Safety culture in healthcare: mixed method study

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Elisiane Lorenzini ◽  
Nelly D. Oelke ◽  
Patricia B. Marck
Keyword(s):  
Mixed Methods ◽  
Safety Culture ◽  
Mixed Methods Research ◽  
Administrative Support ◽  
Safety Climate ◽  
Patient Safety Culture ◽  
Integrated Approach ◽  
Joint Analysis ◽  
Content Type ◽  
Safety Attitudes

PurposeHealthcare providers’ perceptions of management's effectiveness in achieving safety culture improvements are low, and there is little information in the literature on the subject. Objective: The overall aim of this study was to examine the patient safety culture within an interprofessional team – physicians, nurses, nurse technicians, speech therapist, psychologist, social worker, administrative support – practicing in an advanced neurology and neurosurgery center in Southern Brazil.Design/methodology/approachThe authors applied the safety attitudes questionnaire (SAQ) in a mixed methods study, with a quan→QUAL sequential explanatory approach.FindingsIn the quantitative phase, the authors found a negative safety climate through the SAQ. In the qualitative phase, the approach enabled participants to identify specific safety problems. For that, participants proposed improvements that were directly and quickly implemented in the workplace during the study. The joint analysis of the quantitative and qualitative data inferred that the information and reflections of the focus group participants supported and validated the SAQ statistical analysis results. This integrated approach illustrated the importance of various safety culture aspects as a multifaceted phenomenon related to healthcare quality.Originality/valueThis study provides explanations for why management is associated negatively with safety climate in healthcare institutions. In addition, the study provides a novel contribution adding value to mixed methods research methodology.

Applying importance-performance analysis to patient safety culture

2015 ◽  
Vol 28 (8) ◽  
pp. 826-840 ◽  
Author(s):  
Yii-Ching Lee ◽  
Hsin-Hung Wu ◽  
Wan-Lin Hsieh ◽  
Shao-Jen Weng ◽  
Liang-Po Hsieh ◽  
...  
Keyword(s):  
Patient Safety ◽  
Performance Analysis ◽  
Safety Culture ◽  
Safety Climate ◽  
Patient Safety Culture ◽  
Hospital Staff ◽  
Healthcare Organizations ◽  
Content Type ◽  
Safety Attitudes ◽  
Upper Management

Purpose – The Sexton et al.’s (2006) safety attitudes questionnaire (SAQ) has been widely used to assess staff’s attitudes towards patient safety in healthcare organizations. However, to date there have been few studies that discuss the perceptions of patient safety both from hospital staff and upper management. The purpose of this paper is to improve and to develop better strategies regarding patient safety in healthcare organizations. Design/methodology/approach – The Chinese version of SAQ based on the Taiwan Joint Commission on Hospital Accreditation is used to evaluate the perceptions of hospital staff. The current study then lies in applying importance-performance analysis technique to identify the major strengths and weaknesses of the safety culture. Findings – The results show that teamwork climate, safety climate, job satisfaction, stress recognition and working conditions are major strengths and should be maintained in order to provide a better patient safety culture. On the contrary, perceptions of management and hospital handoffs and transitions are important weaknesses and should be improved immediately. Research limitations/implications – The research is restricted in generalizability. The assessment of hospital staff in patient safety culture is physicians and registered nurses. It would be interesting to further evaluate other staff’s (e.g. technicians, pharmacists and others) opinions regarding patient safety culture in the hospital. Originality/value – Few studies have clearly evaluated the perceptions of healthcare organization management regarding patient safety culture. Healthcare managers enable to take more effective actions to improve the level of patient safety by investigating key characteristics (either strengths or weaknesses) that healthcare organizations should focus on.

scholarly journals Study and promotion of safety culture using mixed methods research

