Hospital Safety Culture Research Articles

Translation and Comprehensive Validation of the Hebrew Survey on Patient Safety Culture (HSOPS 2.0).

The study aim was to create an updated valid translation into Hebrew of the AHRQ's survey on patient safety culture for hospitals, version 2.0. It also suggested a supplementary section about workers' safety. Comparable and valid measurement tools are important for national and international benchmarking of patient safety culture in hospitals. The process was carried out by a designated committee according to AHRQ translation guidelines. Methodology included several translation cycles, 6 semistructured cognitive interviews with health workers, and a web-based pilot survey at 6 general hospitals. Main analyses included an exploratory factor analysis, a comparison of the differences in results between versions 1 and 2 of the survey to the differences reported by AHRQ, and content analysis of open-ended questions. A total of 483 returned questionnaires met the inclusion criterion of at least 70% completion of the questionnaire. The demographic distributions suggested this sample to be satisfactory representative. Cronbach's alpha for the translated questionnaire was 0.95, meaning a high internal consistency between the survey items. An exploratory factor analysis revealed 8 underlying factors, and a secondary analysis further divided the first factor into 2 components. The factors structure generally resembled HSOPS 2.0 composite measures. Analyses of the new section about health workers' safety showed high involvement and possible common themes. The study demonstrated good psychometric properties-high reliability and validity of the new translated version of the questionnaire. This paper may serve other countries who wish to translate and adapt the safety culture survey to different languages.

Patient Safety Culture in a Tertiary Referral Hospital: Evidence from a Main Criterion in Accreditation

Objectives: In Iran’s accreditation program, the patient safety dimension is one of the main dimensions, holding the highest weight among the accreditation criteria. The purpose of this study was to identify the patient safety culture (PSC) in a tertiary referral hospital. Methods: The current study was conducted between March and April 2021 in a tertiary hospital in Iran. The sample size was 628 participants, selected through simple random sampling. The hospital survey on patient safety culture (HSOPSC) was used to assess provider and staff perceptions about patient safety issues, medical errors, and event reporting. The survey included 32 items that measure 10 dimensions of PSC. Normality tests, along with non-parametric Mann-Whitney and Kruskal-Wallis tests, were used to examine the relationship between PSC and demographic variables using SPSS 22 software. Results: Based on current findings, among the 10 dimensions of PSC, teamwork and organizational learning-continuous improvement received the highest scores (83% positive response), which were higher than these variables in the Agency for Healthcare Research and Quality (AHRQ) data. Conversely, staffing and work pace, as well as hospital management support for patient safety, received the lowest positive scores (43% and 55% positive response, respectively), which were lower than these variables in the AHRQ data. There was a significant positive relationship between dimensions of PSC and older age, female gender, staff with longer working experience, and longer work hours per week (P < 0.05). Conclusions: The majority of our participants felt that patient safety needs to be enhanced. Based on the findings of this study, it is recommended to emphasize the dimensions of “staffing and work pace” and “hospital management support for patient safety” more in the accreditation criteria to strengthen these dimensions in hospitals. Additionally, we have introduced a comprehensive guide for using an international tool to measure PSC, which hospitals can use to succeed in annual accreditation.

Patient safety culture in a tertiary care hospital in Makkah, Saudi Arabia, a cross-sectional study

BackgroundPatient safety remains an area of global concern, and patient safety culture among healthcare staff is one of its most important determinants. Saudi Arabia is investing much effort in enhancing patient safety. Assessment of patient safety culture is enlightening about the impact of such efforts and invaluable in informing policy makers about future directions. This study aimed to assess patient safety culture in King Abdullah Medical City (KAMC), a tertiary referral center in Makkah, Saudi Arabia.MethodsIn this cross-sectional study the Hospital Survey on Patient Safety Culture (HSOPSC) version 2.0 was distributed electronically to all staff of KAMC. The HSOPSC version 2.0 Data Entry and Analysis Tool was used to compare results obtained from KAMC to those obtained from global data. Additional analyses were performed on SPSS to explore the presence of associations between responses and participant characteristics.ResultsA total of 350 participants completed the questionnaire, 58.6% of whom were nurses. A comparison of the composite measure of all 10 domains of the HSOPSC showed 62% positive responses at KAMC versus 70% in the global database. This difference was statistically significant, with a chi-square of 10.64 and a p value of 0.001. The percentages of positive responses from the KAMC data exceeded those from the global data in the “Organizational learning and continuous improvement” and the “Communication about error” domains (p = 0.002 and 0.003, respectively).ConclusionAlthough safety culture seems to score lower at KAMC than globally, accelerated improvement in the future is expected based on improvement trends in the literature and the national efforts focused on patient safety.

