Patient Safety Culture In Hospitals Research Articles

Perceptions of Pediatric Hospital Safety Culture in the United States: An Analysis of the 2016 Hospital Survey on Patient Safety Culture.

Medical errors in the pediatric population can quickly cause harm. Research identified that hospitals with positive safety cultures work collaboratively to reduce errors. Strategies that identify gaps in hospital's safety culture within the pediatric milieu have not been initiated. This study addressed this gap from an interprofessional perspective. This cross-sectional descriptive study used data from the Agency for Healthcare Research and Quality's 2016 Hospital Patient Safety Culture survey measuring 12 safety culture dimensions for registered nurses (RNs), physician assistants/nurse practitioners (PAs/NPs), physicians (MDs), and administrators/managers (n = 6682) in the United States that were employed in 287 (42%) pediatric hospitals or specialty units. Findings indicated that in the United States, the overall safety culture had low levels of agreement. Pairings between pediatric RNs, PAs/NPs, and MDs had similar levels of agreement for all dimensions but the perceptions of these three practitioners differed when compared with pediatric administrators/managers in nine of the 12 dimensions. The perceptions of pediatric RNs and MDs differed in six of the 12 dimensions, with MDs indicating higher levels of agreement. All four professional groups rated teamwork within hospital units with the highest level of agreement (mean, 4.14), with hospital handoffs and transitions rated the lowest (mean, 2.64). All four professional groups found punitive cultures (mean, 2.71) throughout the pediatric specialty. Variations regarding pediatric professional's perception of safety culture exist within U.S. hospitals. Effective and creative management will support cultures that prevents harm and improves the overall safety of children's care with initiatives that are dedicated to excellence.

A cross-sectional survey on patient safety culture in secondary hospitals of Northeast China.

ObjectivesThis study aims to investigate patient safety culture in secondary hospitals of Heilongjiang, Northeast China, and explore the implications of patient safety culture and practices through the perspectives of various healthcare workers.MethodsA cross-sectional survey using the Safety Attitude Questionnaire (SAQ) was conducted to ascertain the status of patient safety culture in nine secondary hospitals across the six dimensions of the SAQ. Among the 900 staff members who were invited to participate, 665 completed the questionnaire. Descriptive statistics were used to calculate the general means and standard deviations of the patient safety culture dimensions and other numerical variables, and F-test and a multivariate regression analysis were used to statistically analyze the differences in perceptions of safety culture considering the differences in demographic characteristics. All statistical analyses were performed using SPSS v. 22.0.ResultsThe respondents rated job satisfaction as the highest among all six dimensions of the SAQ, followed in order by teamwork climate, working conditions, and stress recognition (the lowest). There were significant differences among the dimensions of patient safety culture and other factors, such as gender, age, job position, and education. Compared with previous studies, teamwork climate and working conditions scores were quite high, while stress recognition score was very low. We also found differences in patient safety culture by demographic characteristics.ConclusionsThe findings revealed the patient safety culture attitudes of healthcare workers in secondary hospitals of Heilongjiang, and provided baseline data for related future research. This evidence may also help government health policymakers and hospital administrators understand related challenges and develop strategies to improve patient safety culture in secondary hospitals of China and perhaps also in other developing countries.

Patient safety culture in Hungarian hospitals

PurposeThe Hospital Survey on Patient Safety Culture (HSOPSC) is a rigorously designed tool for measuring inpatient safety culture. The purpose of this paper is to develop a cross-cultural HSOPSC for Hungary and determine its strengths and weaknesses.Design/methodology/approachThe original US version was translated and adapted using existing guidelines. Healthcare workers (n=371) including nurses, physicians and other healthcare staff from six Hungarian hospitals participated. Answers were analyzed using exploratory factor analyses and reliability tests.FindingsPositive responses in all dimensions were lower in Hungary than in the USA. Half the participants considered their work area “acceptable” regarding patient safety. Healthcare staff worked in “crisis mode,” trying to accomplish too much and too quickly. The authors note that a “blame culture” does not facilitate patient safety improvements in Hungary.Practical implicationsThe results provide valuable information for promoting a more positive patient safety culture in Hungary and for evaluating future strategies to improve patient safety.Originality/valueIntroducing a validated scale to measure patient safety culture in Hungary improves healthcare quality.

