Patient Safety Culture Research Articles

Effects of Grit, Patient Safety Competence, and Patient Safety Culture on the Patient Safety Nursing Activities of Nurses in Comprehensive Nursing Service Wards

Purpose : In this study, we aimed to assess the impacts of grit, patient safety competence, and patient safety culture on the patient safety nursing activities of nurses in comprehensive nursing service wards. Methods : Here, a self-reported survey of 179 nurses from three tertiary hospitals was performed. Data from 171 valid responses were analyzed using descriptive statistics, independent <i>t</i>-test, one-way analysis of variance, Pearson’s correlation, and stepwise multiple regression analyses.Results : The key sub-factors influencing the patient safety nursing activities were attitude (<i>β</i>=.30, <i>p</i> ＜.001) and skill (<i>β</i>=.26, <i>p</i> ＜.001) in the patient safety competence factor and safety environment (<i>β</i>=.26, <i>p</i> ＜.001) in the patient safety culture factor. The regression model explained 42.7% of the variance in patient safety nursing activities (F=43.29, <i>p</i> ＜.001). Conclusion : Overall, these findings highlight the importance of improving the nurse attitude and skills related to patient safety as well as the safety environment in hospitals to enhance the patient safety nursing activities in comprehensive nursing service wards. Targeted educational and training programs should be provided along with organizational support to establish a safe and supportive nursing environment in comprehensive nursing service wards.

Revised Hospital Survey on Patient Safety Culture (HSOPSC 2.0): cultural adaptation, validity and reliability of the Malay version

BackgroundSurveys on Patient Safety Culture™ Hospital Survey (HSOPSC) developed by the U.S. Agency for Healthcare Research and Quality (AHRQ) has been adopted worldwide. The Hospital Survey on Patient Safety Culture (HSOPSC) version 2.0 was released in 2019, but there have been no publications to date of its translation and validation for use in Malaysia. This study aimed to translate and cross-culturally adapt the revised HSOPSC 2.0 into the Malay language and determine its psychometric properties including the content, face, and construct validity, and reliability analyses.MethodsThis study was conducted from April – June 2023 and divided into three stages: translation and cultural adaptation; content and face validation; and construct validation using confirmatory factor analysis and reliability testing among 319 healthcare personnel from a public university hospital in Malaysia.ResultsThe translated instrument demonstrated excellent content validity (I-CVI = 0.80 ~ 1.0, SCVI-average = 0.96) and face validity (I-FVI = 0.80 ~ 1.0, SFVI-average = 0.98). Reliability testing was acceptable (Cronbach’s α = 0.60 ~ 0.80) but indicated that reverse-coded items were poorly perceived. Confirmatory factor analysis showed a satisfactory model fit for the translated instrument (RMSEA = 0.08, GFI = 0.80, CFI = 0.80, and χ2/df = 2.96). Six items had very low factor loadings (< 0.40), with two constructs “Staffing and Work Pace” and “Response to Error” having AVE < 0.4, but acceptable CR ≥ 0.6. No items were removed from the questionnaire despite low factor loadings following a consensus from an expert panel.ConclusionThe Malay version of the HSOPSC 2.0 containing ten domains and 32 items demonstrated satisfactory psychometric properties following expert consensus, with acceptable reliability and construct validity for measuring patient safety culture. Given factor loadings smaller than 0.40 in six items, broader validation is suggested to support the use of the translated instrument in the Malaysian healthcare setting.

