Background
Methods
Questionnaire
Data analyses
Results
Number of respondents | Number of units | ||||
---|---|---|---|---|---|
n | (%) | n | (%) | ||
Location of hospital | Urban area | 5,999 | (69.0) | 291 | (66.1) |
Rural area | 2,701 | (31.0) | 149 | (33.9) | |
Type of hospital | Acute care | 7,603 | (87.4) | 384 | (87.3) |
Long-term care or mixed-care | 1,097 | (12.6) | 56 | (12.7) | |
Number of beds | <200 beds | 1,359 | (15.6) | 75 | (17.0) |
200-499 beds | 3,715 | (42.7) | 199 | (45.2) | |
≥500 beds | 3,626 | (41.7) | 166 | (37.7) | |
Unit type | General ward | 2,279 | (26.2) | 93 | (21.1) |
Physicians' unit†
| 777 | (8.9) | 67 | (15.2) | |
Administration unit | 1,017 | (11.7) | 57 | (13.0) | |
Outpatient unit | 548 | (6.3) | 19 | (4.3) | |
Clinical laboratory or physiology unit | 237 | (2.7) | 17 | (3.9) | |
Long-term care ward | 364 | (4.2) | 17 | (3.9) | |
Dietary unit | 250 | (2.9) | 16 | (3.6) | |
Rehabilitation unit | 379 | (4.4) | 16 | (3.6) | |
Pharmaceutical unit | 214 | (2.5) | 13 | (3.0) | |
Critical care centre, ICU or CCU | 364 | (4.2) | 11 | (2.5) | |
Obstetrics and gynaecology ward, perinatal ward or NICU | 330 | (3.8) | 11 | (2.5) | |
Clinical radiology unit | 181 | (2.1) | 10 | (2.3) | |
Operating room | 232 | (2.7) | 10 | (2.3) | |
Dialysis unit | 92 | (1.1) | 6 | (1.4) | |
Paediatric ward | 177 | (2.0) | 6 | (1.4) | |
Others | 1,259 | (14.5) | 71 | (16.1) | |
Profession | Nurse | 4,039 | (46.4) | - | |
Clerk | 1,253 | (14.4) | - | ||
Physician | 807 | (9.3) | - | ||
Nursing aide or care worker | 639 | (7.3) | - | ||
Technician | 532 | (6.1) | - | ||
Therapist | 376 | (4.3) | - | ||
Dietician or cook | 260 | (3.0) | - | ||
Pharmacist | 183 | (2.1) | - | ||
Others | 550 | (6.3) | - | ||
Not reported | 61 | (0.7) | |||
Gender | Male | 2,052 | (23.6) | - | |
Female | 6,338 | (72.9) | - | ||
Not reported | 310 | (3.6) | - | ||
Total | 8,700 | 440 |
Number of units | The odds ratios for classification as high-PSC units‡
| ||||||
---|---|---|---|---|---|---|---|
Cluster 1: High-PSC units | Cluster 2: Low-PSC units | Total | Odds ratio | 95% CI | P-value | ||
(n =184) | (n =256) | (n =440) | |||||
Location of hospital | Urban area | 128 | 163 | 291 | 1.00 | ||
Rural area | 56 | 93 | 149 | 1.12 | (0.44-2.89) | 0.81 | |
Type of hospital | Acute care | 170 | 214 | 384 | 1.00 | ||
Long-term care or mixed-care | 14 | 42 | 56 | 0.88 | (0.20-3.98) | 0.87 | |
Number of beds | <200 beds | 22 | 53 | 75 | 1.00 | ||
200-500 beds | 79 | 120 | 199 | 0.81 | (0.19-3.45) | 0.77 | |
≥500 beds | 83 | 83 | 166 | 1.20 | (0.22-6.71) | 0.83 | |
Unit type | General ward | 46 | 47 | 93 | 1.00 | ||
Obstetrics and gynaecology ward, perinatal ward or NICU
| 10 | 1 | 11 |
9.71
|
(1.17-80.74)
|
0.04
†
| |
Operating room | 6 | 4 | 10 | 1.76 | (0.45-6.87) | 0.42 | |
Clinical laboratory or physiology unit | 10 | 7 | 17 | 1.47 | (0.50-4.31) | 0.48 | |
