Staff Perceptions Of Safety Culture Research Articles

'What effect do safety culture interventions have on health care workers in hospital settings?' A systematic review of the international literature.

Introduction: Interventions designed to improve safety culture in hospitals foster organisational environments that prevent patient safety events and support organisational and staff learning when events do occur. A safety culture supports the required health workforce behaviours and norms that enable safe patient care, and the well-being of patients and staff. The impact of safety culture interventions on staff perceptions of safety culture and patient outcomes has been established. To-date, however, there is no common understanding of what staff outcomes are associated with interventions to improve safety culture and what staff outcomes should be measured. Objectives: The study seeks to examine the effect of safety culture interventions on staff in hospital settings, globally. Methods and Analysis: A mixed methods systematic review will be conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Searches will be conducted using the electronic databases of MEDLINE, EMBASE, CINAHL, Health Business Elite, and Scopus. Returns will be screened in Covidence according to inclusion and exclusion criteria. The mixed-methods appraisal tool (MMAT) will be used as a quality assessment tool. The Cochrane Collaboration's tool for assessing risk of bias in randomised trials and non-randomised studies of interventions will be employed to verify bias. Synthesis will follow the Joanna Briggs Institute methodological guidance for mixed methods reviews, which recommends a convergent approach to synthesis and integration. Discussion: This systematic review will contribute to the international evidence on how interventions to improve safety culture may support staff outcomes and how such interventions may be appropriately designed and implemented.

‘What effect do safety culture interventions have on health care workers in hospital settings?’ A systematic review of the international literature

Introduction: Interventions designed to improve safety culture in hospitals foster organisational environments that prevent patient safety events and support organisational and staff learning when events do occur. A safety culture supports the required health workforce behaviours and norms that enable safe patient care, and the well-being of patients and staff. The impact of safety culture interventions on staff perceptions of safety culture and patient outcomes has been established. To-date, however, there is no common understanding of what staff outcomes are associated with interventions to improve safety culture and what staff outcomes should be measured. Objectives: The study seeks to examine the effect of safety culture interventions on staff in hospital settings, globally. The research questions are: 1) what effects do interventions to improve safety culture have on staff? 2) What intervention features, safety culture domains or other factors explain these effects? 3) What staff outcomes and experiences are identified? Methods and Analysis: A mixed methods systematic review will be conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Searches will be conducted using the electronic databases of MEDLINE, EMBASE, CINAHL, Health Business Elite, and Scopus. Returns will be screened in Covidence according to inclusion and exclusion criteria. The mixed-methods appraisal tool (MMAT) will be used as a quality assessment tool. The Cochrane Collaboration’s tool for assessing risk of bias in randomised trials and non-randomised studies of interventions will be employed to verify bias. Synthesis will follow the Joanna Briggs Institute methodological guidance for mixed methods reviews, which recommends a convergent approach to synthesis and integration. Discussion: This systematic review will contribute to the international evidence on how interventions to improve safety culture may support staff outcomes and how such interventions may be appropriately designed and implemented.

Post Traumatic Growth in Radiation Medicine Following the COVID-19 Outbreak

Purpose/Objective(s)It has been reported that adversarial growth during traumatic events potentially enhances coping with sequelae. The purpose of this work was to assess post-traumatic growth amongst radiation medicine staff members at the individual level as well as changes in perceptions of departmental culture following the outbreak of the COVID-19 pandemic declared as a US public health emergency in February 2020.Materials/MethodsA post-traumatic growth inventory (PTGI) survey comprising 21 growth indicators was disseminated electronically in May 2020 with the option of anonymous feedback to all 213 members of our multi-center radiation medicine department. The indicators were intended to measure perceptions of change in 3 domains following the outbreak: personal, interpersonal relationships and philosophy of life. In addition, 8 department safety culture survey questions were included in this survey taken from the National Hospital Patient Safety Culture Survey developed by the Agency for Healthcare Research and Quality (AHRQ). The goal was to assess changes in staff perceptions of department culture during the pandemic versus the baseline survey completed in 2019 ahead of the pandemic. The PTGI and AHRQ survey questions were scored using 6- and 5-point Likert scales with the higher scores yielding greatest perceived growth and most favorable perceptions respectively. Principal Factor Analysis with Varimax rotation was conducted on the PTGI indicators. Indicators with the highest degree of perceived change and department cultural improvements were identified.ResultsWith a 56.3% survey response rate, factor analysis on the 21 PTGI indicators yielded Cronbach's alpha values of 0.958, 0.905 and 0.915 corresponding to the aforementioned domains. The average PTGI growth noted was 2.3 which fell between small and moderate on the Likert scale (none: 0, moderate 3, greatest 5.0). The values were 2.42 (personal), 2.11 (inter-personal) and 1.60 (philosophy) for the 3 domains. The total PTGI score was greater for staff members working from home (57.8) compared to frontline workers (43.7) out of 105 points (P-value 0.004). For the AHRQ survey there was an improvement of 18% in staff perceptions of safety culture. Of the 8 indicators, 7 showed improvements compared with baseline while 4 exceeded the 95th percentile of the nationwide responses in 2018.ConclusionA fair to moderate degree of post-traumatic growth was observed during the pandemic, such as in areas of changing priorities on what is important, appreciation of life, compassion for others, and readiness to change. Least change was noted in religious beliefs and openness to express emotions. Staff perceptions of department priorities towards patient safety, effectiveness of policies and openness to staff questioning decisions improved substantially. Growth was thus perceived both at the individual and the department level.

Safety Culture Relationships with Hospital Nursing Sensitive Metrics

Public demand for safer care has catapulted the healthcare industry's efforts to understand relationships between patient safety and hospital performance. This study explored linkages between staff perceptions of safety culture (SC) and ongoing measures of hospital nursing unit-based structures, care processes, and adverse patient outcomes. Relationships between nursing-sensitive measures of hospital performance and SC were explored at the unit-level from 9 California hospitals and 37 nursing units. SC perceptions were measured 6 months prior to collection of nursing metrics and relationships between the two sets of data were explored using correlational and regression analyses. Significant relationships were found with reported falls and process measures for fall prevention. Multiple associations were identified with SC and the structure of care delivery: skill mix, staff turnover, and workload intensity demonstrated significant relationships with SC, explaining 22-45% of the variance. SC was an important factor to understand in the quest to advance safe patient care. These findings have affordability and care quality implications for hospital leadership. When senior leaders prioritized a safety culture, patient outcomes may have improved with less staff turnover and more productivity. A business case could be made for investing in patient safety systems to provide reliably safe care.

Perceptions of safety culture in hospital pharmacy: how safe do we think we are?

ObjectivesDespite growing recognition of the importance of staff perceptions of safety culture to the quality of care provided to patients, there is limited published work describing the safety culture within...