A survey of hospital healthcare professionals’ perceptions toward patient safety culture in Saudi Arabia

BackgroundMedical and allied health professionals should adopt error reduction as a key strategic priority and make patient safety improvement an ongoing, active process within their organization. ObjectiveThe present study investigates the perceptions of healthcare professionals toward patient safety culture in hospitals throughout Hail Region, Kingdom of Saudi Arabia. MethodsThis research, which uses a descriptive cross-sectional approach to evaluate the perceptions of healthcare professionals toward patient safety culture, was conducted at four major hospitals in Hail Region, Kingdom of Saudi Arabia and involved 255 healthcare professionals, who served as respondents based on systematic random sampling. Standard deviation and the chi-square test of independence were used for statistical analysis. This study was approved by the Ethics Review Committee (H-2016-057) of the University of Hail. ResultsAmong the patient safety aspects, patient safety grade received the highest mean value (3.56 ± 0.72), whereas handoffs and transitions received the least consensus (3.00 ± 0.34). Interestingly, hospital work experience significantly correlated to work area (p = 0.026), communications (p = 0.037), and the number of events reported (p = 0.019) in the patient safety dimension. Moreover, the number of years in the area/unit significantly related to the work area (p = 0.047) and supervisor/manager (p = 0.009). Only the number of events reported showed a significant relationship with specialty or profession (p = 0.007). ConclusionHealthcare professionals have an affirmative view toward patient safety culture aspects, and positive relationships were found between the patient safety dimensions and study participants’ profile. The findings presented herein suggest that healthcare professionals affirm the practice of patient safety culture. However, further research is required to continuously appraise the significance of healthcare-based quality indicators. Overall, the assessment results suggest a platform for better intervention and transformation procedures targeting the promotion of patient safety culture.

Assessment of Patient and Occupational Safety Culture in Hospitals: Development of a Questionnaire with Comparable Dimensions and Results of a Feasibility Study in a German University Hospital.

(1) Background: Both patient and occupational safety cultures should be considered when promoting safety culture. To our knowledge, there are no studies that capture patient safety culture (PSC) and occupational safety culture (OSC) in hospitals while using a common questionnaire. The aim of this feasibility study in a German university hospital was to develop a questionnaire to assess both issues analogously. In addition to feasibility outcomes, we report results of PSC-OSC comparisons. (2) Methods: To assess PSC, we used the existing Hospital Survey on Patient Safety Culture (HSPSC) questionnaire. Developing new OSC “twin items” for certain parts of the HSPSC was supported by a previous literature review. Additionally, we developed multiple choice questions to examine knowledge and competencies regarding specific PS/OS aspects. (3) Results: Developing and implementing a combined PSC and OSC assessment instrument was feasible. The overall response rate was 33% (407 nurses, 140 physicians). In general, the statistical reliability of almost all scales was sufficient. Positive PSC perceptions (agreement rates 46–87%) were found in 16 out of 18 scales. Of the four twin scales, the PSC values were significantly better. Individual PS- and OS-related knowledge and competencies were lower than expected. (4) Conclusion: The comparative investigation of patient and occupational safety in a large hospital is a promising approach and can be recommended for further studies. We used our experiences that are presented here in an ongoing bicentric study on the associations between working conditions, occupational safety culture, patient safety culture, and patient safety outcomes (WorkSafeMed).

An intelligent algorithm for assessing patient safety culture and adverse events voluntary reporting using PCA and ANFIS.

