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Alabdaly A, Hinchcliff R, Debono D, Hor SY. Relationship between patient safety culture and patient experience in hospital settings: a scoping review. BMC Health Serv Res 2024; 24:906. [PMID: 39113045 PMCID: PMC11308681 DOI: 10.1186/s12913-024-11329-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Accepted: 07/18/2024] [Indexed: 08/10/2024] Open
Abstract
BACKGROUND Measures of patient safety culture and patient experience are both commonly utilised to evaluate the quality of healthcare services, including hospitals, but the relationship between these two domains remains uncertain. In this study, we aimed to explore and synthesise published literature regarding the relationships between these topics in hospital settings. METHODS This study was performed using the five stages of Arksey and O'Malley's Framework, refined by the Joanna Briggs Institute. Searches were conducted in the CINAHL, Cochrane Library, ProQuest, MEDLINE, PsycINFO, SciELO and Scopus databases. Further online search on the websites of pertinent organisations in Australia and globally was conducted. Data were extracted against predetermined criteria. RESULTS 4512 studies were initially identified; 15 studies met the inclusion criteria. Several positive statistical relationships between patient safety culture and patient experience domains were identified. Communication and teamwork were the most influential factors in the relationship between patient safety culture and patient experience. Managers and clinicians had a positive view of safety and a positive relationship with patient experience, but this was not the case when managers alone held such views. Qualitative methods offered further insights into patient safety culture from patients' and families' perspectives. CONCLUSION The findings indicate that the patient can recognise safety-related issues that the hospital team may miss. However, studies mostly measured staff perspectives on patient safety culture and did not always include patient experiences of patient safety culture. Further, the relationship between patient safety culture and patient experience is generally identified as a statistical relationship, using quantitative methods. Further research assessing patient safety culture alongside patient experience is essential for providing a more comprehensive picture of safety. This will help to uncover issues and other factors that may have an indirect effect on patient safety culture and patient experience.
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Affiliation(s)
- Adel Alabdaly
- Faculty of Health, University of Technology Sydney, Sydney, NSW, Australia.
- College of Nursing, Imam Abdulrahman Bin Faisal University, Dammam, Eastern Province, Saudi Arabia.
| | - Reece Hinchcliff
- School of Applied Psychology, Griffith Health Group, Griffith University, Brisbane, QLD, Australia
- School of Public Health and Social Work, Faculty of Health, Queensland University of Technology, Brisbane, QLD, Australia
| | - Deborah Debono
- School of Public Health, University of Technology Sydney, Sydney, NSW, Australia
| | - Su-Yin Hor
- School of Public Health, University of Technology Sydney, Sydney, NSW, Australia
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Guan T, Chen X, Li J, Zhang Y. Factors influencing patient experience in hospital wards: a systematic review. BMC Nurs 2024; 23:527. [PMID: 39090643 PMCID: PMC11295641 DOI: 10.1186/s12912-024-02054-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2024] [Accepted: 05/30/2024] [Indexed: 08/04/2024] Open
Abstract
BACKGROUND Patient experience plays an essential role in improving clinical effectiveness and patient safety. It's important to identify factors influencing patient experience and to improve quality of healthcare. OBJECTIVE To identify factors that influence patient experience in hospital wards. METHODS We conducted a systematic review including six databases; they were PubMed, CINAHL, Embase, PsycInfo, ProQuest, and Cochrane. Studies were included if they met the inclusion criteria. The JBI checklist was used to perform quality appraisal. We used 5 domains of the ecological model to organize and synthesize our findings to comprehensively understand the multi-level factors influencing the issue. RESULT A total of 138 studies were included, and 164 factors were identified. These factors were integrated into 6 domains. All domains but one (survey-related factors) could be mapped onto the attributes of the ecological framework: intrapersonal, interpersonal, institutional, community, and public policy level factors. All factors had mixed effect on patient experience. The intrapersonal level refers to individual characteristics of patients. The interpersonal level refers to interactions between patients and healthcare providers, such as the caring time spent by a nurse. The institutional level refers to organizational characteristics, rules and regulations for operations, such as hospital size and accreditation. The community level refers to relationships among organizations, institutions, and informational networks within defined boundaries, such as a hospital located in a larger population area. Public policy level refers to local, state, national, and global laws and policies, including health insurance policies. The sixth domain, survey-related factors, was added to the framework and included factors such as survey response rate and survey response time. CONCLUSION The factors influencing patient experience are comprehensive, ranging from intrapersonal to public policy. Providers should adopt a holistic and integrated perspective to assess patient experience and develop context-specific interventions to improve the quality of care. PROSPERO REGISTRATION NUMBER CRD42023401066.
