Safety Culture, Patient Safety, and Quality of Care Outcomes: A Literature Review

Lee, Seung Eun; Scott, Linda D.; Dahinten, V. Susan; Vincent, Catherine; Lopez, Karen V. Dunn; Park, Chang Gyu

doi:10.1177/0193945917747416

Cited by 92 publications

(104 citation statements)

References 44 publications

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“…Overall, positive organisational culture influences various elements of organisational behaviour, including healthcare quality and safety (Braithwaite, Herkes, Ludlow, Testa, & Lamprell, ; DiCuccio, ; Jacobs et al, ; Lee et al, ; Taylor, Clay‐Williams, Hogden, Braithwaite, & Groene, ). Implementation of PSC improves clinical practices; for example, the introduction of PSC has been linked to reductions in adverse events/errors (El‐Jardali, Dimassi, Jamal, Jaafar, & Hemadeh, ; Mardon, Khanna, Sorra, Dyer, & Famolaro, ; Robb & Seddon, ; Singer et al, ; Wang et al, ) and an improvement in certain clinician behaviours such as error reporting (Verbakel, Langelaan, Verheij, Wagner, & Zwart, ).…”

Section: Introductionmentioning

confidence: 99%

Changes in patient safety culture: A patient safety intervention for Finnish forensic psychiatric hospital staff

et al. 2019

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Aim To evaluate how a 3‐year patient safety intervention, more specifically, the implementation of a patient safety incident reporting system, influences patient safety culture. Background Positive patient safety culture improves both the quality of health care and patient safety. Nevertheless, nursing managers need tools that can help them develop and evaluate patient safety culture. Methods The Hospital Survey on Patient Safety Culture was used to evaluate patient safety culture at two Finnish forensic psychiatric hospitals (study and control) over two periods, baseline and follow‐up. Data were analysed using Z‐score and T test statistics. Results The follow‐up results from the study hospital showed that five patient safety culture dimensions exhibited a significantly (p < 0.05) positive change in positive response rates over the 3‐year period. Furthermore, nine out of twelve patient safety culture dimensions at the study hospital showed a significant improvement in mean score. At the control hospital, only the dimension of frequency of reporting events showed a significantly positive change (p < 0.05) in mean score. Conclusion This research shows that the studied patient safety intervention (implementation of the patient safety incident reporting system) significantly influences patient safety culture. Implications for Nursing Management Nursing managers should utilize a variety of patient safety interventions to improve patient safety and focus on leveraging information from patient safety incidents to advance patient safety culture.

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Section: Introductionmentioning

confidence: 99%

Changes in patient safety culture: A patient safety intervention for Finnish forensic psychiatric hospital staff

et al. 2019

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“…A comprehensive view of safety culture comprises both occupational and patient safety culture. Most studies, however, observed occupational and patient safety culture separately [for occupational safety culture see, e.g., [ 2 , 3 ] and for patient safety culture, e.g., [ 4 , 5 , 6 , 7 , 8 , 9 ]. Recently, several studies were conducted that included both constructs [ 10 , 11 , 12 , 13 , 14 ].…”

Section: Introductionmentioning

confidence: 99%

Do Occupational and Patient Safety Culture in Hospitals Share Predictors in the Field of Psychosocial Working Conditions? Findings from a Cross-Sectional Study in German University Hospitals

Wagner

Hammer

Manser

et al. 2018

IJERPH

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Background: In the healthcare sector, a comprehensive safety culture includes both patient care-related and occupational aspects. In recent years, healthcare studies have demonstrated diverse relationships between aspects of psychosocial working conditions, occupational, and patient safety culture. The aim of this study was to consider and test relevant predictors for staff’s perceptions of occupational and patient safety cultures in hospitals and whether there are shared predictors. From two German university hospitals, 381 physicians and 567 nurses completed a questionnaire on psychosocial working conditions, occupational, and patient safety culture. Two regression models with predictors for occupational and patient safety culture were conceptually developed and empirically tested. In the Occupational Safety Culture model, job satisfaction (β = 0.26, p ≤ 0.001), work‒privacy conflict (β = −0.19, p ≤ 0.001), and patient-related burnout (β = −0.20, p ≤ 0.001) were identified as central predictors. Important predictors in the Patient Safety Culture model were management support for patient safety (β = 0.24, p ≤ 0.001), supervisor support for patient safety (β = 0.18, p ≤ 0.001), and staffing (β = 0.21, p ≤ 0.001). The two models mainly resulted in different predictors. However, job satisfaction and leadership seem to play an important role in both models and can be used in the development of a comprehensive management of occupational and patient safety culture.

