scholarly journals Development and pilot testing of survey items to assess the culture of value and efficiency in hospitals and medical offices

2021 ◽  
pp. bmjqs-2020-012407 ◽  
Author(s):  
Joann Sorra ◽  
Katarzyna Zebrak ◽  
Naomi Yount ◽  
Theresa Famolaro ◽  
Laura Gray ◽  
...  
Keyword(s):  
Care Delivery ◽  
Patient Safety Culture ◽  
Organisational Culture ◽  
Healthcare Research ◽  
Cognitive Testing ◽  
Management Support ◽  
Analysis Model ◽  
Factor Analysis Model ◽  
Improve Efficiency ◽  
Composite Measures

BackgroundGiven rising costs and changing payment models, healthcare organisations are increasingly focused on value and efficiency. The goal of our study was to develop survey items to assess clinician and staff perspectives about the extent to which the organisational culture in hospitals and medical offices supports value and efficiency.MethodsDevelopment began with a literature review and interviews with experts and clinicians and staff from hospitals and medical offices. We identified key areas of value and efficiency culture, drafted survey items and conducted cognitive testing. Using purposive sampling to select sites, the 36-item surveys were pilot tested in 47 hospitals and 96 medical offices. Psychometric analysis was conducted on data from 3951 hospital respondents (42% response) and 1458 medical office respondents (63% response).ResultsFactor loadings, multilevel confirmatory factor analysis model fit and reliability estimates were acceptable for the 13 items grouped into 4 composite measures: Empowerment to Improve Efficiency (3 items), Efficiency and Waste Reduction (3 items), Patient Centeredness and Efficiency (3 items) and Management Support for Improving Efficiency and Reducing Waste (4 items). All composite measures were significantly intercorrelated and related to the four Overall Ratings of Healthcare Quality, indicating adequate conceptual convergence among the measures. Eight items assessing Experiences With Activities to Improve Efficiency were also included.ConclusionWe developed psychometrically sound survey items measuring value and efficiency culture. When added to the Agency for Healthcare Research and Quality Surveys on Patient Safety Culture, the item sets extend those surveys by assessing additional dimensions of organisational culture that affect care delivery. Healthcare organisations can use these item sets to assess how well their organisational culture supports value and efficiency and identify areas for improvement.

Assessment of patient safety culture: a comparative case study between physicians and nurses

2017 ◽  
Vol 23 (4) ◽  
pp. 792-810 ◽  
Author(s):  
Ahmed Mohamed Elsheikh ◽  
Mohammed Abdullah AlShareef ◽  
Bassem Salah Saleh ◽  
Muhammad Abdullah Yassin El-Tawansi
Keyword(s):  
Patient Safety ◽  
Safety Culture ◽  
Positive Response ◽  
Care Delivery ◽  
Patient Safety Culture ◽  
Healthcare Research ◽  
Comparative Case Study ◽  
Content Type ◽  
Survey Tool ◽  
Average Percentage

Purpose This study compares responses of physicians and nurses to patient safety culture assessment in the Security Forces Hospital Program Makkah, Saudi Arabia, using the Agency for Healthcare Research and Quality (AHRQ) survey tool and its referenced benchmarking tool. The purpose of this paper is to measure patient safety culture to improve its perception, reaction, and implementation, leading to improvement in care delivery. Design/methodology/approach This study uses convenience sampling, delivering paper copies. The completed surveys were collected by a designated hospital contact person in QPSD. The total population surveyed was 623: 336 nurses, 174 physicians, 9 pharmacists, and 104 technicians. Findings Composite-level results compared to AHRQ database hospitals show values below minimum positive in “Staffing” and “Non-Punitive response to error” to have decreased values in nursing answers than physician ones. The average percentage positive concerning “staffing” items is below the average percentage positive of database hospitals; in nursing, it decreases more; it shows a low positive response regarding enough staff, work hours, and crisis mode; the last item shows a more negative response. The average percentage positive concerning “No punitive Response to Error” is below average positive of database hospitals; in nursing, it decreases more, with a low positive response concerning feeling responsible for mistakes. Originality/value The approach explained in this paper aims to measure patient safety culture, which can be improved through mentioned recommendations.