Patient safety culture (PSC) as a main component of the organizational culture plays a key role in providing safe, effective and economic cares and services in healthcare organizations. PSC provides a way to assist hospitals in order to improve patient safety and prevent medical errors. The present study aimed to measure PSC and healthcare professionals' attitude towards voluntary reporting of adverse events in two hospitals in Iran and to develop a hybrid intelligent approach for modeling PSC grades. The Hospital Survey on Patient Safety Culture (HSOPSC) questionnaire and a two-part questionnaire were used for examining the PSC and healthcare professionals' attitude towards voluntary reporting of adverse events, respectively. Principal component analysis (PCA) was applied to extract of the main components in the HSOPSC questionnaire and to construct 12 dimensions of patient safety culture. The overall grade of patient safety culture was modeled using adaptive neuro-fuzzy inference systems (ANFIS) as a classification problem. Almost half of the participants have experienced a medical error and adverse events. The PSC grade was acceptable from the point of view of 55.5% and 50% of participants in hospital No.1 and hospital No.2, respectively. The overall accuracy of ANFIS in modeling overall grades of patient safety culture in both study hospitals was 0.84. Of those individuals gave an acceptable grade on patient safety culture in both study hospitals, more than 50% believed that all medical errors and near misses should be reported. The ANFIS algorithm was proposed for modeling and predicting of PSC for healthcare organizations. The results confirm the capability of the proposed model to predict patient safety grades in healthcare settings.

Changes in Patient Safety Culture in Palestinian Public Hospitals: Impact of Quality and Patient Safety Initiatives and Programs.

To assess the changes in the patient safety culture between 2011 and 2016 after the implementation of patient safety initiative in Palestinian public hospitals. A cross-sectional quantitative design employed using the Hospital Survey on Patient Safety Culture to collect data. Participants were 1,229 clinical and nonclinical employees from all public hospitals in the West Bank. Significant improvements were observed in patient safety culture with positive responses to 10 (83.3%) composite categories and 36 (86.0%) items of the Hospital Survey on Patient Safety Culture since the baseline survey in 2011 (P < 0.05). The increase in the percent of positive responses to the survey composites ranged from 9.1% (P < 0.001) to "Frequency of events reported" to 3.8% for "Teamwork across hospital units" (P < 0.001). Significant decrease in positive responses to "Staffing" (11.4%) was observed (P < 0.05); no significant change was observed in "Organizational learning-continuous improvement" (P > 0.05). Most participants (70.5%) rated patient safety level in their units/hospital as 'Excellent/Very good', with an increase of 6.3% from the baseline (P < 0.001); no significant increase in the number of reported events in the past 12 months was observed (P < 0.05). Compared with the baseline survey results, patients' safety initiatives and quality improvement programs had positive effect on the safety culture in public Palestinian hospitals.

Strategies for Improving Physician-patient Relationship in China Assessing Patient Safety Culture from the Perceptions of Physicians

Creating a better patient safety culture in hospitals has become a critical topic for providing quality medical services globally. In 2014, there were 115 thousand cases of medical disputes in China. Understanding physicians’ perceptions toward patient safety is a critical issue for hospitals to monitor safety situations for patients. This study aims to identify physicians’ attitudes toward patient safety via the investigation of Sexton et al. (2006)’s Safety Attitude Questionnaire (SAQ), to provide implications for improving medical quality. Pearson’s correlation analysis was used to demonstrate the relationships among six patient safety culture dimensions. Regression analysis was subsequently conducted to realize the degree of influence among important dimensions. Physicians was asked to answer the SAQ in a tertiary hospital in China in 2017. The results of Pearson correlation analysis demonstrate that safety climate had strong and positive relationship with working conditions and teamwork climate, respectively. Similarly, regression results illustrated that working conditions, teamwork climate, and teamwork climate had noteworthy effects on safety climate. The examination of patient safety culture from the viewpoints of physicians provides a basis for hospital managers to monitor the medical quality and service for patients. Hospital managers need to pay more efforts to the essentially important elements of patient safety, such as working conditions, teamwork climate, and job satisfaction, to continuously improve physician-patient relationship.Â

Patient safety culture in a university hospital.