Leadership opportunities to mitigate challenges and barriers of precision health

Abstract Background Precision health, encompassing personalized and proactive health solutions, aims to address this gap by integrating genetic, behavioral, and environmental factors. However, challenges persist in its integration, necessitating new healthcare competencies, particularly in leadership, to expedite the transition. Our goal is to identify barriers and solutions for the implementation of precision health and build a core curriculum of leadership competencies to mitigate challenges and barriers for the implementation of precision health. Methods A systematic literature review of qualitative primary studies on barriers and facilitators to precision health implementation was conducted. Data extracted from included articles were analyzed thematically, adapting leadership competencies outlined in the CanMEDS Physician Competency Framework. This approach identified key leadership traits crucial for precision health implementation. Results 51 articles meeting inclusion criteria yielded 985 barriers and facilitators. Thematic analysis identified 9 primary leadership competencies essential for precision health implementation: application of quality improvement science (30%); fostering a culture of patient safety in data use (10%); advocacy for innovative data management (4%); resource allocation advocacy (9%); evidence-based cost management (4%); driving practice change (8%); prioritization and time management (11%); and optimization of healthcare workforce practices (14%). Discussion The synthesized leadership competencies provide a useful framework for addressing barriers and fostering precision health implementation among healthcare professionals. The high representation of competency related to quality improvement science is emblematic of how cultural elements specific to leadership and management in medicine could represent a strategic asset to foster the implementation of innovative solutions, like precision health, in healthcare. Key messages • Leadership skills are a crucial element in the curriculum of health professionals to support the implementation of precision health in clinical practice. • Incorporating elements of ‘quality improvement science’ in the healthcare professionals education emerged as essential to foster precision health implementation.

Exploring Collaboration and Social Dynamics in the Paediatric Morbidity and Mortality Meeting, A Qualitative Case Study.

To explore collaboration and social dynamics within paediatric Morbidity and Mortality meetings. Qualitative Exploratory Case Study Methodology incorporating semi-structured interviews and qualitative observations. Data were collected in a large quaternary paediatric hospital in Melbourne, Australia. Semi-structured interviews with meeting attendees were conducted after observing and documenting meeting conduct. Reflexive thematic analysis was used to interpret data and generate a thematic map of findings. Forty-four interviews and 32 meeting observations were conducted between July 2019 and January 2020. Participants valued collaboration between attendees in Morbidity and Mortality meetings, however there were barriers to this. They included differing views about roles and negative impacts of hierarchies and authority. Senior doctors dominated discussion, and participants described this occasionally signalling reverence and respect, but sometimes signified intimidation and feeling unsure about how to contribute. Because of this complexity, successfully achieving positive social dynamics in a meeting required active promotion and management. Morbidity and Mortality meetings mirror the complexity and richness of the clinical environment. Descriptions of how meeting conduct can shape positive workplace culture and address hierarchical obstructions to safe clinical care highlight their far-reaching potential. Effective collaboration is an intrinsic part of realising this value. This paper addresses a paucity in the literature in understanding how social dynamics and collaboration in Morbidity and Mortality meetings are interpreted and experienced. These findings illuminate challenges and obstacles to achieving a productive and equitable social dynamic in meetings. They also illustrate positive discrimination strategies that may improve participation and widespread engagement of nurses, junior doctors, and allied health professionals. Importantly, fostering constructive social dynamics in the Morbidity and Mortality meeting could positively impact patient safety culture and therefore patient care. No patient or public contribution.

Developing an NHS patient safety culture: swings and roundabouts.

John Tingle, Associate Professor, Birmingham Law School, University of Birmingham, discusses a new report and consultation on NHS patient safety culture development.

Safety Culture in Focus: Review of Patient Safety Culture Survey Results in Primary Health Care Corporation Qatar

Abstract Background Patient Safety is a crucial aspect of every healthcare organization and understanding the safety culture is essential for improving patient health outcomes. Evaluating the patient safety culture enables the health care organizations to gain insights into how their internal system’s structure and processes impact the patient’s overall well-being. In this paper, the hospital survey on patient safety culture that is adopted from AHRQ was used to examine the patient safety culture in the primary health centers in Qatar (PHCC), allowing for a better understanding of areas of strength and areas that require improvements Method The study aimed at comparing the organization’s safety culture in 2021 and its improvement in 2023. The survey was disseminated into 28 primary health centers with different sizes and patient volumes. The survey was sent electronically to all PHCC staff, allowing for better convenience and higher response rate Findings The results of this survey revealed numerous areas of strength, including teamwork across departments, error reporting, management support, communication error, non-punitive response to errors and staffing. On the other side, survey composites such as continuous learning and teamwork within department were identified as areas for improvement Conclusion By allowing for better insights into the culture of safety and identifying areas of strength and weaknesses, PHCC can make informed decisions and implement effective interventions. This will support in enhancing the health and wellbeing of Qatar’s population that aligns with the national health strategies which improves the overall healthcare in the region.