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Affiliation(s)
- Tingyu Guan
- School of Nursing, Fudan University, Shanghai, China
- Department of Nursing, Fudan University Zhongshan Hospital, Shanghai, China
| | - Xiao Chen
- Department of Nursing, Fudan University Zhongshan Hospital, Shanghai, China
| | - Junfei Li
- School of Nursing, Fudan University, Shanghai, China
- Department of Nursing, Fudan University Zhongshan Hospital, Shanghai, China
| | - Yuxia Zhang
- Department of Nursing, Fudan University Zhongshan Hospital, Shanghai, China.
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Patrician PA, Campbell CM, Javed M, Williams KM, Foots L, Hamilton WM, House S, Swiger PA. Quality and Safety in Nursing: Recommendations From a Systematic Review. J Healthc Qual 2024; 46:203-219. [PMID: 38717788 PMCID: PMC11198958 DOI: 10.1097/jhq.0000000000000430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/27/2024]
Abstract
ABSTRACT As a consistent 24-hour presence in hospitals, nurses play a pivotal role in ensuring the quality and safety (Q&S) of patient care. However, a comprehensive review of evidence-based recommendations to guide nursing interventions that enhance the Q&S of patient care is lacking. Therefore, the purpose of our systematic review was to create evidence-based recommendations for the Q&S component of a nursing professional practice model for military hospitals. To accomplish this, a triservice military nursing team used Covidence software to conduct a systematic review of the literature across five databases. Two hundred forty-nine articles met inclusion criteria. From these articles, we created 94 recommendations for practice and identified eight focus areas from the literature: (1) communication; (2) adverse events; (3) leadership; (4) patient experience; (5) quality improvement; (6) safety culture/committees; (7) staffing/workload/work environment; and (8) technology/electronic health record. These findings provide suggestions for implementing Q&S practices that could be adapted to many healthcare delivery systems.
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Liu Y, Xu J, Yang X, Yue L, Li G, Mah AP. Patient safety culture in private hospitals in China: a cross-sectional study using the revised Hospital Survey on Patient Safety Culture. Front Public Health 2024; 12:1323716. [PMID: 38903597 PMCID: PMC11188423 DOI: 10.3389/fpubh.2024.1323716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Accepted: 05/24/2024] [Indexed: 06/22/2024] Open
Abstract
Background This study aimed to translate the revised Hospital Survey on Patient Safety Culture (HSOPSC 2.0) to Mandarin, evaluate its psychometric properties, and apply it to a group of private hospitals in China to identify the determinants associated with patient safety culture. Methods A two-phase study was conducted to translate and evaluate the HSOPSC 2.0. A cross-cultural adaptation of the HSOPSC 2.0 was performed in Mandarin and applied in a cross-sectional study in China. This study was conducted among 3,062 respondents from nine private hospitals and 11 clinics across six cities in China. The HSOPSC 2.0 was used to assess patient safety culture. Primary outcomes were measured by the overall patient safety grade and patient safety events reported. Results Confirmatory factor analysis results and internal consistency reliability were acceptable for the translated HOSPSC 2.0. The dimension with the highest positive response was "Organizational learning - Continuous improvement" (89%), and the lowest was "Reporting patient safety event" (51%). Nurses and long working time in the hospital were associated with lower assessments of overall patient safety grades. Respondents who had direct contact with patients, had long working times in the hospital, and had long working hours per week reported more patient safety events. A higher level of patient safety culture implies an increased probability of a high overall patient safety grade and the number of patient safety events reported. Conclusion The Chinese version of HSOPSC 2.0 is a reliable instrument for measuring patient safety culture in private hospitals in China. Organizational culture is the foundation of patient safety and can promote the development of a positive safety culture in private hospitals in China.
