201
|
Rosen AK, Singer S, Shibei Zhao, Shokeen P, Meterko M, Gaba D. Hospital Safety Climate and Safety Outcomes: Is There a Relationship in the VA? Med Care Res Rev 2010; 67:590-608. [DOI: 10.1177/1077558709356703] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Strengthening safety climate is recognized as a necessary strategy for improving patient safety. Yet there is little empirical evidence linking hospitals’ safety climate with safety outcomes.The authors explored the potential relationship between safety climate and Veterans Health Administration hospital safety performance using the Patient Safety Indicator (PSI) rates. Safety climate survey data were merged with hospital discharge data to calculate PSIs. Linear regressions examined the relationship between hospitals’ safety climate and dimensions of safety climate with individual PSIs and a PSI composite measure, controlling for organizational-level variables. Safety climate overall was not related to the PSIs or to the PSI composite, although a few individual dimensions of safety climate were associated with specific PSIs. Perceptions of frontline staff were more closely aligned with PSIs than those of senior managers.
Collapse
Affiliation(s)
- Amy K. Rosen
- VA Boston Healthcare System, MA, Boston University School of Public Health, MA,
| | - Sara Singer
- Harvard School of Public Health, Boston, MA, Institute for Health Policy, Massachusetts General Hospital, Boston
| | | | | | - Mark Meterko
- Boston University School of Public Health, MA, Center for Organization, Leadership, and Management Research, a VA Center of Excellence, Boston, MA
| | - David Gaba
- Stanford University, Palo Alto, CA, VA Palo Alto Healthcare System, CA
| |
Collapse
|
202
|
Bodur S, Filiz E. Validity and reliability of Turkish version of "Hospital Survey on Patient Safety Culture" and perception of patient safety in public hospitals in Turkey. BMC Health Serv Res 2010; 10:28. [PMID: 20109186 PMCID: PMC2835702 DOI: 10.1186/1472-6963-10-28] [Citation(s) in RCA: 87] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2009] [Accepted: 01/28/2010] [Indexed: 12/05/2022] Open
Abstract
Background The Hospital Survey on Patient Safety Culture (HSOPS) is used to assess safety culture in many countries. Accordingly, the questionnaire has been translated into Turkish for the study of patient safety culture in Turkish hospitals. The aim of this study is threefold: to determine the validity and reliability of the translated form of HSOPS, to evaluate physicians' and nurses' perceptions of patient safety in Turkish public hospitals, and to compare finding with U.S. hospital settings. Methods Physicians and nurses working in all public hospitals in Konya, a large city in Turkey, were asked to complete a self-administrated patient safety culture survey (n = 309). Data collection was carried out using the Turkish version of HSOPS, developed by Agency for Healthcare Research and Quality (AHRQ). Data were summarized as percentages, means, and SD values. Factor analysis, correlation coefficient, Cronbach's alpha, ANOVA, and t tests were employed in statistical analyses. Items on patient safety were categorized into 10 factors. Factor loadings and internal consistencies of dimension items were high. Results Most of the scores related to dimensions, and the overall patient safety score (44%) were lower than the benchmark score. "Teamwork within hospital units" received the highest score (70%), and the lowest score belonged to the "frequency of events reported" (15%). The study revealed that more than three quarters of the physicians and nurses were not reporting errors. Conclusion The Turkish version of HSOPS was found to be valid and reliable in determining patient safety culture. This tool will be helpful in tracking improvements and in heightening awareness on patient safety culture in Turkey.
Collapse
Affiliation(s)
- Said Bodur
- Department of Public Health and Medical Statistics, Meram Faculty of Medicine, Selcuk University, Konya, Turkey.
| | | |
Collapse
|
203
|
Smith DR, Muto T, Sairenchi T, Ishikawa Y, Sayama S, Yoshida A, Townley-Jones M. Hospital safety climate, psychosocial risk factors and needlestick injuries in Japan. INDUSTRIAL HEALTH 2010; 48:85-95. [PMID: 20160412 DOI: 10.2486/indhealth.48.85] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
To investigate the interactions between safety climate, psychosocial issues and Needlestick and Sharps Injuries (NSI), a cross-sectional study was undertaken among nurses at a university teaching hospital in Japan (89% response rate). NSI were correlated with various aspects of hospital safety climate including supporting one another at work, the protection of staff against blood-borne diseases being a high management priority, managers doing their part to protect staff from blood-borne disease, having unsafe work practices corrected by supervisors, having the opportunity to use safety equipment to protect against blood-borne disease exposures, having an uncluttered work area, and having minimal conflict within their department. In conclusion, this study has demonstrated the importance of hospital safety climate in Japanese health care practice, particularly its relationship with NSI. Although the provision of safer devices remains critical in preventing injuries, ensuring a positive safety climate will also be essential in meeting these important challenges for nurses' occupational health.
Collapse
Affiliation(s)
- Derek R Smith
- WorkCover New South Wales Research Centre of Excellence, School of Health Sciences, Faculty of Health, University of Newcastle, Ourimbah 2258, Australia.
| | | | | | | | | | | | | |
Collapse
|
204
|
Stringer B, Haines AT, Goldsmith CH, Berguer R, Blythe J. Is use of the hands-free technique during surgery, a safe work practice, associated with safety climate? Am J Infect Control 2009; 37:766-72. [PMID: 19647344 DOI: 10.1016/j.ajic.2009.02.014] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2008] [Revised: 02/22/2009] [Accepted: 02/23/2009] [Indexed: 11/28/2022]
Abstract
BACKGROUND A better safety climate has been linked to better compliance with safety behaviors. This study assessed whether "management support," the most commonly measured safety climate dimension, was associated with greater use of the hands-free technique (HFT), a work practice recommended for use during surgery to prevent exposure to blood and body fluids. METHODS Questionnaires from operating room nurses participating in a test retest reliability study and in training sessions for an intervention study, from 9 hospitals in 3 Canadian provinces, were analyzed. RESULTS Response rates in the hospitals varied from 61% to 97%. Four hundred forty-two operating room nurses responded; 16% reported using the HFT approximately 75% or more of the time in surgery, and 39% had received HFT training. Management support and HFT training were each associated with increased HFT use: odds ratio (OR), 6.63; 95% confidence interval (CI): 1.89-23.30 and OR, 6.36; 95% CI: 1.97-20.51, respectively. When training occurred in a context of management support, HFT use was further increased: OR, 9.12; 95% CI: 2.71-30.72. CONCLUSION Consistent with previous research linking management support for health and safety to uptake of safety practices, management support and HFT training acted synergistically to increase HFT use most of the time in surgery.
