What Does a Hospital Survey on Patient Safety Reveal About Patient Safety Culture of Surgical Units Compared With That of Other Units?

Abstract

The objective of this study was to examine the strengths and weaknesses of surgical units as compared with other units, and to provide an opportunity to improve patient safety culture in surgical settings by suggesting targeted actions using Hospital Survey on Patient Safety Culture (HSOPSC) investigation.A Hospital Survey on Patient Safety questionnaire was conducted to physicians and nurses in a tertiary hospital in Shandong China. 12 patient safety culture dimensions and 2 outcome variables were measured.A total of 23.5% of respondents came from surgical units, and 76.5% worked in other units. The “overall perceptions of safety” (48.1% vs 40.4%, P < 0.001) and “frequency of events reported” (63.7% vs 60.7%, P = 0.001) of surgical units were higher than those of other units. However, the communication openness (38.7% vs 42.5%, P < 0.001) of surgical units was lower than in other units. Medical workers in surgical units reported more events than those in other units, and more respondents in the surgical units assess “patient safety grade” to be good/excellent. Three dimensions were considered as strengths, whereas 5 other dimensions were considered to be weaknesses in surgical units. Six dimensions have potential to aid in improving events reporting and patient safety grade. Appropriate working times will also contribute to ensuring patient safety. Medical staff with longer years of experience reported more events.Surgical units outperform the nonsurgical ones in overall perception of safety and the number of events reported but underperform in the openness of communication. Four strategies, namely deepening the understanding about patient safety of supervisors, narrowing the communication gap within and across clinical units, recruiting more workers, and employing the event reporting system and building a nonpunitive culture, are recommended to improve patient safety in surgical units in the context of 1 hospital.

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

“…The Chinese version of the HSOPSC was previously validated for paper distribution in our previous study [ 26 ]. The HSOPSC comprised 42 items, and the participants responded to the items on a five-point Likert scale ranging from “strongly disagree” to “strongly agree” or from “never” to “always”.…”

“…Several studies measured surgical settings, particularly in China, using the HSOPSC. Our previous study [ 26 ] evaluated the patient safety culture in a surgical unit relative to that in other units on the basis of the HSOPSC, but we conducted the study in only one tertiary hospital. The research into safety culture in surgical units and operating rooms provides a reference for other departments.…”

A Longitudinal Study of Assessing the Patient Safety Culture from Nurses’ Viewpoints Based on the Safety Attitudes Questionnaire in Taiwan

“…In order to relentlessly improve patient safety, Shu et al [1] stated that building a patient safety culture is an essential issue in any healthcare systems and hospitals. Patient safety should be started with the enforcement of the system safety of healthcare organizations and an organization's safety culture is a fundamental factor that influences the system safety [2].…”

“…Establishing a positive patient safety culture indicates healthcare organizations strive to improve relentlessly [3]. In addition, a positive patient safety culture improves healthcare organizations' patient safety performance and safety outcomes and shows that organizations place the patient safety culture as one of their highest priorities [1], [4], [5]. Aghdash et al [6] further stated that patient safety is a critical element for healthcare organizations that should be measured in a regular basis to improve patient safety.…”

A percepção de profissionais de saúde sobre cultura de segurança do paciente em hospital universitário

“…Como "áreas frágeis" na instituição, a partir do critério utilizado neste estudo (valores menores que 50% de respostas positivas), foram identificadas as seguintes dimensões: "Apoio da gestão para segurança do paciente" (40,1%), "Percepção geral da segurança do paciente" (46,2%), "Retroalimentação da informação e comunicação sobre erro" (49,4%), "Trabalho em equipe entre as unidades" (46,1%), "Adequação de profissionais" (37,7%), "Passagem de plantão ou de turno/transferências" (49,3%) e "Respostas não punitivas aos erros" (22,9%). A AHRQ, em conjunto com uma organização de enfermagem, articulou algumas ações para o desenvolvimento de uma CS do paciente, incluindo: apoiar o desenvolvimento e a implementação de um programa de segurança do paciente em toda a organização; projetar sistemas e procedimentos clínicos seguros; monitorar atividades clínicas para identificar riscos esperados e inesperados; incentivar um ambiente de notificação de EA não punitivos e com recompensas para os relatos das práticas inseguras; realizar pesquisas de segurança; e garantir que a equipe seja devidamente competente e treinada em relação à segurança do paciente (HUGHES, 2008 (SHU et al, 2015;SANTIAGO;TURRINI, 2015;AL-MANDHARI et al, 2014;EL-JARDALI et al, 2014;REIS, 2013;HAMDAN;SALEEM, 2013;ALAHMADI, 2010). Vale ressaltar a extrema necessidade de melhoria em relação à cultura de culpabilização, o "medo da culpa" por parte dos profissionais deve ser desmitificado dentro das instituições de saúde.…”