2021 ◽  
Vol 8 (2) ◽  
pp. 129-139
Author(s):  
Daiane Brigo Alves ◽  
Elisiane Lorenzini ◽  
Nelly Oelke ◽  
Anthony John Onwuegbuzie ◽  
Adriane Cristina Bernat Kolankiewicz
Keyword(s):  
Patient Safety ◽  
Mixed Methods ◽  
Knowledge Translation ◽  
Safety Culture ◽  
Multidisciplinary Team ◽  
Mixed Methods Research ◽  
Negative Impact ◽  
Patient Safety Culture ◽  
Research Approach ◽  
Safety Attitudes

Abstract Objective With a positive safety culture, institutions offer the best quality and safe care to their patients. The objective of this study was to analyze patient safety culture from the perspective of the multidisciplinary team, to identify factors that influence patient safety culture, and to create/promote—jointly with the study participants—strategies for improving processes of change. Methods The study design represented a mixed methods research approach, with a sequential explanatory design. A multidisciplinary team of workers at a general hospital was eligible for the study. To collect quantitative data, we administered the Safety Attitudes Questionnaire (SAQ). The qualitative phase was accomplished via focus groups (FGs), with participants from the first phase of the study using the principles of deliberative dialogue (DD) as a knowledge-translation strategy. The STROBE guideline was used to develop the study. Results The overall SAQ score was positive (75.1 ± 10.4). Negative scores were found in the fields of Safety Climate, Working Conditions, and Stress Recognition. Focus group discussions identified the aspects that create a negative impact on safety culture, such as ineffective communication, punitive approach in the event of errors, the lack of commitment and adherence to the protocols, and the non-recognition of the stress and the mistakes. Actions for the promotion of safety culture were developed and implemented during the study. Conclusions The use of the principles of DD as a strategy for knowledge translation (KT) made it possible to identify and plan for joint actions to generate improvements in safety culture.

Assessment of patient safety culture during COVID-19: a cross-sectional study in a tertiary a-level hospital in China

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Chih-Hsuan Huang ◽  
Ying Wang ◽  
Hsin-Hung Wu ◽  
Lee Yii-Ching
Keyword(s):  
Patient Safety ◽  
Working Conditions ◽  
Emotional Exhaustion ◽  
Safety Culture ◽  
Team Building ◽  
Reliability And Validity ◽  
Patient Safety Culture ◽  
Cross Sectional ◽  
Content Type ◽  
Safety Attitudes

PurposeThe aims of this study are to (1) evaluate physicians and nurses' perspectives on patient safety culture amid the COVID-19 pandemic and (2) integrate the emotional exhaustion of physicians and nurses into an evaluation of patient safety culture to provide insights into appropriate implications for medical care.Design/methodology/approachPatient safety culture was assessed with the Chinese version of the Safety Attitudes Questionnaire. Confirmatory factor analysis was conducted to validate the structure of the data (i.e. reliability and validity), and Pearson's correlation analysis was performed to identify relationships between safety-related dimensions.FindingsSafety climate was strongly associated with working conditions and teamwork climate. In addition, working conditions was highly correlated with perceptions of management and job satisfaction, respectively. It is worth noting that the stress and emotional exhaustion of the physicians and nurses during this epidemic were high and needed attention.Practical implicationsFor healthcare managers and practitioners, team-building activities, power of public opinions, IoT-focused service, and Employee Assistance Programs are important implications for inspiring the patient safety-oriented culture during the period of the COVID-19 pandemic.Originality/valueThis paper considers the role of emotional state into patient safety instrument, a much less understood but equally important dimension in the field of patient safety.

Patient safety culture in the perception of health professionals: A mixed methods research study

2021 ◽  
Vol 42 ◽  
Author(s):  
Cassiana Gil Prates ◽  
Rita Catalina Aquino Caregnato ◽  
Ana Maria Müller de Magalhães ◽  
Daiane Dal Pai ◽  
Janete de Souza Urbanetto ◽  
...  
Keyword(s):  
Patient Safety ◽  
Mixed Methods ◽  
Safety Culture ◽  
Health Professionals ◽  
Mixed Methods Research ◽  
Work Organization ◽  
Patient Safety Culture ◽  
Integrated Analysis ◽  
Explanatory Mixed Methods ◽  
Perception Of Health