Collapse
|
205
|
|
206
|
|
207
|
Carruthers S, Lawton R, Sandars J, Howe A, Perry M. Attitudes to patient safety amongst medical students and tutors: Developing a reliable and valid measure. MEDICAL TEACHER 2009; 31:e370-6. [PMID: 19811201 DOI: 10.1080/01421590802650142] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
BACKGROUND Patient safety education is an increasingly important component of the medical school curricula. AIMS This study reports on the development of a valid and reliable patient safety attitude measure targeted at medical students, which could be used to compare the effectiveness of different forms of patient safety education delivery. METHODS The Attitudes to Patient Safety Questionnaire (APSQ) was developed as a 45-item measure of attitudes towards five patient safety themes. In Study 1, factor analysis conducted on the responses of 420 medical students and tutors, revealed nine interpretable factors. The revised 37-item APSQ-II was then administered to 301 students and their tutors at two further medical schools. RESULTS Good stability of factor structure was revealed with reliability coefficients ranging from 0.64 to 0.82 for the nine factors. The questionnaire also demonstrated good criterion validity, being able to distinguish between tutors and students across a range of domains. CONCLUSIONS This article reports on the first attempt to develop a valid and reliable measure of patient safety attitudes which can distinguish responses between different groups. The predictive validity of the measure is yet to be assessed. The APSQ could be used to measure patient safety attitudes in other healthcare contexts in addition to evaluating changes in undergraduate curricula.
Collapse
|
208
|
Shaw KN, Ruddy RM, Olsen CS, Lillis KA, Mahajan PV, Dean JM, Chamberlain JM. Pediatric patient safety in emergency departments: unit characteristics and staff perceptions. Pediatrics 2009; 124:485-93. [PMID: 19651575 DOI: 10.1542/peds.2008-2858] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES The goals were (1) to describe emergency department (ED) characteristics thought to be related to patient safety within the Pediatric Emergency Care Applied Research Network, (2) to measure staff perceptions of the climate of safety in EDs, and (3) to measure associations between ED characteristics and a climate of safety. METHODS Twenty-one EDs were surveyed to assess physical structure, staffing patterns, overcrowding, medication administration, teamwork, and methods for promoting patient safety. A validated survey on the climate of safety was administered to all emergency department staff members. Safety climate scores were compared to evaluate associations with ED characteristics. RESULTS A total of 1747 staff members (49%) responded to the survey on the climate of safety. A minority of EDs had organized safety activities such as safety committees (48%) or walk-rounds (38%), used computerized physician order entry (38%), had ED pharmacists (19%), or had formal physician/registered nurse teams (38%). The majority (67%) treated patients in hallways. Most (67%) varied staffing on the basis of seasonal patient volume. Of the 1747 ED staff members (49%) responding to the survey, there was a wide range (28%-82%) in the proportion reporting a positive safety climate. Physicians' ratings of the climate of safety were higher than nurses' ratings, and perceptions varied according to work experience. Characteristics associated with an improved climate of safety were a lack of ED overcrowding, a sick call back-up plan for physicians, and the presence of an ED safety committee. CONCLUSIONS Large variability existed among EDs in structures and processes thought to be associated with patient safety and in staff perception of the safety climate. Several ED characteristics were associated with a positive climate of safety.
Collapse
Affiliation(s)
- Kathy N Shaw
- Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania 19104, USA.
| | | | | | | | | | | | | | | |
Collapse
|
209
|
Härenstam KP, Elg M, Svensson C, Brommels M, Ovretveit J. Patient safety as perceived by Swedish leaders. Int J Health Care Qual Assur 2009; 22:168-82. [PMID: 19536967 DOI: 10.1108/09526860910944656] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE The purpose of this paper is to survey Swedish healthcare leaders' patient safety awareness, the priority they give to safety issues and their views on suitable safety management strategies. DESIGN/METHODOLOGY/APPROACH A total 623 leaders of a sample of 1,129 responded to a mail questionnaire (55 percent response rate). Descriptive statistics of the responses are presented as frequency distributions across respondent subgroups. Means were tested for similarity by a repetitive one-way ANOVA procedure. Homogeneous response groups were sought by hierarchical cluster analysis. FINDINGS Swedish healthcare leaders show relatively high safety awareness and how their organizations prioritize safety management. There is a marked polarization between leaders; half feel that the system works reasonably well, and that adequate funds are available to improve or maintain services. The other half thinks the system needs major change and calls for additional funding. A majority sees system errors as the main cause for adverse events; a substantial minority find human errors to be more important. Two-thirds were willing to make safety performance information on organizations and specialties public, one third was restrictive. RESEARCH LIMITATIONS/IMPLICATIONS Survey instruments used to explore leaders' patient safety views have not yet been rigorously tested against psychometric criteria. One hospital type was slightly over-represented and three regions somewhat under-represented in the respondent groups. ORIGINALITY/VALUE This is the first systematic attempt to explore the views of Swedish healthcare leaders on patient safety. It provides input to a national strategy to improve patient safety.