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Affiliation(s)
- Yan Liu
- Department of Quality and Safety, United Family Healthcare, Beijing, China
| | - Jianing Xu
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- China Hospital Development Institute, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xiaoguang Yang
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- China Hospital Development Institute, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Liu Yue
- Department of Quality and Safety, Beijing United Family Hospital, United Family Healthcare, Beijing, China
| | - Guohong Li
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- China Hospital Development Institute, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Alastair P. Mah
- Department of Medical Affair, United Family Healthcare, Beijing, China
- Faculty of Health, School of Medicine, Deakin University, Geelong, VIC, Australia
- Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
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Botchwey COA, Boateng AA, Ahimah PO, Acquah F, Adoma PO, Kumah E, Boakye DS, Boahen EA, Kruh V, Koomson JBK. Patient safety culture and satisfaction in Ghana: a facility-based cross-sectional study. BMJ Open 2024; 14:e073190. [PMID: 38296299 PMCID: PMC10828863 DOI: 10.1136/bmjopen-2023-073190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Accepted: 01/07/2024] [Indexed: 02/03/2024] Open
Abstract
BACKGROUND Globally, one of the measures of high performing healthcare facilities is the compliance of patient safety culture, which encompasses the ability of health institutions to avoid or drastically reduce patient harm or risks. These risks or harm is linked with numerous adverse patient outcomes such as medication error, infections, unsafe surgery and diagnosis error. OBJECTIVES The general objective of this study was to investigate into the impact of patient safety culture practices experienced on patient satisfaction among patients who attend the Kwesimintsim Government Hospital in the Takoradi municipality. METHODS This study was a descriptive cross-sectional study and a consecutive sampling technique was used to select 336 respondents for the study. Data was collected using a structured questionnaire and processed using Statistical Package for Social Sciences, V.21. Both descriptive and inferential statistics were carried out and result were presented using figures and tables. RESULTS The study found that the overall patient safety compliance level observed by the respondents was poor (29.2%). The prevalence of adverse events experienced among the respondents was high (58%). The leading adverse events mentioned were medication errors, followed by wrong prescriptions and infections. The consequences of these adverse events encountered by the respondents were mentioned as increased healthcare costs (52%), followed by hospitalisation (43%), worsening of health conditions (41%) and contraction of chronic health conditions (22%). Patient safety cultural practices such as teamwork (β=0.17, p=0.03), response to error (β=0.16, p=0.005), communication openness (β=0.17, p=0.003) and handoffs and information exchange (β=0.17, p=0.002) were found to positively influence patient satisfaction. CONCLUSION The poor general compliance of the patient safety culture in the facility is unfortunate, and this can affect healthcare outcomes significantly. The study therefore entreats facility managers and various stakeholders to see patient safety care as an imperative approach to delivering quality essential healthcare and to act accordingly to create an environment that supports it.
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Affiliation(s)
| | - Agartha Afful Boateng
- Health Administration and Education, University of Education, Winneba, Winneba, Central, Ghana
| | - Patricia Ofori Ahimah
- Health Administration and Education, University of Education, Winneba, Winneba, Central, Ghana
| | - Francis Acquah
- Health Administration and Education, University of Education, Winneba, Winneba, Central, Ghana
| | - Prince Owusu Adoma
- Health Administration and Education, University of Education, Winneba, Winneba, Central, Ghana
| | - Emmanuel Kumah
- Health Administration and Education, University of Education, Winneba, Winneba, Central, Ghana
| | - Dorothy Serwaa Boakye
- Health Administration and Education, University of Education, Winneba, Winneba, Central, Ghana
| | - Ebenezer Addae Boahen
- Health Administration and Education, University of Education, Winneba, Winneba, Central, Ghana
| | - Vivian Kruh
- Population and Health, University of Cape Coast College of Humanities and Legal Studies, Cape Coast, Central Region, Ghana
| | - Joseph Bob Kow Koomson
- Population and Health, University of Cape Coast College of Humanities and Legal Studies, Cape Coast, Central Region, Ghana
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Longo BA, Schmaltz SP, Barrett SC, Patrianakos J, Williams SC. Home Health Agency Patient Experience Measures and Their Relationship to Joint Commission Accreditation. Jt Comm J Qual Patient Saf 2023; 49:313-319. [PMID: 37210303 DOI: 10.1016/j.jcjq.2023.04.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 04/13/2023] [Accepted: 04/14/2023] [Indexed: 05/22/2023]
Abstract
BACKGROUND Health care accreditation is a widely accepted mechanism for improving the quality of care and promoting patient safety. An integral dimension of health care quality is the patient experience of care. However, the influence of accreditation on the patient experience is unclear. The Home Health Consumer Assessment of Healthcare Providers and Systems (HHCAHPS) survey is the standard for collecting patient care experience data in the home health setting. The aim of this study was to examine the association of Joint Commission accreditation on patients' experience of care by comparing HHCAHPS ratings from Joint Commission-accredited and non-Joint Commission-accredited home health agencies (HHAs). METHODS This multiyear observational study used 2015-2019 HHCAHPS data obtained from the Centers for Medicare & Medicaid Services (CMS) website and Joint Commission databases. The data set included 1,454 (23.8%) Joint Commission-accredited and 4,643 (76.2%) non-Joint Commission-accredited HHAs. Dependent variables included three composite measures of care (Care of Patients, Provider-Patient Communications, and Specific Care Issues) and two global rating measures. Data were analyzed using a series of longitudinal random effects logistic regression models. RESULTS This study found no association between Joint Commission accreditation and the two global HHCAHPS measures, modest significant increases for Joint Commission-accredited HHAs in measure rates for the Care of Patients and Communication composite measures (p < 0.05), and a more significant increase for the Specific Care Issues composite measure related to medication safety and home safety (p < 0.001). CONCLUSIONS These findings suggest that Joint Commission accreditation may be positively associated with some patient experience of care outcomes. This relationship was most pronounced when there was significant overlap between the focus of the accreditation standards and focus of the HHCAHPS items.
