Measuring Patient Safety Culture in Romania Using the Hospital Survey on Patient Safety Culture (HSOPSC)

Current Advances in Patient-Perceived Quality Assessment Within Romanian Healthcare

The global healthcare landscape is shifting toward patient-centered care, emphasizing the integration of patient feedback into service delivery. Romania, aligning with this trend, has implemented patient-perceived quality assessment tools to enhance healthcare services and better meet patient needs and expectations. This study aims to review comprehensively the implementation and impact of these tools in Romania, focusing on their role in improving healthcare quality. By examining key assessment instruments such as the Patient Satisfaction Questionnaire (PSQ), the Service Quality (SERVQUAL) model, and the Romanian Healthcare Quality Assessment Survey (RHQAS), the research seeks to understand how these tools have been used to identify areas for improvement and drive advancements in patient care. Employing a comprehensive review methodology, the study will conduct a thorough literature search to identify relevant studies, reports, and publications, analyzing the PSQ, SERVQUAL, and RHQAS in detail to understand their measurement domains, psychometric properties, and application within Romania. Additionally, qualitative data from interviews with healthcare providers and patients may be collected to offer further insights into the use and effectiveness of these tools. The study's findings are expected to provide valuable insights into the role of patient-perceived quality assessment tools in enhancing healthcare in Romania, identifying strengths, weaknesses, and opportunities for improvement. The results will highlight the effectiveness of combining international methodologies with localized adaptations to address the specific needs of the Romanian healthcare system, ultimately contributing to the ongoing efforts to improve patient satisfaction and health outcomes by informing the development and refinement of patient-centered care initiatives in Romania.

Patient safety culture in home care settings in Sweden: a cross-sectional survey among home care professionals

BACKGROUND

The connection between a weak patient safety culture and adverse patient events is well known, but although most long-term care is provided outside of hospitals, the focus of patient safety culture is most commonly on inpatient care. In Sweden, more than a third of people who receive care at home have been affected by adverse events, with the majority judged to be preventable. The aim of this study was to investigate the patient safety culture among care professionals working in care at home with older people.

METHODS

This cross-sectional study used a purposive sample of 66 municipal care workers, health care professionals, and rehabilitation staff from five municipal care units in two districts in western Sweden who provided care at home for older people and had been employed for at least six months. The participants completed the Hospital Survey on Patient Safety Culture (HSOPSC) self-report questionnaire, which assessed aspects of patient safety culture-norms, beliefs, and attitudes. Logistic regression analysis was used to test how the global ratings of Patient safety grade in the care units and Reporting of patient safety events were related to the dimensions of safety culture according to the staff's professions and years of work experience.

RESULTS

The most positively rated safety culture dimension was Teamwork within care units (82%), which indicates good cooperation with the closest co-workers. The least positively rated dimensions were Handoffs and transitions among care units (37%) and Management support (37%), which indicate weaknesses in the exchange of patient information across care units and limited support from top-level managers. The global rating of Patient safety grade was associated with Communication openness and Management support (p < 0.01 and p = 0.03, respectively). Staff with less work experience evaluated the Patient safety grade higher than those with more work experience.

CONCLUSIONS

This study suggests that improvements are needed in care transitions and in support from top-level managers and that awareness of patient safety should be improved in staff with less work experience. The results also highlight that an open communication climate within the care unit is important for patient safety.

Trends in the Staff's Perception of Patient Safety Culture in Romanian Hospitals

Introduction. The IRIS-2 project (2019) expanded the application of the HSOPSC in Romanian hospitals, yet applied, for the first time in the country, in 2014 (IRIS-1). The aim is an update on patient safety culture for staff, by geographic region and overall, by year of survey. Materials and methods. A cross-sectional study was carried out in voluntary staff in four hospitals in four regions (n. 1,121 staff) and compared with a previous study based on six hospitals in four regions (n. 969 staff). The instrument was the Romanian version of the HSOPSC with 31 items and 9 dimensions. Statistics to analyze trend were computed using “R”. Results No significant differences between the proportion of positive response (PPRs) by dimension were observed in IRIS-2 with respect to IRIS-1, with two exceptions: significantly lower PPR for “teamwork across hospital units“ (65% versus 73%) and significantly higher PPR for “frequency of events reporting” (65% versus 59%). Four dimensions were well developed and five dimensions needed to be improved. The poorest PPRs were for the “teamwork across hospital units”, the “frequency of event reporting” and the “non punitive response to error” dimensions. Besides, one outcome indicator changed through time: the proportion of the staff who did not report any event was significantly lower (64% versus 73%) and the proportion of the staff who reported “1-2 events” was significantly higher (21% versus 15%). Conclusion. Despite some small progress related to the frequency of events reporting, there is room for further patient safety culture improvement.