Collapse
Affiliation(s)
- Karin Pukk Härenstam
- Medical Management Centre, Karolinska Institutet and Danderyds University Hospital, Stockholm, Sweden.
| | | | | | | | | |
Collapse
|
210
|
Singer SJ, Hartmann CW, Hanchate A, Zhao S, Meterko M, Shokeen P, Lin S, Gaba DM, Rosen AK. Comparing safety climate between two populations of hospitals in the United States. Health Serv Res 2009; 44:1563-83. [PMID: 19619250 DOI: 10.1111/j.1475-6773.2009.00994.x] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVE To compare safety climate between diverse U.S. hospitals and Veterans Health Administration (VA) hospitals, and to explore the factors influencing climate in each setting. DATA SOURCES Primary data from surveys of hospital personnel; secondary data from the American Hospital Association's 2004 Annual Survey of Hospitals. STUDY DESIGN Cross-sectional study of 69 U.S. and 30 VA hospitals. DATA COLLECTION For each sample, hierarchical linear models used safety-climate scores as the dependent variable and respondent and facility characteristics as independent variables. Regression-based Oaxaca-Blinder decomposition examined differences in effects of model characteristics on safety climate between the U.S. and VA samples. PRINCIPAL FINDINGS The range in safety climate among U.S. and VA hospitals overlapped substantially. Characteristics of individuals influenced safety climate consistently across settings. Working in southern and urban facilities corresponded with worse safety climate among VA employees and better safety climate in the U.S. sample. Decomposition results predicted 1.4 percentage points better safety climate in U.S. than in VA hospitals: -0.77 attributable to sample-characteristic differences and 2.2 due to differential effects of sample characteristics. CONCLUSIONS Results suggest that safety climate is linked more to efforts of individual hospitals than to participation in a nationally integrated system or measured characteristics of workers and facilities.
Collapse
Affiliation(s)
- Sara J Singer
- Department of Health Policy and Management, Harvard School of Public Health, Boston, MA 02115, USA.
| | | | | | | | | | | | | | | | | |
Collapse
|
211
|
Aase K, Høyland S, Olsen E, Wiig S, Nilsen ST. Patient safety challenges in a case study hospital--of relevance for transfusion processes? Transfus Apher Sci 2009; 39:167-72. [PMID: 18762458 DOI: 10.1016/j.transci.2008.06.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
The paper reports results from a research project with the objective of studying patient safety, and relates the finding to safety issues within transfusion medicine. The background is an increased focus on undesired events related to diagnosis, medication, and patient treatment in general in the healthcare sector. The study is designed as a case study within a regional Norwegian hospital conducting specialised health care services. The study includes multiple methods such as interviews, document analysis, analysis of error reports, and a questionnaire survey. Results show that the challenges for improved patient safety, based on employees' perceptions, are hospital management support, reporting of accidents/incidents, and collaboration across hospital units. Several of these generic safety challenges are also found to be of relevance for a hospital's transfusion service. Positive patient safety factors are identified as teamwork within hospital units, a non-punitive response to errors, and unit manager's actions promoting safety.
Collapse
Affiliation(s)
- Karina Aase
- University of Stavanger, Faculty of Social Sciences, N-4036 Stavanger, Norway.
| | | | | | | | | |
Collapse
|
212
|
Kaafarani HMA, Itani KMF, Rosen AK, Zhao S, Hartmann CW, Gaba DM. How does patient safety culture in the operating room and post-anesthesia care unit compare to the rest of the hospital? Am J Surg 2009; 198:70-5. [PMID: 19268901 DOI: 10.1016/j.amjsurg.2008.09.017] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2008] [Revised: 08/09/2008] [Accepted: 09/03/2008] [Indexed: 10/21/2022]
Abstract
BACKGROUND A strong patient safety culture in the operating room (OR) and post-anesthesia care unit (PACU) is essential to promote safe care. METHODS The Patient Safety Climate in Healthcare Organizations (PSCHO) survey was administered to employees at 30 Veterans Affairs (VA) hospitals. The survey consisted of 42 close-ended items representing 12 different dimensions of safety. We measured percent problematic response (PPR); higher PPR values reflect weaker safety culture. The "OR/PACU" and the "Other Work Areas" groups' item-specific, dimension-specific, and overall problematic responses were compared. RESULTS The overall and dimension-specific PPRs were similar between the OR/PACU and the Other Work Areas group (overall: 20.2% and 18.1%, respectively; P = .41). When the 2 groups were compared on an item-by-item level, the OR/PACU staff reported more frequent witnessing of unsafe patient care (PPR 55.1% vs 43.2%; P = .01), and perceived less understanding by senior leadership of clinical care (PPR 28.3% vs 17.1%; P = .01) and less hospital interest in quality of care (PPR 20.4% vs 12.5%; P = .03). CONCLUSIONS Specific areas of safety culture in the OR/PACU were found that should be targeted for improvement.
Collapse
|
213
|
Hartmann CW, Meterko M, Rosen AK, Shibei Zhao, Shokeen P, Singer S, Gaba DM. Relationship of Hospital Organizational Culture to Patient Safety Climate in the Veterans Health Administration. Med Care Res Rev 2009; 66:320-38. [DOI: 10.1177/1077558709331812] [Citation(s) in RCA: 72] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Improving safety climate could enhance patient safety, yet little evidence exists regarding the relationship between hospital characteristics and safety climate. This study assessed the relationship between hospitals' organizational culture and safety climate in Veterans Health Administration (VA) hospitals nationally. Data were collected from a sample of employees in a stratified random sample of 30 VA hospitals over a 6-month period (response rate = 50%; n = 4,625). The Patient Safety Climate in Healthcare Organizations (PSCHO) and the Zammuto and Krakower surveys were used to measure safety climate and organizational culture, respectively. Higher levels of safety climate were significantly associated with higher levels of group and entrepreneurial cultures, while lower levels of safety climate were associated with higher levels of hierarchical culture. Hospitals could use these results to design specific interventions aimed at improving safety climate.
