Document Type : Original Article
Department of Business Administration, National Changhua University of Education, Changhua City, Taiwan
School of Business Administration, Hubei University of Economics, Wuhan City, People’s Republic of China
Department of Health Business Administration, Hung Kuang University, Taichung City, Taiwan
School of Health Policy and Management, Chung Shan Medical University, Taichung City, Taiwan
Quality Management Center, Shanghai Changtai Medical Technology Co. Ltd., Shanghai, People’s Republic of China
Background: The issues of patient safety and healthcare quality have become increasingly important around the world since the 1990s. Many hospitals manage to reduce the number of adverse events (AEs) that can threaten patient safety in healthcare organizations. Assessing the existing patient safety culture gives hospital management a clear vision of an organization’s strengths and weaknesses. The Safety Attitudes Questionnaire, with its good psychometric properties and great internal consistency, has been used extensively to assess the patient safety culture in healthcare organizations.
Objective: Physicians and nurses form the core staff of each organization. With different demographic variables, they might perceive patient safety culture differently. This study purposed to identify critical demographic variables from the viewpoints of physicians and nurses that significantly influence the patient safety culture in a regional teaching hospital in Taiwan.
Methods: Linear regression with forward selection was employed in this study to focus on all physicians and nurses using results of a 2015 internal survey in the case hospital. Ten demographic variables were the independent variables, and seven dimensions of the Chinese version of the Safety Attitudes Questionnaire were dependent variables.
Results: Four out of 10 demographic variables had significant impacts on 6 out of 7 dimensions (with the exception of emotional exhaustion) from the Safety Attitudes Questionnaire. “Supervisor/manager” and “experience in position” followed by “age” were viewed by physicians and nurses as the most critical variables affecting the patient safety culture in this regional teaching hospital in Taiwan.
Conclusion: Assessing an organization’s current patient safety culture provides a significant value to improving patient safety. This study revealed that “supervisor/manager” and “experience in position” are the 2 most important demographic variables influencing the patient safety culture. Hospital management should take heed of the suggestions of staff members regarding these characteristics to continuously enhance their patient safety culture.
- Zegers M, de Bruijne MC, Wagner C, et al. Adverse events and potentially preventable deaths in Dutch hospitals: results of a retrospective patient record review study. Qual Saf Health Care. 2009;18(4):297-302. doi:10.1136/qshc.2007.025924.
- Abdou HA. Saber KM. A baseline assessment of patient safety culture among nurses at student university hospital. World J Med Sci. 2011;6(1):17-26.
- Yang CC, Wang YS, Chang ST, Guo SE, Huang MF. A study on the leadership behavior, safety culture, and safety performance of the healthcare industry. Int J Soc Behav Educ Econ Bus Ind Eng. 2009;3(5):546-553.
- Nieva VF, Sorra J. Safety culture assessment: a tool for improving patient safety in healthcare organizations. Qual Saf Health Care. 2003;12(suppl 2):17-23.
- Ulrich B, Kear T. Patient safety and patient safety culture: Foundations of excellent health care delivery. Nephrol Nurs J. 2014;41(5):447-456.
- Singer S. Lin S. Falwell A. Gaba D. Baker L. Relationship of safety climate and safety performance in hospitals. Health Serv Res. 2009;44(2 pt 1):399-421. doi:10.1111/j.1475-6773.2008.00918.x.
- Sexton JB, Helmreich RL, Neilands TB, et al. The safety attitudes questionnaire: Psychometric properties, benchmarking data, and emerging research. BMC Health Serv Res. 2009;6:44. doi:10.1186/1472-6963-6-44.
- Zenere A, Zanolin ME, Negri R, et al. Assessing safety culture in NICU: psychometric properties of the Italian version of safety attitude questionnaire and result implications. J Eval Clin Pract. 2015;22(2):275-282. doi:10.1111/jep.12472.
