How Does Patient Safety Culture in the Surgical Departments Compare to the Rest of the County Hospitals in Xiaogan City of China?

Abstract

Objectives: Patient safety culture affects patient safety and the performance of hospitals. The Hospital Survey on Patient Safety Culture (HSOPSC) is generally used to assess the safety culture in hospitals and unit levels. However, only a few studies in China have measured surgical settings compared with other units in county hospitals using the HSOPSC. This study aims to assess the strengths and weaknesses of surgical departments compared with all other departments in county hospitals in China with HSOPSC. Design: This research is a cross-sectional study. Methods: In 2015, a Chinese translation of HSOPSC was administered to 1379 staff from sampled departments from 19 county hospitals in Xiaogan City (Hubei Province, China) using a simple random and cluster sampling method. Outcome Measures: The HSOPSC was completed by 1379 participants. The percent positive ratings (PPRs) of 12 dimensions (i.e., teamwork within units, organizational learning and continuous improvement, staffing, non-punitive response to errors, supervisor/ manager expectations and actions promoting patient safety, feedback and communication about errors, communication openness, hospital handoffs and transitions, teamwork across hospital units, hospital management support for patient safety, overall perception of safety, as well as frequency of events reported) and the positive proportion of outcome variables (patient safety grade and number of events reported) between surgical departments and other departments were compared with t-tests and X2 tests, respectively. A multiple regression analysis was conducted, with the outcome dimensions serving as dependent variables and basic characteristics and other dimensions serving as independent variables. Similarly, ordinal logistic regression was used to explore the influencing factors of two categorical outcomes. Results: A total of 56.49% of respondents were from surgical departments. The PPRs for “teamwork within units” and “organizational learning and continuous improvement” were ≥75%, which denoted strengths, and the PPRs for “staffing” and “non-punitive response to errors” were ≤50%, which denoted weaknesses in surgical units and other units. Three dimensions for surgical departments were weaker than those for other departments (p < 0.05). The staff from surgical units reported more events compared with the other units, but only a few respondents in surgical settings evaluated patient safety grade as good/excellent. Four dimensions influenced patient safety grade, and three dimensions influenced event reporting in surgical units. Conclusions: Strategies including recruiting workers, using the reporting system, and building a non-punitive culture should be adopted in the surgical units of county hospitals in China to improve safety culture. Supervisors should also prioritise patient safety.

A cultura de segurança do paciente em um hospital público de urgência e emergência

“…Estas áreas estão relacionadas com os supervisores, que desempenham papel importante no auxílio das equipes quanto ao estabelecimento de uma cultura com qualidade e ambiente seguro. A boa liderança é um dos maiores incentivos para melhorar a comunicação e fortalecer a CS (Wang & Tao, 2017).…”

“…Nota-se grande preocupação dos profissionais de que os seus erros sejam registrados em seus arquivos ou que levem a algum tipo de punição, ainda que o hospital não estipule qualquer punição para os erros reportados. Há a crença de que eventos adversos relatados demonstram pouca habilidade, que leva à depreciação do cargo exercido, ferimento da honra ou diminuição na renda (Wang & Tao, 2017).…”

“…Por isso, necessita-se de constante respaldo da liderança em relação aos erros relatados e suas repercussões, com devolutivas sobre as tomadas de decisões. Atitudes e ações dos gestores contribuem diretamente para uma percepção positiva da segurança do paciente, recomendado a melhoria da comunicação entre gestão e equipe, na equipe e entre as equipes (Wang & Tao, 2017).…”

“…Em termos gerais, ainda está longe de uma excelência, pois revela várias áreas enfraquecidas e poucas consolidadas (Wang & Tao, 2017).…”

Quality Assurance and Patient Safety Measures: A Comparative Longitudinal Analysis

“…In several studies conducted in a different setting, front-line professionals were found to usually complain more about actions proposed by the directive staff [6]. Also, some studies have shown the sensibility of the safety culture measures to discriminate against the impact of positive actions to improve safety [19] In this case, we observe a similar pattern, although, curiously, there were not greater differences when comparing safety culture measures between quality coordinators and professionals working in smaller centers.…”