ABSTRACTObjective:to assess patient safety culture in a university hospital. Method:cross-sectional study with data collection through the Hospital Survey on Patient Safety Culture applied in electronic device. A total of 381 employees were interviewed, corresponding to 46% of the sum of eligible professionals. Data were analyzed descriptively. the Cronbach’s alpha was used to calculate the frequency and reliability. Results:most were women (73%) from the nursing area (50%) and with direct contact with patients (82%). The composites related to “teamwork within units” (58%, α=0.68), “organizational learning - continuous improvement” (58%, α=0.63), “supervisor/manager expectations and actions promoting patient safety” (56%, α=0.73) had higher positive responses. Nine composites had low positive responses, with emphasis on “nonpunitive response to error” (18%, α=0.40). Only the item “in this unit, people treat each other with respect” had positive response above 70%. The patient safety assessment in the work unit was positive for 36% of employees, however only 22% reported events in past year. Conclusion:the findings revealed weaknesses in the safety culture at the hospital, with emphasis on culpability.

Healthcare Professional's Perception of Patient Safety Measured by the Hospital Survey on Patient Safety Culture: A Systematic Review and Meta-Analysis.

Objective To assess the culture of patient safety in studies that employed the hospital survey on patient safety culture (HSOPS) in hospitals around the world. Method We searched MEDLINE, EMBASE, SCOPUS, CINAHL, and SciELO. Two researchers selected studies and extracted the following data: year of publication, country, percentage of physicians and nurses, sample size, and results for the 12 HSOPS dimensions. For each dimension, a random effects meta-analysis with double-arcsine transformation was performed, as well as meta-regressions to investigate heterogeneity, and tests for publication bias. Results 59 studies with 755,415 practitioners surveyed were included in the review. 29 studies were conducted in the Asian continent and 11 in the United States. On average studies scored 9 out of 10 methodological quality score. Of the 12 HSOPS dimensions, six scored under 50% of positivity, with “nonpunitive response to errors” the lowest one. In the meta-regression, three dimensions were shown to be influenced by the proportion of physicians and five by the continent where survey was held. Conclusions The HSOPS is widely used in several countries to assess the culture of patient safety in hospital settings. The culture of culpability is the main weakness across studies. Encouraging event reporting and learning from errors should be priorities in hospitals worldwide.

Assessment of patient safety culture in a rural tertiary health care hospital of Central India

Background: A safety culture assessment provides an organization with a basic understanding of the safety related perceptions and attitudes of its managers and staff. While patient safety has been a major area of research in industrialized nations for over a decade, data on the root causes of unsafe care in low-income settings is sparse. The objective of the study was to assess the patient safety culture in a rural tertiary health care hospital situated in Central India.Methods: A survey conducted during year 2015, in a rural tertiary health care teaching hospital, Maharashtra (India). The study participants were the 156 hospital staff working in various clinical work areas. The agency for healthcare research and quality hospital survey on patient safety culture, a validated instrument is used as an assessment tool.Results: Total 144 participants included in the study, 75 (52%) were females and rest were males 48%. Out of these 111 (77), maximum number of staff (57.05%) was belonging to different intensive care units. 57% of participants had worked in the hospital for 1 to 5 years. For the unit level safety culture dimension, the maximum composite score of positive responses was obtained for “Organizational learning- continuous improvement” (67%) followed by “Hospital management support for patient safety” (65%). On the other hand only 48% survey participants gave an affirmative opinion with respect to “Feedback and communication about error”. For the hospital wide dimensions response rate was obtained as 62% for the “Teamwork across Hospital Units” while for the dimension “Hospital Handoffs &amp; Transitions”, the score came out as 55%.Conclusions: The perception of patient safety and standards of patient safety were fairly good in the present rural tertiary health care hospital, but there is an ample of prospect in improvement with regard to event reporting, feedback and non punitive error.

Is hospital patient safety culture relevant?

e18775Background: Hospital culture is the product of multiple factors such as management directives and mission statements which, in turn, can influence individual attitudes and perceptions (Ryan &...

Nurses' Perceptions of Patient Safety Culture in Three Hospitals in Saudi Arabia.

