Changing patient safety culture in China: a case study of an experimental Chinese hospital from a comparative perspective

Abstract

BackgroundThe World Health Organization highlights that patient safety interventions are not lacking but that the local context affects their successful implementation. Increasing attention is being paid to patient safety in Mainland China, yet few studies focus on patient safety in organizations with mixed cultures. This paper evaluates the current patient safety culture in an experimental Chinese hospital with a Hong Kong hospital management culture, and it aims to explore the application of Hong Kong’s patient safety strategies in the context of Mainland China.MethodsA quantitative survey of 307 hospital staff members was conducted using the Hospital Survey on Patient Safety Culture questionnaire. The findings were compared with a similar study on general Chinese hospitals and were appraised with reference to the Manchester Patient Safety Framework.ResultsLower scores were observed among participants with the following characteristics: males, doctors, those with more work experience, those with higher education, and those from the general practice and otolaryngology departments. However, the case study hospital achieved better scores in management expectations, actions and support for patient safety, incident reporting and communication, and teamwork within units. Its weaknesses were related to non-punitive responses to errors, teamwork across units, and staffing.ConclusionsThe case study hospital contributes to a changing patient safety culture in Mainland China, yet its patient safety culture remains mostly bureaucratic. Further efforts could be made to deepen the staff’s patient safety culture mind-set, to realize a “bottom-up” approach to cultural change, to build up a comprehensive and integrated incident management system, and to improve team building and staffing for patient safety.

Emergency medical staff’s perceptions on cultural value difference‐based teamwork issues: A phenomenological study in China

“…Interviewees expressed they would choose to be silent even when they had different opinions than their superiors. They feared punishment if they were to disagree with their superior's decisions, which is known as 'blame culture' (Jeppsson, Ostergren, & Hagstrom, 2003;Sakyi, Awoonor-Williams, & Adzei, 2011;Xu et al, 2018). In our study, nurses complained that some ED Clique Culture • Sometimes our nurses are very distressed.…”

What Do We Know About Teamwork in Chinese Hospitals? A Systematic Review

“…Mixed results are also found in terms of education level and age. Staff with a degree higher than bachelor score "communication openness" (42) and "teamwork across units" (46) significantly higher but "teamwork climate" significantly lower than those with an education level lower than bachelor (35,45). Staff younger than 25 years report significantly higher scores for "teamwork climate" than those older than 50 years in one study (45) but the opposite is found in another study (35).…”

“…The relationship between the input "profession" and team processes is inconclusive, although profession is researched the most in these studies. Two HSOPSC studies show that nurses score "communication openness" significantly higher than doctors (37,42), while two other HSOPSC studies find no significant differences between the ratings of doctors and nurses (36,46). Two SAQ studies find that doctors evaluate "teamwork climate" significantly more positively than nurses (35,45).…”

“…Sixteen studies explore the relationship between inputs and processes (32)(33)(34)(35)(36)(37)(38)(39)(40)(41)(42)(43)(44)(45)(46)(47). The majority of the articles in this subcategory are based on HSOPSC and SAQ (10 out of 16) (33, 35-37, 39, 40, 42, 44-46).…”

“…The input "gender" is found to influence team processes. Female staff perceive significantly better "communication openness" (42), "teamwork within units" (46), and "teamwork climate" (45) than male staff. The relationship between the input "profession" and team processes is inconclusive, although profession is researched the most in these studies.…”