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

2018 ◽  
Vol 5 (7) ◽  
pp. 2791
Author(s):  
R. C. Goyal ◽  
Sonali Choudhari
Keyword(s):  
Health Care ◽  
Patient Safety ◽  
Safety Culture ◽  
Low Income ◽  
Central India ◽  
Patient Safety Culture ◽  
Clinical Work ◽  
Healthcare Research ◽  
Care Hospital ◽  
Management Support

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

Measuring patient safety culture: A study at a teaching hospital in Ghana

2020 ◽  
Vol 25 (6) ◽  
pp. 250-258
Author(s):  
Musilimu Muftawu ◽  
Ece Ugurluoglu Aldogan
Keyword(s):  
Patient Safety ◽  
Teaching Hospital ◽  
Safety Culture ◽  
Healthcare Workers ◽  
Patient Safety Culture ◽  
Healthcare Research ◽  
Average Score ◽  
Management Support ◽  
Cross Sectional Survey ◽  
Event Reporting

Objective This study examined the current patient safety culture from the perspective of healthcare workers in a teaching hospital in Ghana and drew comparison with the Agency for Healthcare Research and Quality 2018 Patient Safety Culture Comparative Database Report. Methods A cross-sectional survey was conducted using the Hospital Survey on Patient Safety Culture developed by the Agency for Healthcare Research and Quality. A total of 435 questionnaires were distributed and 322 valid responses were received (a response rate of 74%). The study sample included 178 nurses, 59 doctors, 19 pharmacists, 35 technicians ((laboratory and radiology), and 31 management staff. The Hospital Survey Excel Tool 1.6 and the Statistical Package for the Social Sciences (SPSS) version 20 were used to analyze the data. Results The overall average score for the 12 dimensions of patient safety culture was 53% which is 12% lower than the Agency for Healthcare Research and Quality 2018 benchmark report of 65%. The dimension with the highest positive mean score was “Teamwork within Hospital Units” (77%) while the one with the lowest score was “Frequency of Event Reporting” (33%). All 12 domains except for Frequency of Event Reporting ( p = 0.414), Management Support for Patient Safety ( p = 0.823), and Teamwork within Units ( p = 0.070) have significant relationship with patient safety culture. Conclusions Generally, the patient safety culture dimension in the teaching hospital was low. Training of healthcare workers on patient safety and a broad based research including all categories of healthcare staff is highly needed in other to fully understand and change the patient safety culture in Ghanaian Hospitals.

Is That Measure Really One-Dimensional?

Methodology ◽  
2018 ◽  
Vol 14 (4) ◽  
pp. 188-196 ◽  
Author(s):  
Esther T. Beierl ◽  
Markus Bühner ◽  
Moritz Heene
Keyword(s):  
Model Fit ◽  
Nuisance Parameters ◽  
Factorial Validity ◽  
Fit Indices ◽  
Analysis Model ◽  
Factor Analysis Model ◽  
One Dimensional ◽  
Confirmatory Factor Analysis Model ◽  
Cutoff Values ◽  
Confirmatory Factor

Abstract. Factorial validity is often assessed using confirmatory factor analysis. Model fit is commonly evaluated using the cutoff values for the fit indices proposed by Hu and Bentler (1999) . There is a body of research showing that those cutoff values cannot be generalized. Model fit does not only depend on the severity of misspecification, but also on nuisance parameters, which are independent of the misspecification. Using a simulation study, we demonstrate their influence on measures of model fit. We specified a severe misspecification, omitting a second factor, which signifies factorial invalidity. Measures of model fit showed only small misfit because nuisance parameters, magnitude of factor loadings and a balanced/imbalanced number of indicators per factor, also influenced the degree of misfit. Drawing from our results, we discuss challenges in the assessment of factorial validity.

The Colorado Cognitive Assessment (CoCA): Development of an Advanced Neuropsychological Screening Tool

2019 ◽  
Author(s):  
Ashita S. Gurnani ◽  
Shayne S.-H. Lin ◽  
Brandon E Gavett
Keyword(s):  
Construct Validity ◽  
Psychometric Properties ◽  
Cognitive Assessment ◽  
Screening Tool ◽  
Depression Scale ◽  
Internal Consistency Reliability ◽  
Screening Tests ◽  
Cognitive Screening ◽  
Analysis Model ◽  
Factor Analysis Model

Objective: The Colorado Cognitive Assessment (CoCA) was designed to improve upon existing screening tests in a number of ways, including enhanced psychometric properties and minimization of bias across diverse groups. This paper describes the initial validation study of the CoCA, which seeks to describe the test; demonstrate its construct validity; measurement invariance to age, education, sex, and mood symptoms; and compare it to the Montreal Cognitive Assessment (MoCA). Method: Participants included 151 older adults (MAge = 71.21, SD = 8.05) who were administered the CoCA, MoCA, Judgment test from the Neuropsychological Assessment Battery (NAB), 15-item version of the Geriatric Depression Scale (GDS-15), and 10-item version of the Geriatric Anxiety Scale (GAS-10). Results: A single factor confirmatory factor analysis model of the CoCA fit the data well, CFI = 0.955; RMSEA = 0.033. The CoCA’s internal consistency reliability was .84, compared to .74 for the MoCA. The CoCA had stronger disattenuated correlations with the MoCA (r = .79) and NAB Judgment (r = .47) and weaker correlations with the GDS-15 (r = -.36) and GAS-10 (r = -.15), supporting its construct validity. Finally, when analyzed using multiple indicators, multiple causes (MIMIC) modeling, the CoCA showed no evidence of measurement non-invariance, unlike the MoCA. Conclusions: These results provide initial evidence to suggest that the CoCA is a valid cognitive screening tool that offers numerous advantages over the MoCA, including superior psychometric properties and measurement non-invariance. Additional validation and normative studies are warranted.