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Kim S, Kitzmiller R, Baernholdt M, Lynn MR, Jones CB. Patient Safety Culture: The Impact on Workplace Violence and Health Worker Burnout. Workplace Health Saf 2023; 71:78-88. [PMID: 36476112 PMCID: PMC9896532 DOI: 10.1177/21650799221126364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND Patient and health care worker safety is an interconnected phenomenon. To date, few studies have examined the relationship between patient and worker safety, specifically with respect to work safety culture. Therefore, we examined patient safety culture, workplace violence (WPV), and burnout in health care workers to identify whether patient safety culture factors influence worker burnout and WPV. METHODS This cross-sectional study used secondary survey data sent to approximately 7,100 health care workers at a large academic medical center in the United States. Instruments included the Hospital Survey on Patient Safety Culture, a WPV scale measuring physical and verbal violence perpetrated by patients or visitors, and the Emotional Exhaustion scale from the Maslach Burnout Inventory. FINDINGS These analyses included 3,312 (47%) hospital staff who directly interacted with patients. Over half of nurse (62%), physician (53%), and allied health professional respondents (52%) reported experiencing verbal violence from a patient, and 39% of nurses and 14% of physicians reported experiencing physical violence from a patient. Burnout levels for nurses (2.67 ± 1.02) and physicians (2.65 ± 0.93) were higher than the overall average for all staff (2.61 ± 1.0). Higher levels of worker-reported patient safety culture were associated with lower odds of WPV (0.47) and lower burnout scores among workers (B = -1.02). Teamwork across units, handoffs, and transitions were dimensions of patient safety culture that also influenced WPV and burnout. CONCLUSIONS/APPLICATION TO PRACTICE Our findings suggest that improvements in hospital strategies aimed at patient safety culture, including team cohesion with handoffs and transitions, could positively influence a reduction in WPV and burnout among health care workers.
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Affiliation(s)
- Sinhye Kim
- The University of North Carolina at
Chapel Hill,Sinhye Kim, PhD, RN, School of Nursing, The
University of North Carolina at Chapel Hill, Carrington Hall CB#7460, Chapel
Hill, NC 27599-7460, USA;
| | | | - Marianne Baernholdt
- The University of North Carolina at
Chapel Hill,The University of Virginia School of
Nursing
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Quigley DD, Slaughter ME, Qureshi N, Gidengil C, Hays RD. Associations of pediatric nurse burnout with involvement in quality improvement. J Pediatr Nurs 2022; 70:e9-e16. [PMID: 36402601 DOI: 10.1016/j.pedn.2022.11.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Revised: 11/03/2022] [Accepted: 11/03/2022] [Indexed: 11/18/2022]
Abstract
PURPOSE Burnout among nurses negatively impacts patient care experiences and safety. Inpatient pediatric nurses are high-risk for burnout due to high patient volumes, inadequate staffing, and needing to balance the demands of patients, families and team members. We examined the associations of inpatient pediatric nurse burnout with their perspectives on the importance of quality at the hospital, patient experience measurement, quality improvement (QI), unit culture, and staffing. METHODS We conducted a cross-sectional study at an urban children's hospital. We surveyed pediatric nurses about their perspectives including the single-item Maslach Burnout Inventory. We fit separate regression models, controlling for role, location and unit, predicting outcome measures from the dichotomized burnout scale. RESULTS Twenty-seven percent of pediatric nurses reported burnout. Nurses who had more confidence in patient experience measurement, received frequent patient experience performance reports, felt included in QI, and experienced QI efforts as integrated into patient care reported not being burned out (compared to those reporting burnout; all p-values<0.05). More open communication among nurses (e.g., about possible problems with care) and unit-level teamwork were also associated with not being burned out, whereas a larger QI workload was associated with burnout (p-values<0.05). CONCLUSIONS Open communication among nurses and nurses being more involved and valued in QI efforts were related to not being burned out. Research is needed to further examine aspects of QI involvement that reduce burnout. PRACTICE IMPLICATIONS Supporting open communication among pediatric nurses, engaging them in QI and integrating QI into patient care while minimizing QI workload may decrease burnout.
