scholarly journals Patient Safety Culture in European Hospitals: A Comparative Mixed Methods Study

Author(s):  
Nina Granel-Giménez ◽  
Patrick Albert Palmieri ◽  
Carolina E. Watson-Badia ◽  
Rebeca Gómez-Ibáñez ◽  
Juan Manuel Leyva-Moral ◽  
...  

Background: Poorly organized health systems with inadequate leadership limit the development of the robust safety cultures capable of preventing consequential adverse events. Although safety culture has been studied in hospitals worldwide, the relationship between clinician perceptions about patient safety and their actual clinical practices has received little attention. Despite the need for mixed methods studies to achieve a deeper understanding of safety culture, there are few studies providing comparisons of hospitals in different countries. Purpose: This study compared the safety culture of hospitals from the perspective of nurses in four European countries, including Croatia, Hungary, Spain, and Sweden. Design: A comparative mixed methods study with a convergent parallel design. Methods: Data collection included a survey, participant interviews, and workplace observations. The sample was nurses working in the internal medicine, surgical, and emergency departments of two public hospitals from each country. Survey data (n = 538) was collected with the Hospital Survey on Patient Safety Culture (HSOPSC) and qualitative date was collected through 24 in-depth interviews and 147 h of non-participant observation. Survey data was analyzed descriptively and inferentially, and content analysis was used to analyze the qualitative data. Results: The overall perception of safety culture for most dimensions was ‘adequate’ in Sweden and ‘adequate’ to ‘poor’ in the other countries with inconsistencies identified between survey and qualitative data. Although teamwork within units was the most positive dimension across countries, the qualitative data did not consistently demonstrate support, respect, and teamwork as normative attributes in Croatia and Hungary. Staffing and workload were identified as major areas for improvement across countries, although the nurse-to-patient ratios were the highest in Sweden, followed by Spain, Hungary, and Croatia. Conclusions: Despite all countries being part of the European Union, most safety culture dimensions require improvement, with few measured as good, and most deemed to be adequate to poor. Dimension level perceptions were at times incongruent across countries, as observed patient safety practices or interview perspectives were inconsistent with a positive safety culture. Differences between countries may be related to national culture or variability in health system structures permitted by the prevailing European Union health policy.

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Nina Granel ◽  
Josep Maria Manresa-Domínguez ◽  
Carolina Eva Watson ◽  
Rebeca Gómez-Ibáñez ◽  
Maria Dolors Bernabeu-Tamayo

Author(s):  
Mohammed Alsabri ◽  
Mervat Abdulaziz AlGhallabi ◽  
Farouk Abdulrahman Al-Qadasi ◽  
Asma Abdullah Yahya Zeeherah ◽  
Adekemi Ebo ◽  
...  

Introduction: Quality and safety is an important challenge in healthcare systems all over the world particularly in developing parts. Objective: This survey aimed to assess patient safety culture (PSC) in emergency departments (EDs) in Yemen and identify its associated factors. Methods: A questionnaire containing the Hospital Survey on Patient Safety Culture (HSOPSC) was distributed to ED physicians, nurses, and clinical, and non-clinical staff at three public teaching general hospitals. The percentages of positive responses on the 12 patient safety dimensions and the summation of PSC and two outcomes (overall patient safety grade and adverse events reported in the past year) were assessed. Factors associated with PSC aggregate score were analyzed. Results: finally, out of 400 questionnaires, 250 (64%) were analyzed. In total, 207 (82.3%) participants were nurses and physicians; 140 (56.0%) were male; 134 (53.6%) were less than 30 years old; and 134 (53.6%) had a university degree. Participants provided the highest ratings for the “teamwork within units” PSC composite (67%). The lowest rating was for “non-punitive response to error” (21.3%). A total of 120 (48.1%) participants did not report any events in the past year and 99 (39.7%) gave their hospital an “excellent/very good” overall patient safety grade. There were significant differences between the hospitals’ EDs in the rating of “handoffs and transitions” (p=0.016), “teamwork within units” (p=0.018), and “frequency of adverse events reported” (p=0.016). Staff working in intensive care units (8.4%, n=21) had lower patient safety aggregate scores. Conclusions: PSC ratings appear to be low in Yemen. This study emphasizes the need to create and maintain a PSC in EDs through the implementation of quality improvement strategies and environment of transparency, open communications, and continuous learning.


2021 ◽  
Vol 42 ◽  
Author(s):  
Cassiana Gil Prates ◽  
Rita Catalina Aquino Caregnato ◽  
Ana Maria Müller de Magalhães ◽  
Daiane Dal Pai ◽  
Janete de Souza Urbanetto ◽  
...  

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.