Cultivating a Culture of Patient Safety in Healthcare Settings: A Systematic Review of Evidence-Based Interventions

Background and purpose: Establishing a robust culture of safety is essential for enhancing health outcomes and minimizing risks to patients. This systematic review aims to synthesize interventions designed to enhance safety culture in healthcare settings. Methods: A comprehensive literature search was performed across multiple databases, including PubMed, CINAHL, and Scopus. The initial search yielded a total of 250 articles. After applying inclusion and exclusion criteria, which considered study design, population, and intervention type, 35 articles were shortlisted for full-text review. Ultimately, 21 studies met the final inclusion criteria, focusing on various interventions aimed at promoting safety culture. Results: The analysis revealed notable variation in the types of safety culture interventions implemented across the studies, with educational programs emerging as the most frequently adopted approach. The effectiveness of these interventions was found to be significantly influenced by both individual and systemic factors, highlighting the importance of contextual elements in promoting safety culture. Additionally, many interventions faced challenges related to sustainability and maintaining long-term impact, suggesting that ongoing support and resources are necessary for success. The review also indicated that the participation of nursing professionals in safety culture initiatives was often limited, despite their critical role in patient care, underscoring the need for strategies that engage this key group more effectively. Conclusion: The review underscores the necessity for targeted strategies that actively engage nursing professionals in safety culture initiatives to foster a safer healthcare environment. The findings serve as a valuable resource for policymakers and healthcare managers aiming to implement best practices for enhancing safety culture.

The Predictors of Patient Safety Culture in Hospital Setting: A Systematic Review.

Patient safety (PS) is a global public health concern. It is estimated that 10% of patients experience preventable harm while hospitalized. Patient safety culture (PSC) has been recognized as essential to improving PS, drawing inspiration from other high-risk industries. In PS research, however, PSC poses conceptual challenges, with inconsistent terminology, a lack of definitions, and limited use of substantiating theory. Despite these challenges, PSC remains widely used in PS research and practice, as it is seen as a potential gateway to understanding sociotechnical complex aspects of the healthcare system and improving safe patient treatment and care. This review explores the concept of PSC in a hospital setting. How PSC is used as an outcome, thus exploring the theoretical position underpinning PSC, which predictors impact PSC, and how these predictors are related to PSC. Using a search of 3 electronic databases, 23 studies that met the inclusion criteria were selected for review. The review identified 81 predictors of PSC. Study population, unit of analysis and method varied widely. PSC as an outcome was assessed based on one of 4 surveys. Thus, the underpinning position of the PSC construct is dominated by an organizational/managerial approach. The large number of predictors explored and the range in outcome measures, units of analysis, and methods make it hard to establish any causal relationship. We argue that studies closer to actual practices in the messy conditions of clinical practice are needed.

Caring in crisis: addressing patient safety, burnout, and long hours in healthcare

