Contribution of PCA/K-means methods to the mixed assessment of patient safety culture

Abstract

PurposeThe assessment of patient safety culture (PSC) is a major priority for healthcare providers. It is often realized using quantitative approaches (questionnaires) separately from qualitative ones (patient safety culture maturity model (PSCMM)). These approaches suffer from certain major limits. Therefore, the aim of the present study is to overcome these limits and to propose a novel approach to PSC assessment.Design/methodology/approachThe proposed approach consists of evaluating PSC in a set of healthcare establishments (HEs) using the HSOPSC questionnaire. After that, principal component analysis (PCA) and K-means algorithm were applied on PSC dimensional scores in order to aggregate them into macro dimensions. The latter were used to overcome the limits of PSC dimensional assessment and to propose a quantitative PSCMM.FindingsPSC dimensions are grouped into three macro dimensions. Their capitalization permits their association with safety actors related to PSC promotion. Consequently, a quantitative PSC maturity matrix was proposed. Problematic PSC dimensions for the studied HEs are “Non-punitive response to error”, “Staffing”, “Communication openness”. Their PSC maturity level was found underdeveloped due to a managerial style that favors a “blame culture”.Originality/valueA combined quali-quantitative assessment framework for PSC was proposed in the present study as recommended by a number of researchers but, to the best of our knowledge, few or no studies were devoted to it. The results can be projected for improvement and accreditation purposes, where different PSC stakeholders can be implicated as suggested by international standards.

Emergence of joint health and safety committees in Algerian companies: an exploratory study

“…Their involvement is measured by the importance they give to regulatory requirements related to JHSCs. In this context, Fourar et al (2021) emphasizes that IJHG 27,4 management commitment in an Algerian company must be communicated at all levels in order to create an "integrated" OHS culture.…”

International Journal of Health Governance review: 26.2

“…Improving assessment of patient safety in Algerian hospitals (from Fourar et al, 2021) Creating a culture of patient safety has been a major priority in modern health care since the publication of the report "To Err is Human" (Institute of Medicine, 1999). Evaluating patient safety culture (PSC) is often approached from a quantitative perspective.…”

“…Evaluating patient safety culture (PSC) is often approached from a quantitative perspective. Qualitative models are not well integrated into this numerical mind-set according to Fourar et al (2021).…”

“…Changes usually involve measures such as transparency in auditing, review of current research, developing interprofessional training and instituting effective supervision. Fourar et al (2021) used a validated tool set to carry out a mixed-method quality evaluation of PSC across a number of major Algerian hospitals. The PSC dimensions they examined were "predisposing factors", "facilitating factors" and "reinforcing factors".…”