BMJ Open ◽  
2019 ◽  
Vol 9 (5) ◽  
pp. e028666
Author(s):  
Gheed Al Salem ◽  
Paul Bowie ◽  
Jill Morrison

ObjectiveAs healthcare organisations endeavour to improve the quality and safety of their services, there is increasing recognition of the importance of building a culture of safety to promote patient safety and improve the outcomes of patient care. Surveys of safety culture/climate have not knowingly been conducted in Kuwait public hospitals, nor are valid or reliable survey instruments available for this context. This study aims to investigate the psychometric properties of the HSOPSC (Hospital Survey on Patient Safety Culture) tool in Kuwaiti public hospitals in addition to constructing an optimal model to assess the level of safety climate in this setting.DesignCross-sectional study.SettingThree public hospitals in Kuwait.ParticipantsAbout 1317 healthcare professionals.Main outcome measureAn adapted and contextualised version of HSOPSC was used to conduct psychometric evaluation including exploratory factor analysis, confirmatory factor analysis reliability and correlation analysis.Results1317 questionnaires (87%) were returned. Psychometric evaluation, showed an optimal model of eight factors and 22 safety climate items. All items have strong factor loadings (0.42–0.86) and are theoretically related. Reliability analysis showed satisfactory results (α >0.60).ConclusionsThis is the first validation study of a standardised safety climate measure in a Kuwaiti healthcare setting. An optimal model for assessing patient safety climate was produced that mirrors other international studies and which can be used for measuring the prevailing safety climate. More importance should be attached to the psychometric fidelity of safety climate questionnaires before extending their use in other healthcare culture and contexts internationally.


2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
ŠD Draganović ◽  
G O Offermanns

Abstract Background Patient safety culture in hospitals (PSC), as well as its measurement and development, have received plenty of attention in Europe in recent years. Several instruments have been developed for its measurement in European countries. As Austria does not have empirically reviewed questionnaires to measure PSC jet, the research question of this study was: Is the globally admitted American questionnaire “Hospital Survey on Patient Safety Culture (HSOPSC)” (Sorra & Nieva, 2004) suitable for the healthcare system in Austria? Methods The HSOPSC contains 42 questions, which constituted twelve factors altogether. The pre-test was done with 101 health professionals. The online survey was conducted in ten public hospitals in 2017. Overall 1525 health professionals participated, which corresponded to a response rate of 23%. A new instrument, namely “Hospital Survey on Patient Safety Culture in Austria (HSPSC-AUT)”, was developed using the Exploratory Factor Analysis (EFA) and the Confirmatory Analysis (CFA). Results The factor structure of HSOPSC was not identical to the factor structure of HSPSC-AUT, developed in our study. The study showcased a new tool, HSPSC-AUT, with 30 items altogether, consisting of seven departmental factors, two hospital factors and one outcome factor. This new tool (HSPSC-AUT) showed pleasant results on the model, indicator, and construct level. The results of CFA for HSPSC-AUT (χ2 [360] = 1408.245, p = 0.0001) showed a better model compared to HSOPSC. The absolute and relative fit-indices showed excellent model adjustment (RMSEA = 0.049, SRMR = 0.041, GFI = 0.927, CFI = 0.941, TLI = 0.929). Conclusions The study presents a new instrument, HSPSC-AUT, for the measurement of PSC. According to the results, HSPSC-AUT (10-factor structure) has a better model fit than the original HSOPSC. This was confirmed by chi-square test, absolute and relative fit-indices, informational criteria, reliability, and construct validity. Key messages The development of an instrument for measuring safety culture is the first step leading to a better PSC. For this reason, HSPSC-AUT is recommended as an instrument to measure the PSC in Austria. Finally, it can be said that the development of a new questionnaire as well as the related measurements of validity and reliability have added value to science and practice.


PLoS ONE ◽  
2021 ◽  
Vol 16 (2) ◽  
pp. e0245966
Author(s):  
Fentaw Mohammed ◽  
Mekuanint Taddele ◽  
Tenaw Gualu

Introduction Patient safety culture is defined as the attitudes, perceptions, and values that staffs share within an organization related to patient safety. The safety of health care is now a major global concern. It is likely that millions of people suffer disabling injuries or death directly related to medical care. Particularly in developing and transitional countries, patient harm is a global public health problem. The objective of the study is to assess patient safety culture and associated factors among health care professionals working in public hospitals in Dessie town, North East Ethiopia, 2019. Methods Facility based quantitative study was employed from March 15 –April 30, 2019 in public hospitals in Dessie town. Four hundred and twenty two health care professionals were recruited to complete a structured pretested self-administered questionnaire. The data was cleaned, coded and entered in to Epi Info-7 and exported to SPSS version 20. Data was further analyzed using bivariate and multivariate logistic regression analyses. Variables with P value of less than 0.05 in multivariate analysis were declared as statistically significant at 95% CI. Results Of the 422 recruited a total of 411 participants completed the survey with a response rate of 97.4%. Close to half (184(44.8%)) of the participants indicated good patient safety culture. Good patient safety culture was positively associated with working in primary hospital (AOR = 2.56, 95% CI = 1.56, 4.21). On the other hand, good patient safety culture was negatively associated with health professional’s age between 25–34 year (AOR = 0.25, 95% CI = 0.08–0.74) and working in Pediatrics ward (AOR = 0.39, 95% CI = 0.17–0.9) and in emergency ward (AOR = O.25, 95%CI = 0.09–0.67). Conclusion The overall level of patient safety culture was under 50%. Good patient safety culture had positive association with working in primary hospital and negative association with professionals’ age between 25–29 year, 30–34 year and working in pediatrics and emergency ward. Implementing actions that support all dimensions of safety culture should be promoted at all levels of hospitals.


2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Ha Thi Nhi Tran ◽  
Thanh Quoc Pham ◽  
Huong Lien Tran ◽  
Hung Dinh Nguyen ◽  
Tu Minh Nguyen ◽  
...  

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