GESTÃO HOSPITALAR E CULTURA DE SEGURANÇA DO PACIENTE NA PERCEPÇÃO DA EQUIPE DE ENFERMAGEM

2017 ◽  
Vol 40 ◽  
Author(s):  
Edenise Maria Santos da Silva-Batalha ◽  
Marta Maria Melleiro
Keyword(s):  
Patient Safety ◽  
Safety Culture ◽  
Patient Safety Culture ◽  
Healthcare Research

O objetivo deste estudo foi avaliar a percepção de trabalhadores de enfermagem de um hospital de ensino acerca da cultura de segurança do paciente frente à gestão hospitalar. Trata-se de uma pesquisa quantitativa desenvolvida em um hospital de 900 leitos. A amostra foi composta por 301 profissionais de enfermagem. O instrumento de coleta foi o questionário da Agency for Healthcare Research and Quality, intitulado Hospital Survey on Patient Safety Culture, traduzido para o Português e adaptado da versão original em inglês. A análise deu-se por meio de estatísticas descritivas e testes específicos. Os resultados referentes à dimensão “Apoio da gestão hospitalar para segurança do paciente” evidenciaram que 53,6% dos participantes discordavam que a administração propiciava um clima de trabalho favorável à segurança do paciente, 46% discordavam que a segurança do paciente fosse uma prioridade da administração e 58,3% concordavam que a administração apenas se interessava pela segurança após a ocorrência de eventos adversos. Tais resultados demonstram a necessidade de envolvimento maior da gestão hospitalar para com a segurança dos pacientes, favorecendo o amadurecimento da cultura de segurança. Ainda, a relação entre a enfermagem e a gestão hospitalar deve ser fortalecida, baseando-se em relações mais próximas e lineares. Conclui-se que não é apenas uma parte da organização que é responsável pela cultura de segurança, há, portanto, a necessidade de envolver a gestão e todos os trabalhadores na criação, implementação e fortalecimento dos sentimentos, valores, comportamentos, atitudes e ações que irão fomentar essa cultura. Palavras-chave: Administração hospitalar. Segurança do paciente. Enfermagem.

Noniterative Estimation for the Multiple Battery Factor Analysis Model

1997 ◽  
Vol 24 (1) ◽  
pp. 3-18 ◽  
Author(s):  
Michael W. Browne ◽  
Krishna Tateneni
Keyword(s):  
Factor Analysis ◽  
Analysis Model ◽  
Factor Analysis Model

Evaluation of patient safety culture in a private general hospital: a case study in Brazil

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
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 ◽  
Safety Culture ◽  
Patient Safety Culture ◽  
Administrative Staff ◽  
Management Support ◽  
Content Type ◽  
Administrative Services ◽  
Graduate Degrees ◽  
Brazilian Version

PurposeThe purpose is to assess the patient safety culture perceived by healthcare and administrative staff in a Brazilian hospital and examine whether education and experience are related to positive perceptions.Design/methodology/approachA descriptive–analytical case study was carried out at Ernesto Dornelles Hospital, a private Brazilian institution. The Brazilian version of the Hospital Survey on Patient Safety Culture was used to assess the perceptions of 618 participants, of whom 315 worked in healthcare assistance and 303 in administrative services. The main outcome was the percentage of positive responses, and the independent variables included the type of work, schooling and length of experience.FindingsNone of the twelve dimensions was strengthened. The percentage of positive responses was the highest for “Hospital management support for patient safety” (67.5%), and the lowest was for “Nonpunitive response to error” (29%). The healthcare staff had a slightly higher average than the administrative staff. The percentage of positive responses from professionals with undergraduate or graduate degrees was higher for the eight dimensions of safety culture. The length of hospital experience was not associated with any dimensions.Originality/valueThis study explored the influence of education and professional experience on the perception of patient safety in healthcare and administrative staff from a private institution. These approaches allow to know with greater depth and clarity factors that are related to the patient safety culture and, thus, have more consistent evidence to support interventions in specific needs.

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