 18,361 personnel and organizational culture surveys to a 5,894 random subsample between March 2004 and May 2005. Secondary data came from the 2004 American Hospital Association Annual Hospital Survey and Dun & Bradstreet. Hierarchical linear regressions assessed relationships between organizational culture and safety climate measures. Findings Aspects of general organizational culture were strongly related to safety climate. A higher level of group culture correlated with a higher level of safety climate, but more hierarchical culture was associated with lower safety climate. Aspects of organizational culture accounted for more than threefold improvement in measures of model fit compared with models with controls alone. A mix of culture types, emphasizing group culture, seemed optimal for safety climate. Practice implications Safety climate and organizational culture are positively related. Results support strategies that promote group orientation and reduced hierarchy, including use of multidisciplinary team training, continuous quality improvement tools, and human resource practices and policies.

Factors affecting the climate of hospital patient safety

The purpose of this paper is to describe three organizational dimensions that influence hospital patient safety climate, also showing and discussing differences between organizational types. Surveys were conducted in four types of Saudi Arabian hospitals. Resultant information was analyzed using factor analysis and multiple-regression. Management support, a proper reporting system and adequate resources were found to influence the hospital patient safety climate. The cross-sectional hospital survey took place in a country that is radically redesigning its healthcare system. Major changes including hospital privatisation and healthcare insurance systems may have significant effects on hospital organizational climates. Improving a hospital's patient safety climate is critical for decreasing errors and providing optimal services. Although much patient safety research has been published, the organizational climate in non-Western countries has not been studied. The paper provides a unique Saudi Arabian hospital perspective and suggests that three dimensions influence the patient safety climate. Hospital managers are encouraged to improve these critical dimensions to positively develop their patient safety climate.