Madam, The World Health Organization defines patient safety as preventing errors and adverse effects to patients associated with health care and “to do no harm to patients”. Specifically, in low and middle-income countries (LMICs), about 134 million adverse events occur each year due to unsafe care in hospitals, resulting in 2.6 million deaths annually. [1] Along with other determining factors, professional well-being, long hours, and burnout syndromes also influence patient care. [2] Burnout is a condition directly linked to workplace environment, stemming from occupational stress and extended working hours. Garcia, C.L. et al., through meta-analysis, found a relationship between the development of burnout and patient safety actions, with a probability of superiority of 66.4%. High levels of burnout and worsening patient safety are related to external factors such as high workload, long working hours, lack of a secure environment, and interpersonal relationships. [3] These findings raise concerns, particularly in a country like Pakistan, where the extent of understaffing and high workload can be inferred from the following statistics: The doctor-to-population ratio in Pakistan was 1:1000 in 2018 [4]. In contrast, the doctor-to-population ratio in Malaysia was 2.2:1000 in 2018 [5]. As a result of this shortage, the current workforce in Pakistan is negatively affected. In a study by Kasi PM et al. on postgraduate trainees in Pakistan, individuals under stress were more likely to report longer working hours. This increased workload made them prone to medical errors, which ultimately undermines the patient safety culture. A study conducted at a tertiary care hospital in Pakistan using the Hospital Survey on Patient Safety Culture (HSOPSC) compared the benchmarks from hospitals in the USA and discovered that high staff workload is a significant concern among staff [6] In Pakistan, where healthcare resources are limited, fostering a culture of effective work-hour management and breaks is essential for creating a healthier and safer environment for health professionals and patients. Ensuring adequate staffing levels to distribute the workload and prevent overburdening is essential. Providing designated areas for relaxation, offering mental health resources and mindfulness programmes like yoga or meditation can help doctors to cope with stress. Furthermore, promoting a culture of multidisciplinary teamwork, a mentorship program, and effective handover protocols during shift changes can ensure continuity of care. Medical institutes should invest in technology that can streamline administrative tasks and reduce paperwork burden. ---Continue

Culture of safety in an adult and paediatric emergency department before and after the COVID-19 pandemic

BackgroundThe WHO recognises patient safety as a serious public health problem. The COVID-19 pandemic affected adult EDs (AEDs) and paediatric EDs (PEDs) differently. We compared the culture of safety in...

Administration management in patient safety culture and barriers to adverse event reporting in the nursing profession

Patient safety is very important in the health field, and for this, parameters such as having quality in the service provided and guaranteeing primary care in an effective manner must be considered. The objective of this article is to know the aspects of the patient safety culture and the safety climate perceived by the nursing staff who work in the participating hospital. The methodology used is a descriptive, cross-sectional observational type; It will be observational because it is a specific type of study that is defined by having a statistical or demographic nature, where 46 health professionals were surveyed. In this investigation, it was identified that there is disagreement with the actions that are implemented, lack of supervision, lack of monitoring, strategies, reports, and high frequency of communication between professionals where the purpose is to provide patient safety and demonstrate all the notifications of adverse events and incidents.

Cross-cultural adaptation and validation of the Hospital Survey on Patient Safety questionnaire for a Chilean hospital

BackgroundHospital Survey on Patient Safety version 2.0 (HSOSPS 2.0) from the Agency for Healthcare Research and Quality enables hospitals to gather the information needed to evaluate the patient safety culture within their institution. However, version 2.0 has not been widely implemented in Chile. This study aims to customize and validate the original HSOSPS 2.0 for a Chilean hospital.MethodsTranslation and cross-cultural adaptation, content validity through a group of experts, and a pilot test with cognitive pretest were applied to 259 participants from the nursing team in 11 hospital services to study construct validity and reliability.ResultsIn the current study, a version of the questionnaire adapted to the Chilean cultural context showed excellent content validity with an index of 0.982 (S-CVI). After conducting exploratory factor analysis, a new model with 7 dimensions and 23 questions was proposed, down from the original 10 dimensions and 32 questions. This new model explains 71% of the variability. The model’s goodness of fit indicators were CFI=0.995, TLI=0.994, and RMSEA=0.048. The results of McDonald’s Omega showed high overall reliability with 0.9325.ConclusionsThis study provides a validated measurement instrument that contributes to improving patient safety conditions at the level of the hospital nursing team in highly complex establishments in Chile. However, the dimensions, such as the number of items, were reduced This questionnaire can be used in future nursing research by expanding the sample among health professionals in Chile.Relevance to clinical practiceApplying this version of the questionnaire will be highly beneficial for clinical administrators and nursing staff. It will improve their care practices and promote patient safety in public hospitals in Chile, as well as assist in enhancing nursing policies.