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“…There has been fairly extensive research into the effects of safety culture on patient safety in healthcare organizations internationally, but these effects are not yet clearly understood. To improve understanding of the relationships it has been recommended that researchers consider using a theoretical framework and give more attention to the use of valid measures and appropriate analytic approaches (Groves, 2014; Lee et al, 2019).…”

mentioning

confidence: 99%

“…Among the five studies we identified that investigated the perspectives of healthcare professionals on safety culture and overall patient safety in various countries (Alswat et al, 2017; Ammouri et al, 2015; El‐Jardali et al, 2011; Saleh et al, 2015; Wang & Tao, 2017), only one used multilevel modeling (i.e., Wang & Tao, 2017), although they all drew participants from multiple hospitals. Similarly, a review of 17 international studies of safety culture and patient safety outcomes found great variation in the level of analysis, with data analyzed at the individual level in five studies, at the unit level in five studies, at both the individual and unit levels in three studies, and at the hospital level in four studies (Lee et al, 2019). Thus, too few studies of safety culture have employed multilevel modeling.…”

mentioning

confidence: 99%

The Enabling, Enacting, and Elaborating Factors of Safety Culture Associated With Patient Safety: A Multilevel Analysis

Lee

Dahinten

2020

J of Nursing Scholarship

Self Cite

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Purpose Worldwide, 1 in 10 hospital patients is harmed while receiving care. Despite evidence that a culture of safety is associated with greater patient safety, these effects and the processes by which safety culture impacts patient safety are not yet clearly understood. Therefore, the purpose of this study was to examine the effects of various safety culture factors on nurses’ perceptions of patient safety using an innovative theoretical model. Design This descriptive, correlational study drew on deidentified, publicly available data from the 2018 Agency for Healthcare Research and Quality Hospital Survey on Patient Safety Culture. The study sample included 34,514 nurses who provided direct care to patients in medical and surgical units in 535 hospitals in the United States. Methods Multilevel linear regression was used to examine the effects of 11 safety culture factors on nurses’ overall perceptions of patient safety. The 11 safety culture factors were grouped as enabling, enacting, and elaborating processes, and entered in separate blocks. Findings All 11 safety culture factors were associated with nurse‐perceived patient safety, and all but two of the 11 factors uniquely predicted nurse‐perceived patient safety. Staffing adequacy was the strongest predictor of nurse‐perceived patient safety, followed by hospital management support for patient safety (both enabling processes), and continuous organizational learning and improvement (an elaborating process). Conclusions Hospital administrators and managers play a key role in promoting a safety culture and patient safety in healthcare organizations through enabling and elaborating processes. Clinical Relevance Organizational efforts should be made to provide sufficient staffing and hospital‐wide support for patient safety. However, all staff, administrators, and managers have a role to play in patient safety.

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Safety Culture, Patient Safety, and Quality of Care Outcomes: A Literature Review

Cited by 92 publications

References 44 publications

Changes in patient safety culture: A patient safety intervention for Finnish forensic psychiatric hospital staff

Changes in patient safety culture: A patient safety intervention for Finnish forensic psychiatric hospital staff

Do Occupational and Patient Safety Culture in Hospitals Share Predictors in the Field of Psychosocial Working Conditions? Findings from a Cross-Sectional Study in German University Hospitals

The Enabling, Enacting, and Elaborating Factors of Safety Culture Associated With Patient Safety: A Multilevel Analysis

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