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Affiliation(s)
- Denise D Quigley
- Behavior and Policy Sciences, RAND Corporation, 1776 Main Street, Santa Monica, CA 90401, United States.
| | - Mary Ellen Slaughter
- Economics, Sociology & Statistics, RAND Corporation, 1776 Main Street, Santa Monica, CA 90401, United States.
| | - Nabeel Qureshi
- Pardee RAND, RAND Corporation, 1776 Main Street, Santa Monica, CA 90401, United States.
| | - Courtney Gidengil
- RAND Boston Office, Behavioral & Policy Sciences, RAND Corporation, 20 Park Plaza, Suite 920, Boston, MA 02116, United States.
| | - Ron D Hays
- Medicine, Health Policy and Management, University of California Los Angeles, David Geffen School of Medicine, United States.
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Dorigan GH, Mingato DFP, Guirardello EDB. Nursing safety attitudes: relationship with time of experience and intention to leave the job. Rev Gaucha Enferm 2021; 41:e20190274. [PMID: 32555953 DOI: 10.1590/1983-1447.2020.20190274] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2019] [Accepted: 01/06/2020] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To evaluate the safety attitudes of the nursing staff and their relationship with staff adequacy and material resources, time of experience and intention to leave the job. METHOD A descriptive and cross-sectional study in a teaching hospital, sampled by convenience, with the application of the Safety Attitudes Questionnaire, collected from January to April 2016. RESULTS 262 professionals participated, of whom 98 were nurses and 164 technicians. They reported a positive safety attitude for job satisfaction. The adequacy of staff and material resources positively influenced safety attitudes. There was a negative correlation between time of experience and perception of management, safety climate, working conditions and safe behaviors and, between the intention to leave the job and the teamwork climate, job satisfaction, and safe behaviors. CONCLUSION The negative perception of safety attitudes was related to the time of experience and to the intention to leave the job.
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Affiliation(s)
- Gisele Hespanhol Dorigan
- Centro Universitário da Fundação Hermínio Ometto (FHO), Curso de Graduação e Pós-Graduação em Enfermagem. Araras, São Paulo, Brasil.,Universidade Estadual de Campinas (UNICAMP), Faculdade de Enfermagem. Campinas, São Paulo, Brasil
| | | | - Edinêis de Brito Guirardello
- Universidade Estadual de Campinas (UNICAMP), Faculdade de Enfermagem, Programa de Pós-Graduação em Enfermagem. Campinas, São Paulo, Brasil
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Mansour H, Abu Sharour L. Results of survey on perception of patient safety culture among emergency nurses in Jordan: Influence of burnout, job satisfaction, turnover intention, and workload. J Healthc Qual Res 2021; 36:370-377. [PMID: 34187762 DOI: 10.1016/j.jhqr.2021.05.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Revised: 04/09/2021] [Accepted: 05/03/2021] [Indexed: 11/19/2022]
Abstract
BACKGROUND Patient safety culture is an essential factor in the decreasing of medical errors and development of the institutions. This study was conducted to determine to what extent the selected variables, including age, weekly working hours, years of experience, burnout, turnover intention, workload, and job satisfaction, predict perceived patient safety culture among emergency nurses in Jordanian hospitals. METHODS A cross-sectional design with convenience sampling approach was used. A total of 157 emergency nurses from governmental and public hospitals were participated in the study and completed the study's survey: Hospital Survey on Patient Safety Culture (PSC), Copenhagen Burnout Inventory-Student Survey (CBI-SS), NASA Task Load Index (NASA-TLX), Nursing Workplace Satisfaction Questionnaire (NWSQ) and turnover intention scale (TIS). RESULTS The results showed that there was a negative relationship found between nurses' age and PSC perception (r=-.166, P=.039), personal burnout and PSC (r=-.160, P=.048), and there was also a negative relationship between turnover intentions and perceived PSC (r=-.334, P=.000). The results from the regression model indicated that turnover intentions, reporting patient safety events, and the number of events reported predicted PSC. The results showed that R2=.29, adjusted R2=.287, F(6,141)=9.45, P<0.01. CONCLUSION Our results suggests that nurses' managers may pay attention to decreasing burnout and analyze turnover intention among nurses in order to improve the culture of patient safety.
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Affiliation(s)
- H Mansour
- Faculty of Nursing, AL-Zaytoonah University of Jordan, Jordan
| | - L Abu Sharour
- Faculty of Nursing, AL-Zaytoonah University of Jordan, Jordan.