Collapse
Affiliation(s)
- Christine W. Hartmann
- Center for Health Quality, Outcomes, and Economic Research, Bedford, MA and Boston University,
| | - Mark Meterko
- Boston University and Center for Organization, Leadership, and Management Research, Boston, MA
| | - Amy K. Rosen
- Center for Health Quality, Outcomes, and Economic Research, Bedford, MA and Boston University
| | - Shibei Zhao
- Center for Health Quality, Outcomes, and Economic Research, Bedford, MA
| | - Priti Shokeen
- Center for Health Quality, Outcomes, and Economic Research, Bedford, MA
| | | | - David M. Gaba
- Stanford University and VA Palo Alto Healthcare System, Palo Alto, CA
| |
Collapse
|
214
|
Which aspects of safety culture predict incident reporting behavior in neonatal intensive care units? A multilevel analysis. Crit Care Med 2009; 37:61-7. [PMID: 19050606 DOI: 10.1097/ccm.0b013e31819300e4] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES Safety culture assessments are increasingly used to evaluate patient-safety programs. However, it is not clear which aspects of safety culture are most relevant in understanding incident reporting behavior, and ultimately improving patient safety. The objective of this study was to examine which aspects of safety culture predict incident reporting behavior in the neonatal intensive care unit (NICU), before and after implementation of a voluntary, nonpunitive incident reporting system. DESIGN Survey study based on a translated, validated version of the Agency for Healthcare Research and Quality Hospital Survey on Patient Safety Culture. This survey incorporates two outcome measures, 11 dimensions of patient-safety culture as well as demographic data. SETTING Eight tertiary care NICUs and one surgical pediatric ICU. SUBJECTS All unit personnel. INTERVENTION Implementation of a specialty-based, voluntary, nonpunitive incident reporting system. MEASUREMENTS AND MAIN RESULTS The survey was conducted before (t = 0) and after (t = 1 yr) the intervention. PRIMARY OUTCOME number of self-reported incidents in the past 12 months. Overall response rate was 80% (n = 700) at t = 0 and 76% (n = 670) at t = 1 yr. Based on a multivariate multilevel regression prediction model, the number of self-reported incidents increased after the intervention and was positively associated with a nonpunitive response to error and negatively associated with overall perceptions of safety and hospital management support for patient safety. CONCLUSIONS A nonpunitive approach to error, hospital management support for patient safety, and overall perceptions of safety predict incident reporting behavior in the NICU. The relation between these aspects of safety culture and patient outcome requires further scrutiny and therefore remains an important issue to address in future research.
Collapse
|
215
|
Leiss JK, Lyden JT, Mathews R, Sitzman KL, Vanderpuije A, Mav D, Kendra MA, Klein C, Humphrey CJ. Blood exposure incidence rates from the North Carolina study of home care and hospice nurses. Am J Ind Med 2009; 52:99-104. [PMID: 19016305 DOI: 10.1002/ajim.20646] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Home care/hospice nurses may be at elevated risk of blood exposure because of the nature of their work and work environment. However, little is known about the incidence of blood exposure in this population. METHODS A mail survey (n = 1,473) was conducted among home care/hospice nurses in North Carolina in 2006. RESULTS The adjusted response rate was 69%. Nine percent of nurses had at least one exposure/year. Overall incidence was 27.4 (95% confidence interval: 20.2, 34.6)/100,000 visits. Nurses who had worked in home care < or =5 years had higher exposure rates than other nurses-seven times higher for needlesticks and 3.5 times higher for non-intact skin exposures. Nurses who worked part time/contract had higher exposure rates than nurses who worked full time-seven times higher for needlesticks and 1.5 times higher for non-intact skin exposures. The rates for part-time/contract nurses with < or =5 years experience were extremely high. Sensitivity analysis showed that it is unlikely that response bias had an important impact on these results. CONCLUSIONS Approximately 150 North Carolina home care/hospice nurses are exposed to blood annually. If these results are representative of other states, then approximately 12,000 home care/hospice nurses are exposed each year nationwide. Improved prevention efforts are needed to reduce blood exposure in home care/hospice nurses. Am. J. Ind. Med. 52:99-104, 2009. (c) 2008 Wiley-Liss, Inc.
Collapse
Affiliation(s)
- Jack K Leiss
- Center for Health Research, Constella Group, LLC, Durham, North Carolina.
| | | | | | | | | | | | | | | | | |
Collapse
|
216
|
Manser T. Teamwork and patient safety in dynamic domains of healthcare: a review of the literature. Acta Anaesthesiol Scand 2009; 53:143-51. [PMID: 19032571 DOI: 10.1111/j.1399-6576.2008.01717.x] [Citation(s) in RCA: 669] [Impact Index Per Article: 44.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
AIMS/BACKGROUND This review examines current research on teamwork in highly dynamic domains of healthcare such as operating rooms, intensive care, emergency medicine, or trauma and resuscitation teams with a focus on aspects relevant to the quality and safety of patient care. RESULTS Evidence from three main areas of research supports the relationship between teamwork and patient safety: (1) Studies investigating the factors contributing to critical incidents and adverse events have shown that teamwork plays an important role in the causation and prevention of adverse events. (2) Research focusing on healthcare providers' perceptions of teamwork demonstrated that (a) staff's perceptions of teamwork and attitudes toward safety-relevant team behavior were related to the quality and safety of patient care and (b) perceptions of teamwork and leadership style are associated with staff well-being, which may impact clinician' ability to provide safe patient care. (3) Observational studies on teamwork behaviors related to high clinical performance have identified patterns of communication, coordination, and leadership that support effective teamwork. CONCLUSION In recent years, research using diverse methodological approaches has led to significant progress in team research in healthcare. The challenge for future research is to further develop and validate instruments for team performance assessment and to develop sound theoretical models of team performance in dynamic medical domains integrating evidence from all three areas of team research identified in this review. This will help to improve team training efforts and aid the design of clinical work systems supporting effective teamwork and safe patient care.