To assess the present patient safety culture of three general hospitals in Saudi Arabia, as perceived by nurses. This study utilized a descriptive, cross-sectional design. A convenience sample of 351 nurses working in three general hospitals in the central region of Saudi Arabia was surveyed in this study using the Hospital Survey of Patients' Safety Culture (HSOPSC) from October 2016 to April 2017. From the 12 composites of the HSOPSC, the nurses perceived only the following two patient safety areas as strengths: teamwork within units and organizational learning-continuous improvement. Six areas of patient safety were identified as weaknesses, namely overall perception of patient safety, handoffs and transitions, communication openness, staffing, frequency of events reported, and nonpunitive response to errors. Nationality, educational attainment, hospital, length of service in the hospital, work area or unit, length of service in the current work area or unit, current position, and direct patient contact or interaction were significant predictors of the nurses' perceived patient safety culture. The findings in this study clarify the current status of patient safety culture in three hospitals in the Kingdom of Saudi Arabia. The present findings should be considered by policymakers, hospital leaders, and nurse executives in creating interventions aimed at improving the patient safety culture in hospitals. A multidimensional network intervention targeting the different dimensions of patient safety culture and involving different organizational levels should be implemented to improve patient safety.

Changing patient safety culture in China: a case study of an experimental Chinese hospital from a comparative perspective.

BackgroundThe World Health Organization highlights that patient safety interventions are not lacking but that the local context affects their successful implementation. Increasing attention is being paid to patient safety in Mainland China, yet few studies focus on patient safety in organizations with mixed cultures. This paper evaluates the current patient safety culture in an experimental Chinese hospital with a Hong Kong hospital management culture, and it aims to explore the application of Hong Kong’s patient safety strategies in the context of Mainland China.MethodsA quantitative survey of 307 hospital staff members was conducted using the Hospital Survey on Patient Safety Culture questionnaire. The findings were compared with a similar study on general Chinese hospitals and were appraised with reference to the Manchester Patient Safety Framework.ResultsLower scores were observed among participants with the following characteristics: males, doctors, those with more work experience, those with higher education, and those from the general practice and otolaryngology departments. However, the case study hospital achieved better scores in management expectations, actions and support for patient safety, incident reporting and communication, and teamwork within units. Its weaknesses were related to non-punitive responses to errors, teamwork across units, and staffing.ConclusionsThe case study hospital contributes to a changing patient safety culture in Mainland China, yet its patient safety culture remains mostly bureaucratic. Further efforts could be made to deepen the staff’s patient safety culture mind-set, to realize a “bottom-up” approach to cultural change, to build up a comprehensive and integrated incident management system, and to improve team building and staffing for patient safety.

Exploring the Influence of Nursing Work Environment and Patient Safety Culture on Missed Nursing Care in Korea

PurposeThis study aimed to explore the influence of nurse work environment and patient safety culture in hospital on instances of missed nursing care in South Korea. MethodsA cross-sectional design was used, in which a structured questionnaire was administered to 186 nurses working at a tertiary university hospital. Data were analyzed using descriptive statistics, t test or analysis of variance, Pearson correlation, and multiple regression analysis. ResultsMissed nursing care was found to be correlated with clinical career, nursing work environment, and patient safety culture. The regression model explained approximately 30.3% of missed nursing care. Meanwhile, staffing and resource adequacy (β = −.31, p = .001), nurse manager ability, leadership and support of nurses (β = −.26, p = .004), clinical career (β = −.21, p = .004), and perception on patient safety culture within unit (β = −.19, p = .041) were determined to be influencing factors on missed nursing care. ConclusionThis study has significance as it suggested that missed nursing care is affected by work environment factors within unit. This means that missed nursing care is a unit outcome affected by nurse work environment factors and patient safety culture. Therefore, missed nursing care can be managed through the implementation of interventions that promote a positive nursing work environment and patient safety culture.

The contribution of open comments to understanding the results from the Hospital Survey on Patient Safety Culture (HSOPS): A qualitative study.