The Relationship between Organizational Culture and Patient safety Culture in Hospitals in Aceh Province

Background: A lack of patient safety culture among nurses can lead to unexpected events for patients as recipients of nursing services. Organizational culture is believed to be related to a good patient safety culture among nurses. The study aims to identify the relationship between organizational culture and patients safety culture in hospitals in Aceh Province. Methods: This Quantitative study used a correlational design with a cross-sectional research approach. The number of samples comprised 219 nurses (total sampling). Data analysis was performed using the person product moment test. Results: Finding of the study showed that there was a significant relationship between organizational culture and the culture of patient safety (p=0.000, r2=0.659). Conclusion: High organizational culture will increase the culture of patient safety by nurses in hospital wards.

Analysis of Risk Factors Related to Nurses' Attitudes and Patient Safety Culture Implementation

Patient safety is a critical global concern, with millions of adverse events occurring annually. Nurses' attitudes towards patient safety culture are pivotal in its successful implementation. This study aimed to assess the risk factors related to nurses' attitudes towards patient safety culture and its relationship with the implementation of patient safety culture in a public hospital dr. H. Moch. Ansari Saleh in Banjarmasin, Indonesia. A cross-sectional study was conducted among nurses working in a public hospital dr. H. Moch. Ansari Saleh in Banjarmasin, Indonesia. Data were collected using a questionnaire adapted from the National Patient Safety Guidelines and the AHRQ Hospital Survey on Patient Safety. The questionnaire assessed nurses' attitudes towards patient safety, the implementation of patient safety culture, and potential risk factors such as age, gender, years of experience, and workload. Data were analyzed using descriptive statistics, Spearman's rank correlation coefficient, and multivariate logistic regression. A total of 85 nurses participated in the study. The majority of nurses (81.2%) exhibited a moderate attitude towards patient safety, while 83.5% reported a moderate level of patient safety culture implementation. Spearman's rank correlation analysis revealed a weak positive correlation (rho = 0.417, p = 0.01) between nurses' attitudes and the implementation of patient safety culture. Multivariate logistic regression analysis identified age (OR = 1.12, 95% CI = 1.01-1.24) and workload (OR = 1.18, 95% CI = 1.05-1.33) as significant risk factors associated with a less positive attitude towards patient safety culture. In conclusion, while there is a positive relationship between nurses' attitudes and patient safety culture implementation, the relationship is weak. Age and workload were identified as significant risk factors for a less positive attitude towards patient safety culture. These findings highlight the need for targeted interventions to address these risk factors and enhance nurses' attitudes, thereby strengthening patient safety culture in the hospital.

The Vital Role of Executive Rounding in Promoting a Culture of Safety in Hospitals.

The Vital Role of Executive Rounding in Promoting a Culture of Safety in Hospitals.

Development and Validation of the Korean Patient Safety Culture Survey Instrument for Hospitals

Purpose: This study aimed to develop a survey instrument to assess the Patient Safety Culture in Korean hospitals and evaluate its validity and reliability.Methods: A preliminary instrument was developed through a literature review, focus group interviews, content validity testing, and pretesting for face validity. A total of 467 hospital employees participated in the psychometric testing. Validity and reliability assessments included content validity, construct validity, criterion-related validity, and internal consistency.Results: The Korean Patient Safety Culture Survey Instrument comprised 35 items across seven factors: leadership, patient safety policy and procedure, patient safety improvement system, teamwork, non-punitive environment, patient safety knowledge and attitudes, and patient safety priority. These seven factors contributed 60.98% of the variance of the total scale. Cronbach’s alpha for internal consistency was .93; the seven factors ranged from .66 to .91.Conclusion: The results of this study showed that the Korean Patient Safety Culture Survey Instrument is reliable, valid, and suitable for measuring patient safety culture in Korean hospitals.

Patient safety culture in private hospitals in China: a cross-sectional study using the revised Hospital Survey on Patient Safety Culture.

