Influence of Gender, Profession, and Managerial Function on Clinicians’ Perceptions of Patient Safety Culture: A Cross-National Cross-Sectional Study

Abstract

Objectives In recent years, several instruments for measuring patient safety culture (PSC) have been developed and implemented. Correct interpretation of survey findings is crucial for understanding PSC locally, for comparisons across settings or time, as well as for planning effective interventions. We aimed to evaluate the influence of gender, profession, and managerial function on perceptions of PSC and on the interplay between various dimensions and perceptions of PSC. Methods We used German and Swiss survey data of frontline physicians and nurses (n = 1786). Data analysis was performed for the two samples separately using multivariate analysis of variance, comparisons of adjusted means, and series of multiple regressions. Results Participants’ profession and managerial function had significant direct effect on perceptions of PSC. Although there was no significant direct effect of gender for most of the PSC dimensions, it had an indirect effect on PSC dimensions through statistically significant direct effects on profession and managerial function. We identified similarities and differences across participant groups concerning the impact of various PSC dimensions on Overall Perception of Patient Safety . Staffing and Organizational Learning had positive influence in most groups without managerial function, whereas Teamwork Within Unit , Feedback & Communication About Error , and Communication Openness had no significant effect. For female participants without managerial functions, Management Support for Patient Safety had a significant positive effect. Conclusions Participant characteristics have significant effects on perceptions of PSC and thus should be accounted for in reporting, interpreting, and comparing results from different samples.

Simulation-based training improves patient safety climate in acute stroke care (STREAM)

“…Interestingly, nurses benefited most from the trial intervention in terms of perceived patient safety (3.19 ± .62 vs. 3.78 ± .54, p = .002) resulting in slightly higher scores than physicians in the post-interventional phase. Similar results were found elsewhere [ 20 , 21 ]. Why nurses are more sensitive to perceive deficits in patient safety has not yet been further evaluated.…”

Measuring Patient Safety Climate in Acute Stroke Therapy

“…Concerning results for individual SAQ factors in our explorative analysis, physicians scored higher than nurses in most items, especially in items concerning teamwork climate (3.84 ± 0.52 vs. 3,58 ± 0.62, p = 0.032) and stress recognition (3.97 ± 0.75 vs. 3.17 ± 0.92, p < 0.001), where higher scores indicate a better sensitivity for the impact of stress (Figure 1). Similar results were found elsewhere (25,26). These might indicate different perceptions of teamwork and stress identify nurses as a particularly vulnerable group.…”

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

“…The large variability in terms of the reliability and validity of the HSPSC across our sample might be due to the influence of professional groups and other subcultures within healthcare 30 62. Many HSPSC items may be very differently interpreted and may elicit very different opinions among different healthcare groups (eg, nursing staff, physicians and managers31 63).…”

“…One explanation for low levels of reliability and validity may be the different interpretations of what constitutes a positive PSC among the diverse occupational groupings and subcultures involved in healthcare delivery 28–30. 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.…”

“…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.…”