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Khateeb R, Keniston A, Moore A, Hrach C, Indovina KA, Kneeland P, Rudolph M, Burden M. Perspectives on Patient Experience: A National Survey of Hospitalists. J Patient Exp 2020; 7:1482-1490. [PMID: 33457605 PMCID: PMC7786688 DOI: 10.1177/2374373520948669] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Despite efforts to improve patient experience (PX), little is known about the perspective of hospitalists regarding PX initiatives and priorities. A survey was distributed to hospitalist groups across the country assessing involvement in PX initiatives and their perceived effectiveness, what PX means to providers, and facilitators/barriers in improving PX. Ninety-nine percent of respondents had encountered some improvement activity around PX. The most prevalent were communication training, group Hospital Consumer Assessment of Healthcare Providers and Systems data, and interdisciplinary bedside rounding. Respondents rated most initiatives a 5 to 6 out of 10 for their effectiveness, with the perception of effectiveness increasing with respondents' assessment of patient experience priority. Learning about others' experiences in improving PX and learning about potential collaborations for quality improvement or research in these areas were areas of interest for future work. Qualitative work highlighted potential barriers in improving PX such as workload and staffing constraints, uncontrollable environmental factors, and unrealistic patient expectations. Improving PX is a priority, and there are many initiatives in place with perceived variable success and perceived barriers in improving PX.
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Affiliation(s)
- Rafina Khateeb
- Division of Hospital Medicine, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Angela Keniston
- Division of Hospital Medicine, University of Colorado School of Medicine, Aurora, CO, USA
| | - Amber Moore
- Division of Hospital Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - Christine Hrach
- Division of Hospitalist Medicine, Department of Pediatrics, Washington University School of Medicine, St. Louis, MO, USA
| | - Kimberly A Indovina
- Division of Hospital Medicine, University of Colorado School of Medicine, Aurora, CO, USA
- Denver Health, Denver, CO, USA
| | - Patrick Kneeland
- Division of Hospital Medicine, University of Colorado School of Medicine, Aurora, CO, USA
| | | | - Marisha Burden
- Division of Hospital Medicine, University of Colorado School of Medicine, Aurora, CO, USA
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Ree E. What is the role of transformational leadership, work environment and patient safety culture for person-centred care? A cross-sectional study in Norwegian nursing homes and home care services. Nurs Open 2020; 7:1988-1996. [PMID: 33072384 PMCID: PMC7544868 DOI: 10.1002/nop2.592] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Revised: 07/03/2020] [Accepted: 07/23/2020] [Indexed: 11/08/2022] Open
Abstract
Aim To examine how transformational leadership, job demands, job resources and patient safety culture contribute in explaining person-centred care in nursing homes and home care services. Design Cross-sectional study. Methods Healthcare professionals in four Norwegian nursing homes (N = 165) and four home care services (N = 139) participated in 2018. Multiple regression analyses were used to examine to what degree transformational leadership, job demands, job resources and patient safety culture dimensions predicted person-centred care. Results Transformational leadership, job demands and job resources explained 41% of the variance in person-centred care, with work pace as the strongest predictor (β = 0.39 p < .001). The patient safety culture dimensions explained 57.5% of the variance in person-centred care, with staffing being the strongest predictor (β = 0.31 p < .001). There were small differences between nursing homes and home care. In total, transformational leadership, pace of work, staffing and factors related to communication were the strongest predictors for person-centred care.
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Affiliation(s)
- Eline Ree
- SHARE – Centre for Resilience in HealthcareFaculty of Health SciencesUniversity of StavangerStavangerNorway
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Kaczorowski KM, Drayton NA, Grimston MR. Gaining perspective into the term 'safety culture'; how emergency nurses view its meaning in their everyday practice: a focus group study in an Australian setting. Australas Emerg Care 2020; 23:1-5. [PMID: 32113919 DOI: 10.1016/j.auec.2020.01.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2019] [Revised: 01/31/2020] [Accepted: 01/31/2020] [Indexed: 12/23/2022]
Abstract
BACKGROUND The creation of the safety culture coordinator role within an Australian Local Health District followed a critical incident in one of its emergency departments. As part of the role, it was important to have an understanding of how nurses viewed the term safety culture in order to support them in implementing any changes that would influence their everyday practice. METHODS A descriptive qualitative design was chosen for the study. Focus groups allowed the perspectives of nurses to be heard and represented. RESULTS Five themes emerged from the data: defining safety culture, influences of team culture, differences in environmental impact, the reality of reporting incidents and commitment to best practice and patient care. These highlighted the influencing factors that promoted and inhibited a safety culture. CONCLUSION This study provides a greater understanding of what supports a positive safety culture and the challenges that nurses face. Across the three emergency departments, nurses had similar beliefs about safety culture, with a consensus that safety was everyone's responsibility. This has enabled the safety culture coordinator position to have greater consideration of what initiatives are valued and important in working with nurses to design strategies that influence their safety culture.