ABSTRACT Objective: To analyze the patient safety culture perceived by health professionals working in a hospital and to understand the elements influencing it. Methods: A sequential explanatory mixed methods study, conducted in 2017 in two interrelated stages in a hospital. The quantitative stage was carried out by applying the questionnaire to 618 professionals and the qualitative stage, with ten, using the focus group technique. The analysis was descriptive statistics for the quantitative data and of content for the qualitative data. Subsequently, the data were submitted to integrated analysis. Results: Of the 12 dimensions, seven were considered weak, the most critical being “non-punitive response to error” with 28.5% of positive answers. Bureaucratic, poorly designed and uncoordinated processes, regional decisions, communication failures, hierarchy, overload, punishment and judicialization were related to the perception. Conclusions: The patient safety culture was considered weak, and elements related to work organization, people management and legal risk influenced this negative perception.

scholarly journals Patient safety culture in Slovenian out-of-hours primary care clinics

2017 ◽  
Vol 56 (4) ◽  
pp. 203-210 ◽  
Author(s):  
Zalika Klemenc-Ketiš ◽  
Ellen Tveter Deilkås ◽  
Dag Hofoss ◽  
Gunnar Tschudi Bondevik
Keyword(s):  
Patient Safety ◽  
Safety Culture ◽  
Safety Climate ◽  
International Study ◽  
Patient Safety Culture ◽  
Cross Sectional Study ◽  
Full Time ◽  
Cross Sectional ◽  
Out Of Hours ◽  
Safety Attitudes

Abstract Introduction Patient safety culture is a concept which describes how leader and staff interaction, attitudes, routines and practices protect patients from adverse events in healthcare. We aimed to investigate patient safety culture in Slovenian out-of-hours health care (OOHC) clinics, and determine the possible factors that might be associated with it. Methods This was a cross-sectional study, which took place in Slovenian OOHC, as part of the international study entitled Patient Safety Culture in European Out-of-Hours Services (SAFE-EUR-OOH). All the OOHC clinics in Slovenia (N=60) were invited to participate, and 37 agreed to do so; 438 employees from these clinics were invited to participate. We used the Slovenian version of the Safety Attitudes Questionnaire – an ambulatory version (SAQAV) to measure the climate of safety. Results Out of 438 invited participants, 250 answered the questionnaire (57.1% response rate). The mean overall score ± standard deviation of the SAQ was 56.6±16.0 points, of Perceptions of Management 53.6±19.6 points, of Job Satisfaction 48.5±18.3 points, of Safety Climate 59.1±22.1 points, of Teamwork Climate 72.7±16.6, and of Communication 51.5±23.4 points. Employees working in the Ravne na Koroškem region, employees with variable work shifts, and those with full-time jobs scored significantly higher on the SAQ-AV. Conclusion The safety culture in Slovenian OOHC clinics needs improvement. The variations in the safety culture factor scores in Slovenian OOHC clinics point to the need to eliminate variations and improve working conditions in Slovenian OOHC clinics.

scholarly journals The Association between the Participation of Quality Control Circle and Patient Safety Culture

2020 ◽  
Vol 17 (23) ◽  
pp. 8872
Author(s):  
Ni-Hu Tang ◽  
Shang-Feng Tsai ◽  
Jaw-Horng Liou ◽  
Yuan-Hui Lai ◽  
Shih-An Liu ◽  
...  
Keyword(s):  
Job Satisfaction ◽  
Quality Control ◽  
Patient Safety ◽  
Working Conditions ◽  
Safety Culture ◽  
Work Experience ◽  
Safety Climate ◽  
Patient Safety Culture ◽  
Safety Attitudes ◽  
Stress Recognition

