Document Type : Original Article
Health Management Research Center, Baqiyatallah University of Medical Sciences, Tehran, IR Iran
Health Management and Economics Research Center, Isfahan University of Medical Sciences, Isfahan, IR Iran
Human Resource for Health Office, Ministry of Health and Medical Education, Tehran, IR Iran
Background: Patient safety is a serious global public health issue. Estimates show that every day many patients are harmed while receiving hospital care. Health care staff plays a key role in providing quality and safe patient care, especially physicians who are main members of the medical team and a critical element in patient safety efforts.
Objective: The current study used a Theory of Planned Behavior (TPB) framework to investigate predictors of patient safety intentions and behavior of physicians.
Methods: This descriptive analytical study was conducted in 8 hospitals with 52 physicians participating. A researcher-designed questionnaire was prepared to investigate patient safety behaviors and behavior constructs of physicians based on the guidelines of constructing a TPB Questionnaire: Conceptual and Methodological Considerations. The content validity and reliability of the questionnaire were confirmed. Binary logistic regression analysis was performed using SPSS18.
Results: The total mean score of physician safety behavior indicated that 3.8±0.92. 42% of physicians reported their safety behavior at a good level. There was no significant difference between the patient safety function of physicians in public and private hospitals (P=0.8) and working in medical or surgical wards (P=0.4). Among TPB constructs, “normative beliefs” had the greatest influence on physician intention for safety behaviors (wald=3.828, P=0.05).
Conclusion: The results showed that “normative beliefs” had the greatest influence on physician intention for safety behaviors; therefore, it seems that patient safety must be the most important concern of all health care staff, specifically managers and executives throughout health care centers.
- Organizations JCoAoH. Facts about patient safety WHO 2002 [cited 7]. Available from: http:// www.who.int/ features/ factfiles/ patient_safety/en/.
- Tourani S, Hassani M, Ayoubian A, Habibi M, Zaboli R. Analyzing and prioritizing the dimensions of patient safety Culture in emergency wards using the TOPSIS technique. Glob J Health Sci. 2015;7(4):143-50. [DOI]
- Sendlhofer G, Brunner G, Tax C, Falzberger G, Smolle J, Leitgeb K, et al. Systematic implementation of clinical risk management in a large university hospital: the impact of risk managers. Wien Klin Wochenschr. 2015;127(1-2):1-11. [DOI]
- Sutker WL. The physician's role in patient safety: What's in it for me? Proc (Bayl Univ Med Cent). 2008;21(1):9-14.
- Steiger B. Special report: quality of care survey. Doctors say many obstacles block paths to patient safety. Physician Exec. 2007;33(3):6-14.
- Bates DW, Larizgoitia I, Prasopa-Plaizier N, Jha AK. Global priorities for patient safety research. BMJ. 2009;338(7704):1242-4. [DOI]
- Brier R, Corrigan J, Donaldson M, Kohn L. committee on quality of health care in america, institute of medicine. Crossing the Quality Chasm: A New Health System for the 21st Century Washington, DC: National Academies Pr. 2001:25-6.
- Classen DC, Kilbridge PM. The roles and responsibility of physicians to improve patient safety within health care delivery systems. Acad Med. 2002;77(10):963-72. [DOI]
- Javadi M, Kadkhodaee M, Yaghoubi M, Maroufi M, Shams A. Applying theory of planned behavior in predicting of patient safety behaviors of nurses. Mater Sociomed. 2013;25(1):52-5. [DOI]
- Majidi SA, Ayoubian A, Mardani S, Hashemidehaghi Z. A survey of the quality of nursing services for brain trauma patients in the emergency wards of hospitals in Guilan Province, Iran (2012). Electron Physician. 2014;6(1):747-53.
- Ajzen I. The theory of planned behavior. Organ Behav Hum Decis Process. 1991;50(2):179-211. [DOI]
- Ajzen I. Constructing a TPB questionnaire: Conceptual and methodological considerations. 2002.
- Armitage CJ, Conner M. Efficacy of the Theory of Planned Behaviour: a meta-analytic review. Br J Soc Psychol. 2001;40(Pt 4):471-99. [DOI]
- Gharlipour Z, Ghaffari M, Hoseini Z, Heidarabadi AB, Tavassoli E, Hozuri M, et al. Investigation of educational intervention based on Theory of Planned Behavior on breakfast consumption among middle school students of Qom City in 2012. J Educ Health Promot. 2015;4:39.
- Talbot AL, Dorrian J, Chapman J. Using the Theory of Planned Behaviour to examine enrolled nursing students' intention to care for patients with alcohol dependence: A survey study. Nurse Educ Today. 2015;35(11):1054-61. [DOI]
- Asgari H, Esfahani SS, Yaghoubi M, Javadi M, Karimi S. Investigating selected patient safety indicators using medical records data. J Educ Health Promot. 2015;4:54. [DOI]
- Cook RI, Woods DD. Operating at the sharp end: the complexity of human error. Hum Error Med. 1994;13:225-310.
- Reason J. Human error: models and management. BMJ. 2000;320(7237):768-70. [DOI]
- Yaghoubi M, Rahmati-Najarkolaei F. Patient-physician communicative patterns, physicians’ job satisfaction, and patients’ satisfaction: the case of a hospital in Isfahan. Iran J Health Sci. 2014;2(2):37-44.
- Kohn LT, Corrigan JM, Donaldson MS. To err is human:: building a Safer Health System: National Academies Press; 2000.
- Hutchinson AM, Sales AE, Brotto V, Bucknall TK. Implementation of an audit with feedback knowledge translation intervention to promote medication error reporting in health care: a protocol. Implement Sci. 2015;10:70. [DOI]
- Spencer CS, Roberts ET, Gaskin DJ. Differences in the rates of patient safety events by payer: implications for providers and policymakers. Med Care. 2015;53(6):524-9. [DOI]
- Fargen KM, Neal D, Blackburn SL, Hoh BL, Rahman M. Health disparities and stroke: the influence of insurance status on the prevalence of patient safety indicators and hospital-acquired conditions. J Neurosurg. 2015;122(4):870-5. [DOI]
- Saravi BM, Mardanshahi A, Ranjbar M, Siamian H, Azar MS, Asghari Z, et al. Rate of medical errors in affiliated hospitals of mazandaran university of medical sciences. Mater Sociomed. 2015;27(1):31-4. [DOI]
- Pugel AE, Simianu VV, Flum DR, Patchen Dellinger E. Use of the surgical safety checklist to improve communication and reduce complications. J Infect Public Health. 2015;8(3):219-25. [DOI]
- World Health Organization. Word Alliance for Patient Safety. Guidelines for safe surgery: safe surgery saves lives [Internet]. Geneva; 2009 [cited 2013 Feb 22].
- Pooreh S, Hosseini Nodeh Z. Impact of education based on theory of planned behavior: an investigation into hypertension-preventive self-care behaviors in Iranian girl adolescent. Iran J Public Health. 2015;44(6):839-47.
- Faqah A, Moiz B, Shahid F, Ibrahim M, Raheem A. Assessment of blood donation intention among medical students in Pakistan--An application of theory of planned behavior. Transfus Apher Sci. 2015;53(3):353-9. [DOI]