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Affiliation(s)
- Kellie M Kaczorowski
- Education and Training Service, Nepean Blue Mountains Local Health District, PO Box 63 Penrith NSW 2751 Kingswood, Australia.
| | - Nicola A Drayton
- Practice Development Unit, Nepean Blue Mountains Local Health District, Penrith NSW 2750 Australia
| | - Mitchell R Grimston
- Education and Training Service, Nepean Blue Mountains Local Health District, PO Box 63 Penrith NSW 2751 Kingswood, Australia
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Cracking the Code for Quality: The Interrelationships of Culture, Nurse Demographics, Advocacy, and Patient Outcomes. J Nurs Adm 2020; 50:152-158. [PMID: 32040052 DOI: 10.1097/nna.0000000000000859] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The aim of this study was to describe the complex relationships among patient safety culture, nurse demographics, advocacy, and patient outcomes. BACKGROUND Why has healthcare lagged behind other industries in improving quality? Little nursing research exists that explores the multifactorial relationships that impact quality. METHODS A convenience sample of 1045 nurses from 40 medical/surgical units was analyzed using a correlational cross-sectional design with secondary data analysis. Data sources included survey results for patient safety culture, nurse perceptions of patient advocacy, and patient experience and fall and pressure ulcer rates. RESULTS Significant findings included a positive correlation between patient safety culture and advocacy and a negative correlation between safety culture, advocacy, and years of experience as a nurse. No significant correlations were found between safety culture and patient outcomes or advocacy and patient outcomes. CONCLUSIONS Newer nurses were more positive about safety culture and advocacy, whereas experienced nurses were overall less positive.
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15
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Abstract
BACKGROUND Registered nurses are pivotal in the analysis, recognition, and reporting of patient safety issues before harm occurs to patients. Little has been written about the relationship between the professional responsibility of reporting safety concerns and the processes that exist. PROBLEM More needs to be known about how nurses can best report factors in work environments that impact patient safety. Learning more about processes that exist amidst literature that illuminates the issues related to reporting and patient safety culture is needed. Also, best practice or key exemplars depicting how professional responsibility has been implemented are needed. Limited has been written exploring professional responsibility concern processes in Canada and internationally. APPROACH We completed a case study exploration comprising a public facing Web site scan of information about professional responsibility-like processes across Canada, as well as an extensive literature search exploring factors that are linked with nurse reporting of patient safety concerns. CONCLUSION Themes from related literature identify patient safety culture, leadership qualities, communication, positive nurse factors, speaking up, and whistle-blowing as important aspects that facilitate, or are related to, the ability for nurses to express professional responsibility concerns. Alberta has a well-developed system of reporting such concerns; however, the lack of research and literature on these topics requires additional focus in nursing internationally.
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16
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Ree E, Wiig S. Employees' perceptions of patient safety culture in Norwegian nursing homes and home care services. BMC Health Serv Res 2019; 19:607. [PMID: 31464630 PMCID: PMC6716833 DOI: 10.1186/s12913-019-4456-8] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2019] [Accepted: 08/23/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Most health care services are provided in the primary health care sector, and an increasing number of elderly is in need of these services. Nonetheless, the research on patient safety culture in home care services and nursing homes remains scarce. This study describes staff perceptions of patient safety culture in Norwegian home care services and nursing homes, and assesses how various patient safety culture dimensions contribute to explaining overall perceptions of patient safety. METHODS Cross-sectional surveys were conducted among healthcare professionals in Norwegian home care services (N = 139) and nursing homes (N = 165) in 2018, response rates being 67.5% and 65%, respectively. A Norwegian version of the international recognized Nursing Home Survey on Patient Safety Culture was used. Descriptive statistics and t-tests were used to explore staff perceptions of patient safety culture. We used multiple regression analyses to explore the degree to which patient safety culture dimensions could explain overall perceptions of patient safety. RESULTS The number of patient safety dimensions having an average score of more than 60% positive responses was seven out of 10 in nursing homes, and nine out of 10 in home care. Staffing had the lowest scores in both health care services. Home care services scored significantly higher than nursing homes on teamwork (eta squared = .053), while nursing homes scored somewhat higher on handover (eta squared = .027). In home care, total explained variance of overall perceptions of patient safety was 45%, with teamwork, staffing, and handoffs as significant predictors. The explained variance in nursing homes was 42.7%, with staffing and communication openness as significant predictors. CONCLUSIONS There are differences in perceptions of patient safety culture between nursing homes and home care services. Staffing is important for patient safety perceptions in both health care services. In home care, teamwork seems to be a significant contributing factor to patient safety, and building sound teams with mutual trust and collaboration should therefore be an essential part of managers' work with patient safety. In nursing homes, the main focus when building a good patient safety culture should be on open communication, ensuring that staff's ideas and suggestions are valued.