Collapse
Affiliation(s)
- T Manser
- ETH Zurich, Center for Organizational and Occupational Sciences, Zurich, Switzerland.
| |
Collapse
|
217
|
Hofoss D, Deilkås E. Roadmap for patient safety research: approaches and roadforks. Scand J Public Health 2009; 36:812-7. [PMID: 19004899 DOI: 10.1177/1403494808096168] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
UNLABELLED Patient safety improvement is a healthcare priority worldwide. Pioneer research reports include the 1984 Harvard Medical Practice Study, and the 1999 report "To err is human''. Patient safety research is expanding rapidly. Among the Scandinavian countries, Denmark is the patient safety improvement leader, and Norway is the laggard, having only recently institutionalized safety research and then having started with industrial safety research, and only recently having expanded into patient safety research. AIMS To produce a roadmap for patient safety research, indicating three main roadforks. Patient safety research can be conducted along a number of lines. To identify patient safety problems and come up with ideas for patient safety improvement one can investigate 1) particular cases of adverse events, 2) the design of healthcare delivery systems, or 3) the culture of the care-giving institutions. The study of safety culture can be subdivided into the study of organization culture in general (and in particular of leadership culture) and the study of patient safety culture. The article provides a number of references to existing instruments of patient safety research. METHODS Qualitative interpretation of the referenced literature. RESULTS Scrutinizing adverse events for errors is health care's traditional way of improving patient safety. The idea of rethinking the design of care delivery systems has been accompanied by claims of modernity. The study of patient safety culture is the most recent approach. The three approaches are discussed in separate sub-chapters. CONCLUSIONS Although chronology suggests a developmental trend, the three approaches should not necessarily be seen as steps up the ladder of evolution. Each approach does have its merits.
Collapse
Affiliation(s)
- Dag Hofoss
- Health Services Research Unit, Akershus University Hospital, Lørenskog, Norway.
| | | |
Collapse
|
218
|
|
219
|
Smits M, Christiaans-Dingelhoff I, Wagner C, Wal GVD, Groenewegen PP. The psychometric properties of the 'Hospital Survey on Patient Safety Culture' in Dutch hospitals. BMC Health Serv Res 2008; 8:230. [PMID: 18990256 PMCID: PMC2588576 DOI: 10.1186/1472-6963-8-230] [Citation(s) in RCA: 144] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2008] [Accepted: 11/07/2008] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND In many different countries the Hospital Survey on Patient Safety Culture (HSOPS) is used to assess the safety culture in hospitals. Accordingly, the questionnaire has been translated into Dutch for application in the Netherlands. The aim of this study was to examine the underlying dimensions and psychometric properties of the questionnaire in Dutch hospital settings, and to compare these results with the original questionnaire used in USA hospital settings. METHODS The HSOPS was completed by 583 staff members of four general hospitals, three teaching hospitals, and one university hospital in the Netherlands. Confirmatory factor analyses were performed to examine the applicability of the factor structure of the American questionnaire to the Dutch data. Explorative factor analyses were performed to examine whether another composition of items and factors would fit the data better. Supplementary psychometric analyses were performed, including internal consistency and construct validity. RESULTS The confirmatory factor analyses were based on the 12-factor model of the original questionnaire and resulted in a few low reliability scores. 11 Factors were drawn with explorative factor analyses, with acceptable reliability scores and a good construct validity. Two items were removed from the questionnaire. The composition of the factors was very similar to that of the original questionnaire. A few items moved to another factor and two factors turned out to combine into a six-item dimension. All other dimensions consisted of two to five items. CONCLUSION The Dutch translation of the HSOPS consists of 11 factors with acceptable reliability and good construct validity. and is similar to the original HSOPS factor structure.
Collapse
MESH Headings
- Attitude of Health Personnel
- Communication
- Factor Analysis, Statistical
- Health Care Surveys/instrumentation
- Hospital Bed Capacity, 500 and over
- Hospitals, General/organization & administration
- Hospitals, General/standards
- Hospitals, Teaching/organization & administration
- Hospitals, Teaching/standards
- Hospitals, University/organization & administration
- Hospitals, University/standards
- Humans
- Medical Errors/prevention & control
- Netherlands
- Organizational Culture
- Patient Care Team/standards
- Personnel, Hospital/classification
- Personnel, Hospital/psychology
- Psychometrics/instrumentation
- Safety Management/methods
- Safety Management/standards
- Surveys and Questionnaires/standards
- Total Quality Management
- Translations
- United States
Collapse
Affiliation(s)
- Marleen Smits
- NIVEL, Netherlands Institute for Health Services Research, P.O. Box 1568, 3500 BN Utrecht, The Netherlands
| | - Ingrid Christiaans-Dingelhoff
- EMGO Institute, Department of Public and Occupational Health, VU University Medical Center, Amsterdam, The Netherlands
| | - Cordula Wagner
- NIVEL, Netherlands Institute for Health Services Research, P.O. Box 1568, 3500 BN Utrecht, The Netherlands
- EMGO Institute, Department of Public and Occupational Health, VU University Medical Center, Amsterdam, The Netherlands
| | - Gerrit van der Wal
- EMGO Institute, Department of Public and Occupational Health, VU University Medical Center, Amsterdam, The Netherlands
| | - Peter P Groenewegen
- NIVEL, Netherlands Institute for Health Services Research, P.O. Box 1568, 3500 BN Utrecht, The Netherlands
- Utrecht University, Department of Sociology and Department of Human Geography, Utrecht, The Netherlands
| |
Collapse
|
220
|
Turnberg W, Daniell W. Evaluation of a healthcare safety climate measurement tool. JOURNAL OF SAFETY RESEARCH 2008; 39:563-568. [PMID: 19064040 DOI: 10.1016/j.jsr.2008.09.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/09/2008] [Revised: 07/19/2008] [Accepted: 09/17/2008] [Indexed: 05/27/2023]
Abstract
PROBLEM Psychometrically validated measurement tools are needed to evaluate an organization's safety climate. In 2000, Gershon and colleagues published a new healthcare safety climate measurement tool to determine its relationship to safe work behavior (Gershon, R., Karkashian, C., Grosch, J., Murphy, L., Escamilla-Cejudo, A., Flanagan, P., et al. (2000). Hospital safety climate and its relationship with safe work practices and workplace exposure incidents. American Journal of Infection Control, 28, 211-21). The present study evaluated the psychometric properties of the Gershon tool when modified to address respiratory rather than bloodborne pathogen exposures. METHOD Medical practitioners, nurses, and nurse aides (n=460) were surveyed using the modified Gershon tool. Data were analyzed by factor analysis and psychometric properties of the tool evaluated. RESULTS Eight safety climate dimensions were extracted from 25 items (Cronbach's alpha range: 0.62 - 0.88). Factor extractions and psychometric properties were reasonably consistent with those of the Gershon tool. IMPACT ON INDUSTRY The Gershon safety climate tool appears to have sufficient reliability and validity for use by healthcare decision makers as an indicator of employee perceptions of safety in their institution.