Promoting patient safety culture (PSC) is a critical issue for healthcare providers. Quality control circles program (QCCP) can be used as an effective tool to foster long-lasting improvements on the quality of medical institution. The effect of QCCP on PSC is still unknown. This was a retrospective study conducted with matching data. A safety attitudes questionnaire (SAQ) was used for the evaluation of PSC. The association between all scores of six subscales of SAQ and the participation QCCP were analyzed with both the Mann–Whitney and Kruskal–Wallis tests. A total of 2718 valid questionnaires were collected. Most participants of QCCP were females (78.9%), nurses (52.6%), non-supervisors (92.2%), aged <40 years old (64.8%), degree of specialist or university graduates (78%), and with work experience of <10 years (61.6%). Of all participants, the highest scores were in the dimension of safety climate (74.11 ± 17.91) and the lowest scores in the dimension of working conditions (68.90 ± 18.84). The participation of QCCP was associated with higher scores in four dimensions, namely: teamwork climate (p = 0.006), safety climate (p = 0.037), perception of management (p = 0.009), and working conditions (p = 0.015). The participation or not of QCCP had similar results in the dimension of job satisfaction and stress recognition. QCCP was associated with SAQ in subjects with the following characteristics: female, nurse, non-supervisor, aged >50 years old, higher education degrees and with longer working experiences in the hospital. In this first study on the association between each dimension of SAQ and the implementation of QCCP, we found that QCCP interventions were associated with better PSC. QCCP had no benefits in the dimensions of job satisfaction and stress recognition.

scholarly journals Causal Relationship Analysis of the Patient Safety Culture Based on Safety Attitudes Questionnaire in Taiwan

2018 ◽  
Vol 2018 ◽  
pp. 1-8 ◽  
Author(s):  
Yii-Ching Lee ◽  
Pei-Shan Zeng ◽  
Chih-Hsuan Huang ◽  
Hsin-Hung Wu
Keyword(s):  
Job Satisfaction ◽  
Patient Safety ◽  
Safety Culture ◽  
Safety Climate ◽  
Patient Safety Culture ◽  
Laboratory Method ◽  
Critical Dimensions ◽  
Safety Attitudes ◽  
Safety Attitudes Questionnaire ◽  
Relationship Analysis

This study uses the decision-making trial and evaluation laboratory method to identify critical dimensions of the safety attitudes questionnaire in Taiwan in order to improve the patient safety culture from experts’ viewpoints. Teamwork climate, stress recognition, and perceptions of management are three causal dimensions, while safety climate, job satisfaction, and working conditions are receiving dimensions. In practice, improvements on effect-based dimensions might receive little effects when a great amount of efforts have been invested. In contrast, improving a causal dimension not only improves itself but also results in better performance of other dimension(s) directly affected by this particular dimension. Teamwork climate and perceptions of management are found to be the most critical dimensions because they are both causal dimensions and have significant influences on four dimensions apiece. It is worth to note that job satisfaction is the only dimension affected by the other dimensions. In order to effectively enhance the patient safety culture for healthcare organizations, teamwork climate, and perceptions of management should be closely monitored.

scholarly journals Patient safety culture in primary and home care services

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Letícia Martins Lousada ◽  
Francisco Clécio da Silva Dutra ◽  
Beatriz Viana da Silva ◽  
Natália Lúcia Lima de Oliveira ◽  
Ismael Brioso Bastos ◽  
...  
Keyword(s):  
Primary Care ◽  
Job Satisfaction ◽  
Home Care ◽  
Safety Culture ◽  
Safety Climate ◽  
Care Program ◽  
Patient Safety Culture ◽  
Home Care Services ◽  
Cross Sectional ◽  
Safety Attitudes

Abstract Background Safety culture is still a poorly studied subject in primary care and home care, although these settings are considered gateways to access to healthcare. This study aims to evaluate safety culture in primary and home care settings. Methods An observational cross-sectional study was carried out with 147 professionals from nine districts covered by one home care program and six primary healthcare centres. The Safety Attitudes Questionnaire (SAQ) was used to evaluate the safety culture, in which scores ≥75 are indicative of a positive safety culture. Results A total of 56 (86,1%) questionnaires returned from the home care professionals and 91 (86,6%) from the primary care professionals. The Job satisfaction domain was the best evaluated, achieving a score of 88.8 in home care and 75.1 in primary care. The achievement of high scores on Safety Climate, Job Satisfaction, Teamwork Climate, and Total SAQ was related to male gender, and time of professional experience of three to 4 years. Perception of management and Working conditions had the lowest scores, and this result was related with long time of experience. Conclusions It is concluded that professionals working in home care gave higher scores for safety culture in their workplace than the primary care workers.