This study aimed to translate the revised Hospital Survey on Patient Safety Culture (HSOPSC 2.0) to Mandarin, evaluate its psychometric properties, and apply it to a group of private hospitals in China to identify the determinants associated with patient safety culture. A two-phase study was conducted to translate and evaluate the HSOPSC 2.0. A cross-cultural adaptation of the HSOPSC 2.0 was performed in Mandarin and applied in a cross-sectional study in China. This study was conducted among 3,062 respondents from nine private hospitals and 11 clinics across six cities in China. The HSOPSC 2.0 was used to assess patient safety culture. Primary outcomes were measured by the overall patient safety grade and patient safety events reported. Confirmatory factor analysis results and internal consistency reliability were acceptable for the translated HOSPSC 2.0. The dimension with the highest positive response was "Organizational learning - Continuous improvement" (89%), and the lowest was "Reporting patient safety event" (51%). Nurses and long working time in the hospital were associated with lower assessments of overall patient safety grades. Respondents who had direct contact with patients, had long working times in the hospital, and had long working hours per week reported more patient safety events. A higher level of patient safety culture implies an increased probability of a high overall patient safety grade and the number of patient safety events reported. The Chinese version of HSOPSC 2.0 is a reliable instrument for measuring patient safety culture in private hospitals in China. Organizational culture is the foundation of patient safety and can promote the development of a positive safety culture in private hospitals in China.

The impact of nurse empowerment program on patient safety culture in general public hospital in Indonesia

Background Patient safety is crucial to health-care quality and is one of the major parameters monitored by all health-care organizations around the world. Nurses play a critical role in improving the quality of care and patient safety because of their intensity in caring patients and families. Objectives This study aimed to determine the impact of nurse empowerment program on patient safety culture in general public hospital in Indonesia. Methods This study was designed as a quasi-experimental design in Indonesia. This program was conducted for three months with a five-day workshop (4 h for each day), followed by hanging up posters and handing out informative pamphlets to the experimental group's nurses and supervisors at their place of work in three common place that visited by nurses such as changing room, nurse station and near toilet. Results In the intervention group, patient safety culture practice score was significantly increased from 3.11(standard deviation [SD] = 1.43) before intervention to 4.89 (SD = 1.33) after three-month intervention (T2), with the t was 5.78, and p = .001. While in the control group, no significant increased score of patient safety culture practice before intervention and after three months intervention (3.05 ± 1.49 vs. 3.09 ± 1.25, t = 0.76, p = .516). Conclusion The implementation of this innovative empowerment program, which included nurses and supervisors, resulted in an increase in patient safety culture scores as well as growth in domain score. Therefore, this program can be used to advance these critical facets of patient safety culture, which are currently underdeveloped.

Interplay between leadership and patient safety in dentistry: a dental hospital-based cross-sectional study

ObjectivesThe study aimed to study the association of leadership practices and patient safety culture in a dental hospital.DesignHospital-based, cross-sectional studySettingRiphah Dental Hospital (RDH), Islamabad, Pakistan.ParticipantsAll dentists working at RDH were...

Comparing hospital leadership and front-line workers’ perceptions of patient safety culture: an unbalanced panel study

Background/aimThis article examines the relationships between workers’ hospital leadership status, hospital front-line status and patient safety culture in hospitals throughout the USA. By identifying possible disparities in perception, targeted interventions...

Assessment of Patient Safety Culture Among Nurses Working at Tertiary Care Hospitals in Aljouf Region, Saudi Arabia.

Patient safety is a fundamental element in healthcare quality and a major challenge in achieving universal health coverage, especially in low- and middle-income countries. The first step to improve patient safety is to evaluate the safety culture in hospitals. This study aimed to investigate the patient safety culture among nurses and determine the factors affecting it. This cross-sectional study was conducted among 423 nurses working at tertiary care hospitals in the Al-Jouf region in Saudi Arabia. The highest score for patient safety among nurses was for teamwork within units (16.41 ± 2.44). The lowest score was for nonpunitive response to errors (5.87 ± 1.92). In addition, 83% of the participants did not report any events in the past 12 months. More perception of patient safety was significantly higher among females than males in dimensions of teamwork within units, frequency of events reported, and staffing. Furthermore, teamwork within units, management support for patient safety, staffing, non-punitive response to errors, and handoffs and transitions were significantly higher among participants in direct contact with patients. The Hospital Survey on Patient Safety Culture (HSOPSC) scale is significantly higher among non-Saudi nurses, nurses with bachelor's education, nurses with less working hours per week, and those who had training on patient safety. The current study showed that the majority of the participants did not report any events in the past 12 months. The highest score for patient safety culture dimensions among nurses was for teamwork within units while the lowest score was for nonpunitive response to errors.