Collapse
|
221
|
Deilkås ET, Hofoss D. Psychometric properties of the Norwegian version of the Safety Attitudes Questionnaire (SAQ), Generic version (Short Form 2006). BMC Health Serv Res 2008; 8:191. [PMID: 18808693 PMCID: PMC2572612 DOI: 10.1186/1472-6963-8-191] [Citation(s) in RCA: 101] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2008] [Accepted: 09/22/2008] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND How to protect patients from harm is a question of universal interest. Measuring and improving safety culture in care giving units is an important strategy for promoting a safe environment for patients. The Safety Attitudes Questionnaire (SAQ) is the only instrument that measures safety culture in a way which correlates with patient outcome. We have translated the SAQ to Norwegian and validated the translated version. The psychometric properties of the translated questionnaire are presented in this article. METHODS The questionnaire was translated with the back translation technique and tested in 47 clinical units in a Norwegian university hospital. SAQ's (the Generic version (Short Form 2006) the version with the two sets of questions on perceptions of management: on unit management and on hospital management) were distributed to 1911 frontline staff. 762 were distributed during unit meetings and 1149 through the postal system. Cronbach alphas, item-to-own correlations, and test-retest correlations were calculated, and response distribution analysis and confirmatory factor analysis were performed, as well as early validity tests. RESULTS 1306 staff members completed and returned the questionnaire: a response rate of 68%. Questionnaire acceptability was good. The reliability measures were acceptable. The factor structure of the responses was tested by confirmatory factor analysis. 36 items were ascribed to seven underlying factors: Teamwork Climate, Safety Climate, Stress Recognition, Perceptions of Hospital Management, Perceptions of Unit Management, Working conditions, and Job satisfaction. Goodness-of-Fit Indices showed reasonable, but not indisputable, model fit. External validity indicators - recognizability of results, correlations with "trigger tool"-identified adverse events, with patient satisfaction with hospitalization, patient reports of possible maltreatment, and patient evaluation of organization of hospital work - provided preliminary validation. CONCLUSION Based on the data from Akershus University Hospital, we conclude that the Norwegian translation of the SAQ showed satisfactory internal psychometric properties. With data from one hospital only, we cannot draw strong conclusions on its external validity. Further validation studies linking the SAQ-scores to patient outcome data should be performed.
Collapse
Affiliation(s)
- Ellen T Deilkås
- Health Services Research Unit, Akershus University Hospital, Lorenskog, Norway.
| | | |
Collapse
|
222
|
Ginsburg L, Gilin D, Tregunno D, Norton PG, Flemons W, Fleming M. Advancing measurement of patient safety culture. Health Serv Res 2008; 44:205-24. [PMID: 18823446 DOI: 10.1111/j.1475-6773.2008.00908.x] [Citation(s) in RCA: 53] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVE To examine the psychometric and unit of analysis/strength of culture issues in patient safety culture (PSC) measurement. DATA SOURCE Two cross-sectional surveys of health care staff in 10 Canadian health care organizations totaling 11,586 respondents. STUDY DESIGN A cross-validation study of a measure of PSC using survey data gathered using the Modified Stanford PSC survey (MSI-2005 and MSI-2006); a within-group agreement analysis of MSI-2006 data. Extraction Methods. Exploratory factor analyses (EFA) of the MSI-05 survey data and confirmatory factor analysis (CFA) of the MSI-06 survey data; Rwg coefficients of homogeneity were calculated for 37 units and six organizations in the MSI-06 data set to examine within-group agreement. PRINCIPAL FINDINGS The CFA did not yield acceptable levels of fit. EFA and reliability analysis of MSI-06 data suggest two reliable dimensions of PSC: Organization leadership for safety (alpha=0.88) and Unit leadership for safety (alpha=0.81). Within-group agreement analysis shows stronger within-unit agreement than within-organization agreement on assessed PSC dimensions. CONCLUSIONS The field of PSC measurement has not been able to meet strict requirements for sound measurement using conventional approaches of CFA. Additional work is needed to identify and soundly measure key dimensions of PSC. The field would also benefit from further attention to strength of culture/unit of analysis issues.