Evaluation of Patient Safety Culture: A Survey of Clinicians in a Cardiovascular Operating Room

2012 ◽  
Vol 7 (5) ◽  
pp. 328-337 ◽  
Author(s):  
Linda Henry ◽  
Sharon L. Hunt ◽  
Mary Kroetch ◽  
Y. Tony Yang
Keyword(s):  
Patient Safety ◽  
Operating Room ◽  
Safety Culture ◽  
Safety Climate ◽  
Patient Safety Culture ◽  
Ventricular Assist ◽  
Perceived Safety ◽  
Safety Attitudes ◽  
Emergency Situations ◽  
Device Placement

Objective The aim of this study was to understand the perceived safety culture and attitudes of caregivers in a large cardiovascular operating room (CVOR) in a mid-Atlantic state where more than 1500 procedures are performed annually to include ventricular assist device placement and heart and lung transplantations. Methods We analyzed deidentified data obtained from a safety survey completed anonymously by frontline caregivers in the CVOR via the Safety Attitudes Questionnaire developed by Pasquel Metrics. Results The responses from the CVOR clinicians were overall positive for their perceptions of the CVOR safety climate, with the majority saying they would feel safe being treated as a patient, liked their job, and were aware of the proper channels regarding patient safety. However, many made claims of experiencing fatigue and stress due to an excessive workload and participation in emergency situations. Furthermore, the support/clinical perfusion teams were found to have experienced the greatest amount of stress and discomfort, whereas it seems the surgeons were impacted the least. Conclusions This study suggests that reactions to different situations in the operating room are dependent on the role of the caregiver. Therefore, interventions to improve communication among the caregivers must be geared on an individual group basis.

scholarly journals Assessing Patient Safety Culture in Hospital Settings

2021 ◽  
Vol 18 (5) ◽  
pp. 2466
Author(s):  
Abdulmajeed Azyabi ◽  
Waldemar Karwowski ◽  
Mohammad Reza Davahli
Keyword(s):  
Patient Safety ◽  
Safety Culture ◽  
Work Experience ◽  
Safety Climate ◽  
Current Knowledge ◽  
Improve Patient Safety ◽  
Patient Safety Culture ◽  
Healthcare Industry ◽  
Safety Attitudes ◽  
Healthcare Settings

The current knowledge about patient safety culture (PSC) in the healthcare industry, as well as the research tools that have been used to evaluate PSC in hospitals, is limited. Such a limitation may hamper current efforts to improve patient safety worldwide. This study provides a systematic review of published research on the perception of PSC in hospitals. The research methods used to survey and evaluate PSC in healthcare settings are also explored. A list of academic databases was searched from 2006 to 2020 to form a comprehensive view of PSC’s current applications. The following research instruments have been applied in the past to assess PSC: the Hospital Survey on Patient Safety Culture (HSPSC), the Safety Attitudes Questionnaire (SAQ), the Patient Safety Climate in Health Care Organizations (PSCHO), the Modified Stanford Instrument (MSI-2006), and the Scottish Hospital Safety Questionnaire (SHSQ). Some of the most critical factors that impact the PSC are teamwork and organizational and behavioral learning. Reporting errors and safety awareness, gender and demographics, work experience, and staffing levels have also been identified as essential factors. Therefore, these factors will need to be considered in future work to improve PSC. Finally, the results reveal strong evidence of growing interest among individuals in the healthcare industry to assess hospitals’ general patient safety culture.

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