IntroductionTo develop high-quality and safe healthcare, a good safety culture is an important feature of healthcare-providing structures. The objective of this study was to analyze the qualitative data of the comments section of a Hospital Survey on Patient Safety (HSOPS) questionnaire to clarify the answers given to the closed questions.MethodUsing the original data from a cross-sectional survey of 5,064 employees at a single university hospital in France, we conducted a qualitative study by analyzing the comments of a HSOPS survey and conducting in-depth interviews with 19 healthcare providers. We submitted the comments and the interviews to a thematic analysis.ResultsA total of 3,978 questionnaires were returned, with 247 comments collected. The qualitative analysis identified several structural failures. The main categories of the open comments were concordant with the lowest dimension scores found in the quantitative analysis. The most frequently reported failures were related to the staffing and hospital management support dimensions. The healthcare professionals perceived the lack of resources, including understaffing, as the major barrier to the development of a patient safety culture. Concrete organizational issues related to hospital handoffs and risk coordination were identified, such as transfers from the emergency departments and the lack of feedback following self-reporting of incidents.ConclusionThe analysis of the open comments complemented the HSOPS scores, increasing the level of detail in the description of the hospital’s patient safety culture. Combined with a classical quantitative approach used in HSOPS-based surveys, the qualitative analysis of open comments is useful to identify organizational weaknesses within the hospital.

The impact of social capital on clinical risk management in nursing: a survey in Iranian public educational hospitals.

AimThis study aimed to explore the social capital impact on clinical risk management from nurses’ viewpoints.DesignThis was a cross‐sectional and analytical study conduct in six public educational hospitals affiliated to Tehran University of Medical Sciences (TUMS).MethodQuestionnaires were used as the data collection tool. Data were analysed using descriptive statistics, parametric and non‐parametric tests by SPSS 16 at a significance level of 0.05.ResultsRisk management, social capital and all its three dimensions evaluated in moderate level. It is confirmed that the social capital is one of the factors associated with the improvement of clinical risk management. There was a significant relationship between clinical risk management and social capital. In this respect, hospital managers and decision‐makers could enhance clinical risk management by identifying and increasing different dimensions of social capital which consequently led to have a better patient safety culture in hospitals.

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.

Baseline assessment of patient safety culture in public hospitals in Kuwait

Conducting patient safety culture assessments can provide hospitals with information on how structures and processes within their system can impact patient outcomes. This study used the Hospital Survey on Patient Safety Culture (HSOPSC) to conduct an assessment of patient safety culture in public hospitals in Kuwait and benchmark against regional and international studies that utilized the same tool. This objective of this study is to examine the association between the predictors and outcomes of patient safety culture. This cross sectional study adopted a customized version of HSOPSC developed by the Agency for Healthcare Research and Quality. The survey targeted selected public hospital staff with at least one year of experience. Data was analyzed using SPSS 24 at a significance level of 0.05. Univariate analysis was utilized to obtain an overview of respondent demographics. The association between patient safety grade and the number of events reported and the remaining patient safety culture composites was analyzed using ANOVA f-test. Four regression models were constructed, two adopted Generalized Estimating Equations and the others were linear models. Results were benchmarked against similar initiatives in Lebanon, Saudi Arabia and USA. A total of 12,092 employees from 16 public hospitals in Kuwait completed the survey. The overall response rate was 60.5% (20,003 distributed surveys). Areas of strength were Teamwork within Units, Organizational Learning—Continuous Improvement, Management Support for Patient Safety, Supervisor/Manager Expectations & Actions Promoting Patient Safety, and Feedback and Communication about Error. Regression findings highlighted significant association between patient safety outcomes and composites. Benchmarking analysis revealed that Kuwaiti hospitals are performing at or better than benchmark on several composites compared to regional and international findings. This is the first major study addressing patient safety culture in public hospitals in Kuwait. Despite having some areas for improvement, public hospitals in Kuwait were found to have multiple areas of strength. Improving patient safety culture is critical if hospitals want to improve quality and safety of medical services. Study findings can guide and inform country level strategies to further improve the systems governing patient safety practices.

Assessment Of Patient Safety Culture In Benghazi Children's Hospital "BCH"

Assessment Of Patient Safety Culture In Benghazi Children's Hospital "BCH"