Safety Culture and Patient Safety Outcomes in East Asia: A Literature Review

Abstract

This review examined associations between safety culture aspects and patient safety outcomes in East Asian hospitals and identified relevant research priorities. Using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines, 16 articles were identified for review. Patient safety nursing activity was the most commonly investigated outcome in relation to safety culture aspects. Among safety culture aspects, feedback and communication, frequency of event reporting, teamwork within units, and managers’ support for patient safety were most significantly related to patient safety outcomes. Areas for further research include the use of theory or theoretical frameworks, consensus upon the scoring strategies for computation of safety culture scores, and selecting appropriate units of analysis and statistical analyses. Finally, researchers should examine relations between unit-specific and nation-specific safety culture and patient safety outcomes, given the influence of cultural attitudes and behaviors on patient safety.

Comparative Studies on Patient Safety Culture to Strengthen Health Systems Among Southeast Asian Countries

“…The status of patient cultural safety in Southeast Asian countries was highlighted in this review. Most studies used either the HSOPSC or the SAQ to measure safety culture, which mirrored previous findings ( 11 ). Ten Vietnamese hospitals used the HSOPSC, and the average percentage outcome for safety culture was positive (58.9%), which was less than that reported among American hospitals ( 16 ).…”

“…In contrast, patient safety culture was recognized as a key factor to improve patient safety ( 10 ) and quality of care in healthcare organizations, and the creation of safety culture was the first approach to guide healthcare providers into patient safety. Patient safety is explained as “the product of individual and group values, attitudes, perceptions, competencies, and patterns of behavior that determine the commitment to, and the style and proficiency of, and organization's health and safety management;” however, the measurement of patient safety has varied in previous research and several recommendations have been made to develop a standard measurement tool on patient safety ( 11 ).…”

Adaptation and validation of a Korean-language version of the revised hospital survey on patient safety culture (K-HSOPSC 2.0)

“…Healthcare organizations in Korea have made attempts to assess safety culture, but there has been no universal, validated tool for this purpose. Although translations of the original HSOPSC 1.0 or its modified versions have been commonly used to measure patient safety culture in Korea [6], the authors of those studies have failed to identify the instrument's psychometric properties [7]. Moreover, a recent psychometric evaluation of the Korean version of the HSOPSC 1.0 [8] revealed that six of the 12 dimensions had internal consistency values below 0.70, with the lowest four Cronbach's alphas ranging from 0.31 to 0.55.…”

Philippine professional core competencies’ impact on nurses’ key performance indicators (KPIs) for patient safety outcomes

“…Furthermore, Sholl et al, (2019) claimed that staff nurses' lack of competence and professionalism creates a great impact on the patients' safety in terms of physical, emotional and psychological aspects. Openness in communication is statistically significant with an enhancement of safety culture and that the patients must demonstrate active engagement in this process (Ansari et al, 2019;Chegini et al, 2019;Lee and Quinn, 2019). Communication in clinical settings is so vital that it must be practiced in all areas of care plans including medication management, such as medical reconciliation even in complex areas (Manias et al, 2019;Martyn et al, 2019;Stark et al, 2019).…”