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Affiliation(s)
- Eline Ree
- SHARE - Centre for Resilience in Healthcare, Faculty of Health Sciences, University of Stavanger, N-4036, Stavanger, Norway.
| | - Siri Wiig
- SHARE - Centre for Resilience in Healthcare, Faculty of Health Sciences, University of Stavanger, N-4036, Stavanger, Norway
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Mahmodi Shan G, Royani Z, Kord F, Kazemi SB, Ghana S, Rahimian S, Kalantary S, Seyed Ghasemi N. Effect of In-Person and E-Training on Nurse Managers' Perception of Patient Safety Culture in Hospitals of the Golestan Province, Iran. JOURNAL OF CLINICAL AND BASIC RESEARCH 2019. [DOI: 10.29252/jcbr.3.1.34] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
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18
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Babic B, Volpe AA, Merola S, Mauer E, Cozacov Y, Ko CY, Michelassi F, Saldinger P. Sustained culture and surgical outcome improvement. Am J Surg 2018; 216:841-845. [PMID: 29482831 DOI: 10.1016/j.amjsurg.2018.02.016] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2017] [Revised: 01/30/2018] [Accepted: 02/07/2018] [Indexed: 11/16/2022]
Abstract
BACKGROUND A focus on the culture of safety and patient outcomes continues to grow in importance. Several initiatives targeted at individual deficits have been described but few institutions have shown the effect of a global change in culture on patient outcomes. METHODS Patient care perception was assessed using Safety Attitudes Questionnaire (SAQ) by Pascal Metrics®. A change in culture was initiated, followed by implementation of initiatives targeting communication and patient safety. ACS-NSQIP data was analyzed to assess outcomes during the period of improved culture. RESULTS Our institution had poor outcomes as measured by ACS-NSQIP data and several deficiencies in our culture score. Both statistically improved after initiative implementation. A difference in mean culture score across time (p < 0.001 = .031) was seen from 2013 to 2015, while NSQIP odds ratios falling in the 'exemplary' category increased. CONCLUSION Our results demonstrate an improvement in both culture and outcomes from 2013 to 2015, suggesting a correlation between culture and surgical outcomes.
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Affiliation(s)
- Bruna Babic
- Department of Surgery, New York Presbyterian-Queens, Flushing, NY, USA; Department of Surgery, Weill Cornell Medicine, New York, NY, USA.
| | | | - Stephen Merola
- Department of Surgery, New York Presbyterian-Queens, Flushing, NY, USA; Department of Surgery, Weill Cornell Medicine, New York, NY, USA
| | - Elizabeth Mauer
- Division of Biostatistics and Epidemiology, Department of Healthcare Policy and Research, New York-Presbyterian/Weill Cornell Medical Center, New York, NY, USA
| | - Yaniv Cozacov
- Department of Surgery, New York Presbyterian-Queens, Flushing, NY, USA
| | - Clifford Y Ko
- Department of Surgery, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA; Division of Research and Optimal Patient Care, American College of Surgeons, Chicago, IL, USA
| | | | - Pierre Saldinger
- Department of Surgery, New York Presbyterian-Queens, Flushing, NY, USA; Department of Surgery, Weill Cornell Medicine, New York, NY, USA
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Abstract
Health care organizations recognize that it is difficult to achieve consistent excellence in patient experience. Nursing leaders cannot underestimate the importance of the role they play in efforts to improve the patient experience. This article outlines a call to action for nurse leaders to consider reframing the patient experience as a focal point for the entire organization's strategic approach and tactics. This involves facilitating a dialogue about the organization's patient experience definition; building a strong, positive organization culture; creating processes to ensure the engagement of all voices; ensuring a focus across the continuum of care; and addressing the key drivers of patient experience excellence.
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Affiliation(s)
- Victoria Niederhauser
- College of Nursing, University of Tennessee Knoxville (Dr Niederhauser); and The Beryl Institute, Southlake, Texas (Dr Wolf)
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Lee SE, Scott LD, Dahinten VS, Vincent C, Lopez KD, Park CG. Safety Culture, Patient Safety, and Quality of Care Outcomes: A Literature Review. West J Nurs Res 2017; 41:279-304. [DOI: 10.1177/0193945917747416] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
This integrative literature review was conducted to examine the relationships between safety culture and patient safety and quality of care outcomes in hospital settings and to identify directions for future research. Using a search of six electronic databases, 17 studies that met the study criteria were selected for review. This review revealed semantic inconsistencies, infrequent use of a theory or theoretical framework, limited discussions of validity of instruments used, and significant methodological variations. Most notably, this review identified a large array of nonsignificant and inconsistent relationships between safety culture and patient safety and quality of care outcomes. To improve understanding of the relationships, investigators should consider using a theoretical framework and valid measures of the key concepts. Researchers should also give more attention to selecting appropriate sampling and data collection methods, units of analysis, levels of data measurement and aggregation, and statistical analyses.
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