The Influence of Leadership Style and Cognitive Attitudes on Patient Safety Culture With Coordination as a Moderation Variable in Inpatient Nurses at Tzu Chi Hospital

This research is based on the results of initial observations which indicate that several safety incident problems will occur in the year 2022. The aim of this research is to reveal empirically the influence of leadership style and cognitive attitudes on patient safety culture with coordination as a moderator. This type of research is quantitative with a cross sectional study design. The population used is nurses who work in inpatient installations. The sampling technique is non-probability sampling, with perm = calculation of the number of samples using Slovin's formula with an error rate of 10%, so that a total sample of 64 respondents was found. The data collection technique uses a questionnaire, and the analysis method uses three box method analysis and PLS-SEM with the help of the Smart-PLS program. The results of the analysis prove that leadership style, cognitive attitude and coordination simultaneously and partially influence patient safety culture, and cognitive attitude is the most dominant variable capable of improving patient safety culture. Coordination cannot moderate the influence of leadership style on patient safety culture, but coordination can weaken the influence of cognitive attitudes on patient safety culture.

Economic burden of healthcare-associated infections (HAI) in a pediatric hospital in Honduras

Abstract Background In numerous reports, the World Health Organization has published that in LMICs approximately 15% of hospitalized patients acquire an HAI. In the Region of the Americas, many countries have made considerable progress in implementing IPC Programs. At Hospital María Especialidades Pediátricas (HMEP), the IPC Program aims to generate a patient safety culture mainly, but also reduce costs for the hospital and the patient. However, in LMICs, non-quality costs, including those associated with HAI, are rarely measured. This abstract aims to demonstrate the economic burden of HAI in hospitalized patients at HMEP between January 2020 and October 2023 and estimate the number of HAIs and associated costs prevented by the IPC Program. Methods At HMEP the IPC Program started in 2017, and the Accounting Department has measured the costs associated with treating and managing every HAI reported since January 2020. Provider costs for every HAI are estimated using a bottom-up (microcosting) approach in which three variables are considered: days of stay, all laboratory tests used for diagnosis and follow-up, and antimicrobials administered to treat the infection. The costs for each variable derive from the hospital’s purchasing system. This process allows us to estimate the annual HAI expenditure. For the estimation of costs avoided, we first calculated the average cost of each HAI using the yearly amount spent and dividing this amount by the number of HAIs registered in the same period. Considering the proportion of patients who suffered an HAI at HMEP compared to the 15% incidence reported by the WHO, we calculated a difference in proportions and were able to estimate the number of HAIs prevented and subsequent costs avoided. We use the NHSN HAI definitions since Honduras does not have a National IPC Program with standardized epidemiological criteria. The results are presented using descriptive statistics. Results During this time, 260 HAIs were identified at HMEP, average 5.6 per month, 57-70 yearly. The proportion of patients who developed an HAI was found to have decreased from 8.6% in 2020 to 5.2% in 2023. The total expenditure attributed to HAIs during the period was USD 913,774.21 (USD 19,865.0 pm). The costliest HAIs were CVC-associated bloodstream infections. HMEP is a public hospital and operates with funds provided by the government, which are deemed insufficient considering the complexity of the patients receiving care at the hospital. The estimated costs represent 2-3% of the hospital’s annual budget. Without the IPC Program, the predicted number of HAIs, according to the WHO, would have been 570 (15% of inpatients). We estimate 310 prevented HAIs, with an associated total cost of USD 1,103,577.99. Conclusion Regardless of the hospital’s methodology, measuring the economic burden related to HAIs is important for decision-making. The main objective of an IPC Program is to guarantee patient safety; however, especially in low-resource settings, it is also important to aim for a cost reduction. Limitations: our methodology does not include other variables (e.g. human resources); therefore, the data underestimates the real expenditure. We aim to improve the costing methodology for more accurate data.

