Analysis of Affecting Factors on Patient Safety Culture in Public and Private Hospitals in Iran

Abstract

Background: Patient safety culture is one of the main components of the quality of health services and is one of the main priorities of health studies. Considering the importance of this issue, this study aimed to determine and compare the views of health care staff on the patients’ safety culture and impact of effective factors on patient safety culture in public and private hospitals in Tehran, Iran. Methods: This cross-sectional study was carried out on a sample of 1203 health care workers employed in three public and three private hospitals in Tehran, Iran. Stratified random sampling was used in this study. Data were collected using maslach burnout inventory and patient safety culture questionnaire (HSOPSC). IBM SPSS v22 and Amos v23 were used to perform path analysis. Results: 867 (72.57%) females and 747 (27.43%) males with a mean age of 33.88 ± 7.66 were included. The average percentage of positive responses to safety culture questionnaire in public and private hospitals was 65.5% and 58.3%, respectively. The strengths of patient safety culture in public hospitals were in three dimensions including non-punitive response to errors (80%), organizational learning—continuous improvement (79.77%), and overall perceptions of patient safety (79.77%), and in private hospitals, were three dimensions including non-punitive responses to errors (71.41%), organizational learning—continuous improvement (69.24%), and teamwork within units (62.35%). The type of hospital and work-shift hours had an effect on the burnout and patient safety questionnaire scores (P-value <0.05). The path analysis results indicate the fitness of the proposed model (RMSEA= 0.024). The results showed a negative impact of work shift (β= -0.791), occupational burnout (β= -0.554) and hospital type (β= -0.147) on the observance of patient safety culture. Conclusion: providing feedback on errors and requirements for the frequent incident reporting, and patient information exchange seem necessary to promote the patient's safety culture. Also, considering the negative impact of the shift work and burnout on patient safety culture, by planning and managing these factors appropriately, correct actions could be designed to improve the safety culture.

Existing perception of Patient safety among health personnel in operating room at CHICH (Children Hospital & Institute of Child Health, Lahore.

“…3 Positive response rate of this study showed much better results when compared to developed countries such as 60% to 80% in Norway, USA, Egypt and China. 13 The dimensions, "Personal attitude to Patient safety" and "Personnel influence over the safety", showed highest positive response among all cadres (88% and 67%) respectively.…”

“…Is also provides a clear overview of the patient safety aspects that require more attention. 13,14,15 A number of researches have been conducted on patient safety in recent years. In current study, the four HCP's were included and all had different response rate on 5 dimensions.…”

Organizational Factors in Implementation of Patient Safety Culture in Hospitals: Systematic Literature Review

“…The workload that is not balanced with the number of nurses in the room as happened in Iran and Jordan affects the application of patient safety cultural values. Research conducted by Khoshakhlagh et al, (2019) describes the negative impacts of excessive shift work, namely reduced compliance and quality of patient safety, double fatigue from work shifts, and increased medical errors. This negative impact has a direct impact on the implementation of a patient safety culture when increases burnout.…”

“…The imbalance between the number of health workers and the workload has a negative impact on patients and nurses. The negative impacts of overwork are reduced compliance and quality of patient safety, double fatigue from work shifts, and increased medical errors (Khoshakhlagh et al, 2019).…”

Relações Entre Ciência E Técnica Na Enfermagem: Reflexão Filosófica

“…Ao verificar "O Aprendizado organizacional e melhoria contínua", é corroborado uma porcentagem alta nesta dimensão, o mesmo foi identificado em estudo realizado no Irã, com 79,77% de respostas positivas, apresentando-se como a melhor dimensão avaliada neste estudo (KHOSHAKHLAGH et al, 2019). Os bons resultados se devem aos programas de educação permanente desenvolvida por profissionais de saúde que buscam identificar a presença de uma cultura de aprendizagem, na qual os erros são notificados, averiguados e revertidos em alterações positivas que levam a melhorias da assistência, e mostrou-se como uma das melhores avaliações positivas.…”