- Nguyen G, Gambashidze N, Ilyas SA, Pascu D. Validation of the safety attitudes questionnaire (short form 2006) in Italian in hospitals in the northeast of Italy. BMC Health Serv Res. 2015;15:284. doi:10.1186/s12913-015-0951-8.
- 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.
- Kaya S, Barsbay S, Karabulut E. The Turkish version of the safety attitudes questionnaire: psychometric properties and baseline data. Qual Saf Health Care. 2010;19(6):572-577. doi:10.1136/qshc.2008.032003.
- Devriendt E, Van den Heede K, Coussement J, et al. Content validity and internal consistency of the Dutch translation of the safety attitudes questionnaire: An observational study. Int J Nurs Stud. 2012;49:327-337. doi:10.1016/j.ijnurstu.2011.10.002.
- Göras C, Wallentin FY, Nilsson U, Ehrenberg A. Swedish translation and psychometric testing of the safety attitudes questionnaire (operating room version). BMC Health Serv Res. 2013;13:104. doi:10.1186/1472-6963-13-104.
- Hamdan H. Measuring safety culture in Palestinian neonatal intensive care units using the safety attitudes questionnaire. J Crit Care. 2013;28:886.e7–886.e14.
- Lee YC, Wu HH, Hsieh WL, Weng SJ, Hsieh LP, Huang CH. Applying importance-performance analysis to patient safety culture. Int J Health Care Qual Assur. 2015;28(8):826-840. doi:10.1108/IJHCQA-03-2015-0039.
- Lee YC, Chi CY, Huang CS, Wu HH. Identifying critical demographic variables that affect the Chinese version of the safety attitudes questionnaire in a regional teaching hospital in Taiwan. 6th International Conference on Application of Information and Communication Technology and Statistics in Economy and Education (ICAICTSEE – 2016); 2016:FA-04.
- Lee YC, Weng SJ, Huang CH, Hsieh WL, Wu HH. Analyzing emotional exhaustion from viewpoints of physicians and nurses – A case of a regional teaching hospital. TEM J. 2016;5(2):231-235. doi:10.18421/TEM52-17.
- Lee YC, Huang SC, Huang CH, Wu HH. A new approach to identify high burnout medical staffs by kernel k-means cluster analysis in a regional teaching hospital in Taiwan. Inquiry. 2016;53. doi:10.1177/0046958016679306.
- Kim J, An K, Kim MK, Yoon SH. Nurses’ perception of error reporting and patient safety culture in Korea. West J Nurs Res. 2007;29(7):827-844.
- Karagiannopoulos M, Anyfantis D, Kotsiantis SB, Pintelas PE. Feature selection for regression problems. Proceedings of the 8th Hellenic European Research on Computer Mathematics & Its Applications (HERCMA ’07); 2007:20-22.
- 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(5):1999-2021. doi:10.1111/j.1475-6773.2007.00706.x.
- El-Jardali F, Dimassi H, Jamal D, Jaafar M, Hemadeh N. Predictors and outcomes of patient safety culture in hospitals. Health Serv Res. 2011;11:45. doi:10.1186/1472-6963-11-45.
- Barling J, Loughlin C, Kelloway EK. Development and test of a model linking safety-speciﬁc transformational leadership and occupational safety. J Appl Psychol. 2002;87:488-496.
- Clarke S, Ward K. The role of leader influence tactics and safety climate in engaging employees’ safety participation. Soc Risk Anal. 2006;26(5):1175-1185. doi:10.1111/j.1539-6924.2006.00824.x.
- Kahter WA, Akhu-Zaheya LM, Al-Mahasneh SI, Khater R. Nurses’ perceptions of patient safety culture in Jordanian hospitals. Int Nurs Rev. 2015;62(1):82-91. doi:10.1111/inr.12155.
- Gallego B, Westbrook MT, Dunn AG, Braithwaite J. Investigating patient safety culture across a system: multilevel modelling of differences associated with service types and staff demographics. Int J Qual Health Care. 2012;24(4):311-320. doi:10.1093/intqhc/mzs028.