The Relationship of Organizational Culture and Patient Safety Culture on Service Development in The Hospital Dr. Ario Wirawan Salatiga

The primary objective of his research is to examine the relationship between the organizational culture and patient safety culture at the Dr. Ario Wirawan Pulmonary Hospital in Salatiga, specifically in the context of service development. Dr. Ario Wirawan Salatiga admitted 99 participants to the study at Lung Hospital. Data collection was conducted through the use of a questionnaire. Utilizing a non-probability sampling method for the sampling procedure. The data analysis technique included multiple linear regression analyses. The study's findings indicate that organizational culture has a pivotal role in stimulating service growth, exerting a distinct and substantial influence. The study's findings clearly indicate that the most prominent part of patient safety culture in hospitals is "teamwork in units." Conversely, the aspects that need enhancement include "staffing" and "handoff and transition." (2) A robust safety culture has a substantial and beneficial impact on the advancement of services.

Psychometric Analysis of the Indian Version of the Patient Safety Culture Tool (I-HSOPSC 2.0) Validation

Patient safety, which is both an overarching principle and a key factor in determining the quality of healthcare, continues to be a priority in healthcare systems on a global scale. A cross-sectional study in accredited Indian hospitals aimed to evaluate the HSOPSC V-2 (Hospital Survey on Patient Safety Culture). 1,603 healthcare professionals participated, assessing psychometric features using confirmatory factor analysis in SMART PLS 4. The average composite positive response rate was 64.8%. High positive responses (79%) were seen in ‘teamwork’, ‘communication about error’, and ‘hospital management support for patient safety’. However, ‘staffing and work pace’ (30%), ‘response to error’ (50%), ‘communication openness’, and ‘reporting patient safety events’ (both 59%) had lower positive responses, indicating room for improvement. Findings suggest I-HOSPSC 2.0’s content validity, reliability, and construct validity in measuring patient safety culture in Indian hospitals. It can aid administrators in assessing safety culture and improving patient safety and treatment efficacy. Notably, this is the inaugural HSOPSC V-2 validation research in the Indian healthcare context. Future research should explore the tool’s psychometric properties based on care setting levels due to substantial differences between public and private healthcare setups in India.

Safety Culture in Acc¬¬redited Hospitals During Pandemic of COVID-19

COVID-19 pandemic is a challenge for hospitals to ensure quality and safety of patients and health workers to create a hospital safety culture. Referring to cases, till December 25, 2022, number of deaths worldwide reached 6,678,098 people with 656,864,989 people confirmed positive. This case infects health workers with highest death rate during hospital treatment. Hospital safety culture is related to improving health services quality. Measuring safety culture requires combination of quantitative and qualitative to get comprehensive of safety culture. This study aimed to obtain a qualitative description of safety culture during the COVID-19 pandemic in accredited hospitals. Qualitative descriptive research by selecting informants using purposive sampling at three accredited hospitals. Instruments refer to modified questionnaire from forty-two focus group discussion’s questions and ten in-depth interview’s questions grouped into six indicators. Results showed that three accredited hospitals have safety culture programs and hospital occupational safety and health. Hospitals have commitment, supportive leadership, supervision, and sustainability monitoring and evaluation. They have adapted regulations for COVID-19. A conducive work environment is also available for making patients and workers safe. They have provided information, reminded each other, and behaved safely as safety participation. Communication is carried out through socialization and feedback. Training is available for supporting patient and worker safety. Accreditation standards could be immensely helpful in conducting safety efforts. The conclusion is three accredited hospitals have implemented safety culture during COVID-19 by six indicators, including: leadership, safety communication, regulations, work environment, participation, and training. Accreditation is important for safety culture hospital. Keywords: safety culture, hospital, accreditation, qualitative, pandemic

Patient Safety Culture in Hospitals based on Agency For Health Care Research And Quality (AHRQ)

Patient Safety Culture in Hospitals based on Agency For Health Care Research And Quality (AHRQ)

The Knowledge and Perceptions of Patient Safety and Patient Safety Culture During Dental Training: A Caribbean Perspective.

Patient safety and the culture of keeping patients safe are not well-researched concepts in dentistry. Research is lacking on patient safety culture in dental teaching hospitals. This study examined the knowledge and perceptions of patient safety and patient safety culture in a Caribbean dental school among clinical faculty, dental surgery assistants and recent graduates. A qualitative research design using an anonymous online open-ended questionnaire, which underwent face validity by three subject matter experts, was used to acquire data to answer three developed research questions. Qualitative data was uploaded to QDA Miner and a five-stage thematic analysis using emergent coding was used to develop themes to answer the research questions. Qualitative data was obtained from 28 respondents, 12 clinical faculty, 10 recent graduates, and 6 dental surgery assistants. Four participants graduated in 2020, 1 graduated in 2021, and 5 graduated in 2022. The ages of participants ranged from 23 to 74 years. Themes used to answer the research questions included: the application of a clinical knowledge-based framework for the understanding of patient safety, understanding the individual elements of patient safety culture, gatekeepers of patient safety, and understanding personal limitations. Clinical and curriculum leaders at this dental school should consider the introduction of a patient safety curriculum given respondents understand patient safety from a clinical experiential perspective only and many respondents perceive patient safety culture as being guided predominantly by rules and policies with clinical faculty bearing the ultimate responsibility for keeping patients safe.

