Issues and complexities in safety culture assessment in healthcare

Abstract

The concept of safety culture in healthcare—a culture that enables staff and patients to be free from harm—is characterized by complexity, multifacetedness, and indefinability. Over the years, disparate and unclear definitions have resulted in a proliferation of measurement tools, with lack of consensus on how safety culture can be best measured and improved. A growing challenge is also achieving sufficient response rates, due to “survey fatigue,” with the need for survey optimisation never being more acute. In this paper, we discuss key challenges and complexities in safety culture assessment relating to definition, tools, dimensionality and response rates. The aim is to prompt critical reflection on these issues and point to possible solutions and areas for future research.

The anatomy of safe surgical teams: an interview-based qualitative study among members of surgical teams at tertiary referral hospitals in Norway

“…This knowledge clarifies that support when an adverse event occurs is essential to prevent negative emotions such as anxiety and fear of future adverse events that influence cognitive functions [ 17 ]. This study added weight to the suggestion that healthcare professionals’ well-being may affect patient safety [ 38 , 44 , 45 ]. A previous review and this study highlighted the absence of structured peer support and debriefing after an adverse event [ 43 ].…”

“…Likewise, there could be justifications for exploring patients’ perceptions and experiences regarding adverse events. Finally, leaders should promote proactive learning from successful pathways for a positive learning perspective because of the high number of successful surgical procedures [ 38 , 44 , 48 ]. Focusing on success and learning from excellence represent a new paradigm of safety, described as the ‘safety 2-perspective’ and ‘resilience engineering’ in the literature [ 48 – 50 ].…”

Exploring the fear of clinical errors: associations with socio-demographic, professional, burnout, and mental health factors in healthcare workers – A nationwide cross-sectional study

“…Unlike previous approaches that primarily focus on the identification and documentation of errors, this approach emphasizes gaining an understanding the internal experiences and perceptions of HCW. The fear of error has been overlooked in patient safety culture assessments, and could provide valuable insights into both working conditions and the psychological state of HCW ( 8 , 9 ). Fear of clinical error could serve as an indicator of the pressures and challenges HCW face, which also pose a threat to patient safety.…”