Strengthening resilience and patient safety in healthcare institutions during the COVID-19 pandemic: Experience from a quasi-medical center

The COVID-19 global pandemic exposed healthcare system vulnerabilities, further endangering patient safety. This article explores perspectives on resilience and patient safety among healthcare workers using data from the Taiwan Patient Safety Culture Survey (TPSCS) and implementing Patient Safety Leadership Walkrounds (PSLWs) at E-Da Hospital. In 2021 and 2022, 1340 and 1114 staff members from clinical departments completed TPSCS questionnaires, respectively. 89 leaders from clinical departments participated in PSLWs in 2022. Among the four job categories, scores of Safety Attitude Questionnaire (SAQ) were lower among nurses and medical technicians, while perceptions of resilience and work-life balance were lowest among nurses. Between the two-year surveys, nurses exhibited significant decreases in SAQ in 2022 compared to 2021, while perceptions of work condition and work-life balance significantly declined among pharmacists. Resilience perception significantly decreased among all job categories except physicians during the pandemic. Mediation analyses showed teamwork climate, job satisfaction, management, work condition, and work-life balance were directly associated with safety climate, while resilience acts as a mediator, indirectly potentiating these relationships. Through PSLWs, we identified concerns about patient safety, including workforce, systems, processes, equipment, and work environment. Among these, workforce shortages and unsatisfactory pay emerged as the most pressing challenges. Strong leadership was recognized as a crucial factor in enhancing resilience and patient safety. This study suggests that TPSCS and PSLWs are worth regularly promoting among hospital institutions. Additionally, our findings highlight the urgency of healthcare organizations and governmental agencies to undertake policy reforms to improve healthcare workers’ well-being.

Designing an Intervention to Improve Medication Safety for Nursing Home Residents Based on Experiential Knowledge Related to Patient Safety Culture at the Nursing Home Front Line: Cocreative Process Study.

Despite years of attention, avoiding medication-related harm remains a global challenge. Nursing homes provide essential health care for frail older individuals, who often experience multiple chronic diseases and polypharmacy, increasing their risk of medication errors. Evidence of effective interventions to improve medication safety in these settings is inconclusive. Focusing on patient safety culture is a potential key to intervention development as it forms the foundation for overall patient safety and is associated with medication errors. This study aims to develop an intervention to improve medication safety for nursing home residents through a cocreative process guided by integrated knowledge translation and experience-based codesign. This study used a cocreative process guided by integrated knowledge translation and experience-based co-design principles. Evidence on patient safety culture was used as an inspirational source for exploration of medication safety. Data collection involved semistructured focus groups to generate experiential knowledge (stage 1) to inform intervention design in a multidisciplinary workshop (stage 2). Research validation engaging different types of research expertise and municipal managerial representatives in finalizing the intervention design was essential. Acceptance of the final intervention for evaluation was aimed for through contextualization focused on partnership with a municipal advisory board. An abductive, rapid qualitative analytical approach to data analysis was chosen using elements from analyzing in the present, addressing the time-dependent, context-bound aspects of the cocreative process. Experiential knowledge was represented by three main themes: (1) closed systems and gaps between functions, (2) resource interpretation and untapped potential, and (3) community of medication safety and surveillance. The main themes informed the design of preliminary intervention components in a multidisciplinary workshop. An intervention design process focused on research validation in addition to contextualization resulted in the Safe Medication in Nursing Home Residents (SAME) intervention covering (1) campaign material visualizing key roles and responsibilities regarding medication for nursing home residents and (2) "Medication safety reflexive spaces" focused on social and health care assistants. The cocreative process successfully resulted in the multifaceted SAME intervention, grounded in lived experiences shared by some of the most important (but often underrepresented in research) stakeholders: frontline health care professionals and representatives of nursing home residents. This study brought attention toward closed systems related to functions in medication management and surveillance, not only informing the SAME intervention design but as opportunities for further exploration in future research. Evaluation of the intervention is an important next step. Overall, this study represents an important contribution to the complex field of medication safety. RR2-10.2196/43538.