Enhancing Patient Safety Culture in Hospitals.

Patient safety has become a top priority for healthcare organizations. Abetter patient safety environment is associated with a lower probability of significant complications. Training programmers is critical to promoting patient safety and minimizing misunderstandings. The quality, performance, and productivity of the healthcare industry can be dramatically improved by changing the patient safety atmosphere operating within the hospital sector. Hospitals can significantly reduce medical errors and adverse events by implementing the program and training programmers to prioritize patient safety. This will improve patient outcomes and increase efficiency and effectiveness. Creating a patient safety culture within hospitals will contribute to a higher standard of care and improved overall performance in the healthcare industry. Hospitals can identify systemic problems and implement proactive measures to prevent future incidents by creating an environment in which healthcare professionals feel comfortable reporting errors. A patient safety culture encourages collaboration and open communication among healthcare teamsleading to more effective and coordinated care.

COMPARATIVE ANALYSIS OF PATIENT SAFETY CULTURE DYNAMICS IN UKRAINE AND THE USA HEALTHCARE FACILITIES REFERENCE TO ESTABLISHING SAFE HOSPITAL ENVIRONMENT

Introduction. WHO widely draws the attention of the world community to safety culture as an effective basis for ensuring safety in the hospital environment. However, WHO warns that "changing culture is more difficult than introducing new structural and organizational mechanisms". Therefore, systems for assessing patient safety culture in hospitals are widely used in many countries today.
 The aim of the study. To analyze and compare the dynamics of patient safety culture in Ukraine and the USA healthcare facilities.
 Materials and methods. The study utilized bibliographic, statistical, and sociological research methods. The research material consisted of a questionnaire survey of medical personnel on patient safety culture in 2016 (163 surveys from 3 healthcare facilities) and a questionnaire survey conducted in 2023 (174 surveys from 4 healthcare facilities). Results of patient safety culture monitoring in US hospitals for 2014 and 2021 were used for comparison. The survey of medical personnel was conducted using the AHRQ leadership questionnaire.
 Results. The percentage of positive responses for 5 out of the 12 characteristics of patient safety culture that we investigated in domestic healthcare facilities in 2023 was significantly lower than in 2016. The main reason for this negative trend in patient safety culture within domestic healthcare facilities can be attributed to the COVID-19 pandemic and Russia's military aggression, but the primary cause lies in the absence of a comprehensive strategy for improving this culture. Over the past 8 years, the proportion of respondents willing to disclose errors in their professional activities, as well as the mistakes of their colleagues and other incidents, without fearing that their mistakes and incident reports will harm them, has remained largely unchanged. The slight trend toward improvement in patient safety culture indicators in US hospitals, despite significant attention to it, indicates the challenges we face in the journey towards forming a positive safety culture.
 Conclusions. The prevailing reactive safety culture in domestic healthcare, along with the lack of positive changes, hinders the implementation of modern safety strategies in the medical field. The data from our own research and scientific literature highlight the urgent need for in-depth examination of the state of patient safety culture in domestic healthcare facilities and the development of a methodological framework adapted to international standards for evaluating safety culture in medical institutions. The formation of a positive national culture in general, and safety culture within healthcare facilities in particular, should be regarded as a crucial prerequisite for the post-war reconstruction of the country and its integration into the civilized, economically developed global community.

Clinical risk management: a new frontier for Italian Cardiology

Patient safety is the moral and ethical responsibility of healthcare professionals, representing a constantly evolving field in industrialized countries whose key factors are sustainability, training and prevention. Clinical risk management is primarily concerned with systems issues, but people are of paramount importance to effective teamwork and leadership. Hospitals have recently been urged to adopt the methods of high-fidelity organizations to identify and change ineffective practice patterns: recognizing that little things that go wrong are early warning signs of trouble, near miss and errors become information about the health of systems and learn from them. Italian Cardiology will have to assume clinical risk as a common practice, through a rigorous examination of the causes of adverse events, staff training, sharing of validated adverse event analysis tools, identification of corrective actions and definition of shared procedures, the systematic control of the adoption of the planned interventions, the evaluation of the results of the measures implemented by applying stringency and scientific method in this area. The text tries to explain, in a pragmatic way, the main problems that hinder the diffusion of the culture of safety in Italian hospitals and in cardiology by proposing solutions.