Collapse
Affiliation(s)
- Liane Ginsburg
- School of Health Policy and Management, Faculty of Health, York University, HNES Building 413, 4700 Keele Street, Toronto, ON, Canada M3J 1P3.
| | | | | | | | | | | |
Collapse
|
223
|
|
224
|
Kho ME, Perri D, McDonald E, Waugh L, Orlicki C, Monaghan E, Cook DJ. The climate of patient safety in a Canadian intensive care unit. J Crit Care 2008; 24:469.e7-13. [PMID: 19327293 DOI: 10.1016/j.jcrc.2008.05.002] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2008] [Revised: 04/24/2008] [Accepted: 05/08/2008] [Indexed: 11/17/2022]
Abstract
BACKGROUND We assessed multidisciplinary team members' perspectives of patient safety climate in a 15-bed, closed medical-surgical intensive care unit through a self-administered questionnaire. METHODS We invited all clinicians and nonclinicians to complete a short demographic section and a modified Safety Climate Survey (SCS) in which higher scores represent a better safety climate. We used multivariable regression to examine factors associated with higher safety climate scores. In an open-ended question, we asked all respondents for suggestions to improve patient safety, analyzing text in triplicate, independently. RESULTS Our response rate was 93.2% (136/146). Respondents were nurses (49.4%), physicians (16.1%), other clinicians (30.3%), and nonclinical staff (11.8%). The mean (SD) SCS score was 4.0 (0.6) of a maximum of 5. We found no independent predictors of safety climate scores. Qualitative data revealed 3 major safety themes needing solutions: appropriate staffing, medication safety, and improving the bedside care of obese patients. CONCLUSIONS Although our baseline safety climate score was encouraging, room for improvement exists. Future research will analyze the responsiveness of the SCS scale to change, following our recently instituted initiatives such as a new graduate integration program, an improved medication dispensing system, newly installed lifting devices, and the critical care response team.
Collapse
Affiliation(s)
- Michelle E Kho
- Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, Canada.
| | | | | | | | | | | | | |
Collapse
|
225
|
Rosen AK, Gaba DM, Meterko M, Shokeen P, Singer S, Zhao S, Labonte A, Falwell A. Recruitment of Hospitals for a Safety Climate Study: Facilitators and Barriers. Jt Comm J Qual Patient Saf 2008; 34:275-84. [DOI: 10.1016/s1553-7250(08)34034-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
226
|
Kao LS, Thomas EJ. Navigating Towards Improved Surgical Safety Using Aviation-Based Strategies. J Surg Res 2008; 145:327-35. [PMID: 17477934 DOI: 10.1016/j.jss.2007.02.020] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2006] [Revised: 02/08/2007] [Accepted: 02/11/2007] [Indexed: 01/22/2023]
Abstract
Safety practices in the aviation industry are being increasingly adapted to healthcare in an effort to reduce medical errors and patient harm. However, caution should be applied in embracing these practices because of limited experience in surgical disciplines, lack of rigorous research linking these practices to outcome, and fundamental differences between the two industries. Surgeons should have an in-depth understanding of the principles and data supporting aviation-based safety strategies before routinely adopting them. This paper serves as a review of strategies adapted to improve surgical safety, including the following: implementation of crew resource management in training operative teams; incorporation of simulation in training of technical and nontechnical skills; and analysis of contributory factors to errors using surveys, behavioral marker systems, human factors analysis, and incident reporting. Avenues and challenges for future research are also discussed.
Collapse
Affiliation(s)
- Lillian S Kao
- Department of Surgery, University of Texas Health Science Center at Houston, Houston, Texas 62008, USA.
| | | |
Collapse
|
227
|
Bonner AF, Castle NG, Perera S, Handler SM. Patient Safety Culture: A Review of the Nursing Home Literature and Recommendations for Practice. THE ANNALS OF LONG-TERM CARE : THE OFFICIAL JOURNAL OF THE AMERICAN MEDICAL DIRECTORS ASSOCIATION 2008; 16:18-22. [PMID: 21701601 PMCID: PMC3119574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Patient safety culture (PSC) is a critical factor in creating high-reliability health-care organizations. Most PSC research studies to date have been conducted in acute care settings; however, nursing home studies have recently begun to appear in the literature. Nursing homes differ from hospitals in a number of ways, including the population they serve, the medical model of care, and having the vast majority of direct care provided by non-licensed certified nursing assistants. Research has shown that nursing home PSC differs in important ways from PSC in acute care institutions. Recent PSC studies conducted in nursing homes and related quality and safety research can guide recommendations for nursing homes wishing to evaluate their own PSC. Relationships between PSC measurement, quality improvement, and workforce issues are potentially important and may influence clinical outcomes.
Collapse
Affiliation(s)
- Alice F Bonner
- Dr. Bonner is at the University of Massachusetts Graduate School of Nursing, Worcester; Dr. Castle is at the Department of Health Policy and Management, Graduate School of Public Health, University of Pittsburgh; Dr. Perera is in the Division of Geriatric Medicine, Department of Medicine, and at the Department of Biostatistics, School of Medicine, University of Pittsburgh; and Dr. Handler is in the Division of Geriatric Medicine, Department of Medicine, and at the Department of Biomedical Informatics, School of Medicine, University of Pittsburgh
| | | | | | | |
Collapse
|
228
|
Hellings J, Schrooten W, Klazinga N, Vleugels A. Challenging patient safety culture: survey results. Int J Health Care Qual Assur 2008; 20:620-32. [PMID: 18030963 DOI: 10.1108/09526860710822752] [Citation(s) in RCA: 136] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
PURPOSE The purpose of this paper is to measure patient safety culture in five Belgian general hospitals. Safety culture plays an important role in the approach towards greater patient safety in hospitals. DESIGN/METHODOLOGY/APPROACH The Patient Safety Culture Hospital questionnaire was distributed hospital-wide in five general hospitals. It evaluates ten patient safety culture dimensions and two outcomes. The scores were expressed as the percentage of positive answers towards patient safety for each dimension. The survey was conducted from March through November 2005. In total, 3,940 individuals responded (overall response rate = 77 per cent), including 2,813 nurses and assistants, 462 physicians, 397 physiotherapists, laboratory and radiology assistants, social workers and 64 pharmacists and pharmacy assistants. FINDINGS The dimensional positive scores were found to be low to average in all the hospitals. The lowest scores were "hospital management support for patient safety" (35 per cent), "non-punitive response to error" (36 per cent), "hospital transfers and transitions" (36 per cent), "staffing" (38 per cent), and "teamwork across hospital units" (40 per cent). The dimension "teamwork within hospital units" generated the highest score (70 per cent). Although the same dimensions were considered problematic in the different hospitals, important variations between the five hospitals were observed. PRACTICAL IMPLICATIONS A comprehensive and tailor-made plan to improve patient safety culture in these hospitals can now be developed. ORIGINALITY/VALUE Results indicate that important aspects of the patient safety culture in these hospitals need improvement. This is an important challenge to all stakeholders wishing to improve patient safety.