Cultura de Calidad y Seguridad del Paciente

Quality and safety in health is a concept that has gradually been installed on the agendas of different health organizations; however, it is still an incipient concept within the area. The objective of this research was to describe the concepts and application of the culture of quality and patient safety today in different health organizations. For this purpose, a qualitative methodology was carried out, with a phenomenological approach through the narrative review of scientific articles from the Scielo, Scopus and WOS databases, during the months of April to June 2023. 12 articles that met the criteria were obtained. with the requirements of not being older than 6 years and in Spanish and English. The results show the relevance of determining the perception of quality culture with a validated instrument, obtaining neutral results, showing the incipient development of the patient safety culture. In conclusion, the lifting of five categories and the relevance of a good organizational climate and culture are determining factors to be able to implement a safety culture, since there is no quality of care without safety.

Exploring the Relationship Between Hospital Patient Safety Culture and Performance on Measures of Hospital-Acquired Conditions

Objective The aim of the study is to examine the relationship between hospital perceptions of patient safety culture and the incidence of hospital-acquired conditions (HACs) included in Medicare’s HAC Reduction Program utilizing updated and standardized metrics. Methods The pooled cross-sectional study design utilized the 2018 and 2021 datasets from (1) the Agency for Healthcare Research and Quality’s Hospital Survey on Patient Safety Culture (HSOPS), (2) the American Hospital Association’s annual survey, and (3) the Center for Medicare and Medicaid’s Hospital Compare dataset. The final analytic sample included 131 acute care, nonfederal, U.S. facilities. Multivariable linear regression models were used to compare the HSOPS domains of patient safety culture to CMS’s HAC metrics. Results Controlling for hospital structural and patient-mix characteristics, hospitals with higher staff-reported ratings of overall patient safety culture (‘overall perceptions of patient safety’ and ‘patient safety grade’) had significantly lower rates of HACs, including total HAC rate, catheter-associated urinary tract infections, and central line-associated blood stream infections (P’s &lt; 0.000–0.044). Higher HSOPS domain scores were variably associated with lower HAC rates, with consistently significant associations found for domains related to nonpunitive, open communication (P’s &lt; 0.05). Conclusions Our relatively robust results suggest that while patient safety culture may not be the only strategy necessary to improve HAC rates, it needs to be aligned with other efforts to improve quality and safety. This underscores the importance of cultivating a culture of psychological safety that promotes open feedback and communication about errors.

The Influence of Hospital Physician Integration on Culture of Patient Safety.

Medical errors are responsible for a large number of deaths every year in the Unites States. Hospitals use various strategies including leadership, staffing, and structural changes to deal with this concerning issue. Hospital physician integration is a structural strategy to possibly improve patient safety. Using the conceptual lens of Donabedian's Structure Process Outcome model, this study aims to investigate how hospital physician integration affects organizational, management, and communication attributes of patient safety culture. A pooled cross sectional study design using the Hospital Survey on Patient Safety Culture, the American Hospital Association data, and Area Health Resource File was used to analyze the relationship between hospital physician integration and organizational and management patient safety culture attributes. The dataset comprised of hospital level data from 2021 and 2022 for patient safety culture and hospital characteristics and contained a final sample of 205 observations. The independent variable was levels of integration across five levels. Three attributes of safety culture were chosen-positive perceptions of communication openness, organizational learning, and hospital management support for patient safety. The control variables were organizational characteristics. Multivariable linear regression was used as the analytic method. Findings demonstrated a statistically significant correlation between higher level of hospital physician integration and positive perceptions of hospital management support for patient safety. There are 0.063 higher positive perceptions of hospital management support for patient safety for higher levels of integration compared with lower levels of integration (P < 0.05). Perceptions of communication openness and organizational learning did not demonstrate a statistically significant correlation with any level of hospital physician integration. Hospital physician integration and hospital management support for patient safety were moderately but significantly related. Hospital physician integration allows resources to become available for physician. As physicians take on management roles management of resources and eventually performance can improve, there is a need for future research in this area to examine if integration is a step in the right direction to overcome the challenges of patient safety and if investments in resources and training can be beneficial to safety culture.

Effect of the Green Cross method on patient safety culture in a postanaesthesia care unit: a longitudinal quasi-experimental study

BackgroundHospitals should adopt multiple methods to monitor incidents for a comprehensive review of the types of incidents that occur. Contrary to traditional incident reporting systems, the Green Cross (GC) method...