Healthcare professionals’ perspectives on working conditions, leadership, and safety climate: a cross-sectional study

Abstract

BackgroundPromoting patient and occupational safety are two key challenges for hospitals. When aiming to improve these two outcomes synergistically, psychosocial working conditions, leadership by hospital management and supervisors, and perceptions of patient and occupational safety climate have to be considered. Recent studies have shown that these key topics are interrelated and form a critical foundation for promoting patient and occupational safety in hospitals. So far, these topics have mainly been studied independently from each other. The present study investigated hospital staffs’ perceptions of four different topics: (1) psychosocial working conditions, (2) leadership, (3) patient safety climate, and (4) occupational safety climate. We present results from a survey in two German university hospitals aiming to detect differences between nurses and physicians.MethodsWe performed a cross-sectional study using a standardized paper-based questionnaire. The survey was conducted with nurses and physicians to assess the four topics. The instruments mainly consisted of scales of the German version of the COPSOQ (Copenhagen Psychosocial Questionnaire), one scale of the Copenhagen Burnout Inventory (CBI), scales to assess leadership and transformational leadership, scales to assess patient safety climate using the Hospital Survey on Patient Safety Culture (HSPSC), and analogous items to assess occupational safety climate.ResultsA total of 995 completed questionnaires out of 2512 distributed questionnaires were returned anonymously. The overall response rate was 39.6%. The sample consisted of 381 physicians and 567 nurses. We found various differences with regard to the four topics. In most of the COPSOQ and the HSPSC-scales, physicians rated psychosocial working conditions and patient safety climate more positively than nurses. With regard to occupational safety, nurses indicated higher occupational risks than physicians.ConclusionsThe WorkSafeMed study combined the assessment of the four topics psychosocial working conditions, leadership, patient safety climate, and occupational safety climate in hospitals. Looking at the four topics provides an overview of where improvements in hospitals may be needed for nurses and physicians. Based on these results, improvements in working conditions, patient safety climate, and occupational safety climate are required for health care professionals in German university hospitals – especially for nurses.Electronic supplementary materialThe online version of this article (10.1186/s12913-018-3862-7) contains supplementary material, which is available to authorized users.

Hospital Survey on Patient Safety Culture (HSPSC): a systematic review of the psychometric properties of 62 international studies

“…Previous work, for example, has shown that physicians report higher levels of PSC when there is good teamwork across units and a unit-level management that promotes PSC 31. Nursing staff, by contrast, are more likely to report higher levels of PSC safety when they feel that there is enough staff in the unit 31–33. In addition to these concerns, the psychometric properties of PSC instruments may be affected by other factors such as national culture 34.…”

Relationship of patient safety culture with factors influencing working environment such as working hours, the number of night shifts, and the number of days off among healthcare workers in Japan: a cross-sectional study

“…Some studies have suggested that working environment deterioration of healthcare workers is associated with an increase in the number of event reports [11,12]; however, few studies have examined the influence of working hours, the number of night shifts, and the number of days off on patient safety culture. Working environment associated with each profession may affect patient safety culture differently because each profession has different working environment characteristics [13][14][15].…”

Assessing the quality of medication documentation: development and feasibility of the MediDocQ instrument for retrospective chart review in the hospital setting

“…The instrument development process described here was part of the larger research project ‘Working conditions, safety culture and patient safety in hospitals—what predicts the safety of the medication process?’ (WorkSafeMed) that examined the associations between frontline staff perceptions of working conditions, patient safety, occupational safety climate and patient safety outcomes. WorkSafeMed was a cross-sectional study conducted between 2014 and 2017 in two German university hospitals 37…”