Collapse
|
229
|
Windle PE, Krenzischek DA, Mamaril M. Development and Initial Testing of the Perianesthesia Safe Practices Instrument: An ASPAN Pilot Study. J Perianesth Nurs 2007; 22:370-84. [DOI: 10.1016/j.jopan.2007.09.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2006] [Revised: 09/01/2007] [Accepted: 09/11/2007] [Indexed: 11/29/2022]
|
230
|
Singer S, Meterko M, Baker L, Gaba D, Falwell A, Rosen A. Workforce perceptions of hospital safety culture: development and validation of the patient safety climate in healthcare organizations survey. Health Serv Res 2007; 42:1999-2021. [PMID: 17850530 PMCID: PMC2254575 DOI: 10.1111/j.1475-6773.2007.00706.x] [Citation(s) in RCA: 143] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
OBJECTIVE To describe the development of an instrument for assessing workforce perceptions of hospital safety culture and to assess its reliability and validity. DATA SOURCES/STUDY SETTING Primary data collected between March 2004 and May 2005. Personnel from 105 U.S. hospitals completed a 38-item paper and pencil survey. We received 21,496 completed questionnaires, representing a 51 percent response rate. STUDY DESIGN Based on review of existing safety climate surveys, we developed a list of key topics pertinent to maintaining a culture of safety in high-reliability organizations. We developed a draft questionnaire to address these topics and pilot tested it in four preliminary studies of hospital personnel. We modified the questionnaire based on experience and respondent feedback, and distributed the revised version to 42,249 hospital workers. DATA COLLECTION We randomly divided respondents into derivation and validation samples. We applied exploratory factor analysis to responses in the derivation sample. We used those results to create scales in the validation sample, which we subjected to multitrait analysis (MTA). PRINCIPAL FINDINGS We identified nine constructs, three organizational factors, two unit factors, three individual factors, and one additional factor. Constructs demonstrated substantial convergent and discriminant validity in the MTA. Cronbach's alpha coefficients ranged from 0.50 to 0.89. CONCLUSIONS It is possible to measure key salient features of hospital safety climate using a valid and reliable 38-item survey and appropriate hospital sample sizes. This instrument may be used in further studies to better understand the impact of safety climate on patient safety outcomes.
Collapse
Affiliation(s)
- Sara Singer
- Center for Health Policy, Stanford University, 117 Encina Commons, Stanford, CA 94305-6019, USA
| | | | | | | | | | | |
Collapse
|
231
|
Schutz AL, Counte MA, Meurer S. Development of a patient safety culture measurement tool for ambulatory health care settings: analysis of content validity. Health Care Manag Sci 2007; 10:139-49. [PMID: 17608055 DOI: 10.1007/s10729-007-9014-y] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
The development of patient safety culture in health care organizations is a necessary precursor to patient safety improvement. However, existing tools to measure patient safety culture are intended for implementation in hospitals. A new, abbreviated patient safety culture survey was developed for use in ambulatory health care settings. This survey was tested for content validity utilizing a panel of six experts. It had a clarity interrater agreement (IR) of 0.75, a clarity content validity index (CVI) of 0.95, a representativeness IR of 0.75 and a representativeness CVI of 0.95. The content validity analysis served as a useful tool for assessing the relevance and comprehensiveness of this survey of patient safety culture in ambulatory care organizations.
Collapse
Affiliation(s)
- Amanda L Schutz
- School of Public Health, Saint Louis University, 4304 A Maryland Avenue, St. Louis, MO 63108, USA.
| | | | | |
Collapse
|
232
|
Stone PW, Du Y, Gershon RRM. Organizational Climate and Occupational Health Outcomes in Hospital Nurses. J Occup Environ Med 2007; 49:50-8. [PMID: 17215713 DOI: 10.1097/01.jom.0000251622.05429.0c] [Citation(s) in RCA: 50] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE The objective of this study was to determine relationships between organizational climate (OC) factors and occupational health outcomes (lost workdays, musculoskeletal injury, blood and body fluid exposures, injuries, and burnout) among hospital-based nurses. METHODS Measures were obtained through a self-administered, anonymous survey distributed in 13 New York City hospitals. Multivariate models appropriate for clustered data were developed. These analyses controlled for nurse and employment characteristics. Independent effects of OC factors were examined. RESULTS Surveys from 2047 predominantly registered nurses were obtained (response rate 50%). More than 75% reported lost workdays due to illness in the previous 4-month period and over one third reported experiencing some type of injury. OC factors were independently associated with injuries and measures of burnout (P < or = 0.05). CONCLUSIONS OC is significantly associated with the health and well-being of hospital nurses.
Collapse
Affiliation(s)
- Patricia W Stone
- Department of Nursing, Columbia University School of Nursing, New York, NY, USA.
| | | | | |
Collapse
|