Outpatient unit | 11 | 8 | 19 | 1.44 | (0.52-4.00) | 0.48 | |
Physicians' unit¶
| 36 | 31 | 67 | 1.16 | (0.60-2.26) | 0.66 | |
Critical care centre, ICU or CCU | 6 | 5 | 11 | 1.10 | (0.31-3.98) | 0.88 | |
Paediatric ward | 3 | 3 | 6 | 1.06 | (0.20-5.72) | 0.94 | |
Dietary unit | 6 | 10 | 16 | 0.66 | (0.21-2.07) | 0.47 | |
Others | 26 | 45 | 71 | 0.61 | (0.32-1.18) | 0.14 | |
Dialysis unit | 2 | 4 | 6 | 0.57 | (0.10-3.36) | 0.53 | |
Pharmaceutical unit | 4 | 9 | 13 | 0.49 | (0.14-1.77) | 0.28 | |
Clinical radiology unit | 3 | 7 | 10 | 0.48 | (0.11-2.02) | 0.32 | |
Administration unit
| 11 | 46 | 57 |
0.26
|
(0.12-0.56)
|
<0.01
†
| |
Rehabilitation unit
| 2 | 14 | 16 |
0.16
|
(0.03-0.79)
|
0.02
†
| |
Long-term care ward
| 2 | 15 | 17 |
0.15
|
(0.03-0.83)
|
0.03
†
|
Sub-dimensions | All respondents | General ward | Administration unit | Physicians’ unit¶
| Outpatient unit | Long-term care ward | Critical care centre, ICU or CCU | ||||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
(n =8,700) | (n =2,279) | (n =1,017) | (n =777) | (n =548) | (n =364) | (n =364) | |||||||||||||||
Odds ratio | 95% CI | P | Odds ratio | 95% CI | P | Odds ratio | 95% CI | P | Odds ratio | 95% CI | P | Odds ratio | 95% CI | P | Odds ratio | 95% CI | P | Odds ratio | 95% CI | P | |
Frequency of events reported |
1.36
|
(1.19-1.56)
|
<0.01
†
| 1.19 | (0.87-1.64) | 0.27 | 1.41 | (0.68-2.91) | 0.35 | 0.81 | (0.50-1.31) | 0.39 | 0.47 | (0.15-1.46) | 0.19 | 0.70 | (0.18-2.71) | 0.61 | 1.10 | (0.46-2.65) | 0.83 |
Overall perceptions of patient safety |
1.39
|
(1.14-1.70)
|
<0.01
†
| 1.52 | (0.97-2.39) | 0.07 | 1.61 | (0.55-4.73) | 0.39 | 1.30 | (0.65-2.61) | 0.46 | 0.78 | (0.16-3.77) | 0.76 | 0.50 | (0.04-5.80) | 0.58 |
4.57
|
(1.36-15.32)
|
0.01
†
|
Supervisor/manager expectations and actions promoting safety |
1.54
|
(1.26-1.88)
|
<0.01
†
|
2.30
|
(1.45-3.64)
|
<0.01
†
| 0.63 | (0.20-1.97) | 0.42 |
2.13
|
(1.06-4.27)
|
0.03
†
| 0.68 | (0.15-3.08) | 0.61 |
27.08
|
(2.74-267.32)
|
0.01
†
| 1.71 | (0.53-5.48) | 0.37 |
Organisational learning - continuous improvement | 1.20 | (1.00-1.43) | 0.05 | 1.21 | (0.81-1.82) | 0.36 | 1.69 | (0.66-4.32) | 0.27 | 0.79 | (0.42-1.50) | 0.47 | 1.21 | (0.30-4.80) | 0.79 |
16.64
|
(1.41-196.24)
|
0.03
†
| 0.83 | (0.27-2.59) | 0.75 |
Teamwork within hospital units |
1.79
|
(1.49-2.16)
|
<0.01
†
|
2.12
|
(1.37-3.29)
|
<0.01
†
| 2.98 | (0.99-9.00) | 0.05 | 1.59 | (0.78-3.24) | 0.20 | 1.47 | (0.37-5.91) | 0.58 | 0.27 | (0.04-2.04) | 0.21 | 1.79 | (0.58-5.54) | 0.31 |
Communication openness | 1.16 | (0.97-1.39) | 0.10 | 0.89 | (0.59-1.34) | 0.58 | 1.42 | (0.56-3.60) | 0.46 | 1.15 | (0.61-2.17) | 0.68 | 0.58 | (0.15-2.21) | 0.42 | 1.77 | (0.31-10.29) | 0.52 | 0.32 | (0.1-1.04) | 0.06 |
Feedback and communication about error |
1.47
|
(1.23-1.75)
|
<0.01
†
|
1.62
|
(1.07-2.45)
|
0.02
†
| 2.05 | (0.80-5.31) | 0.14 | 1.81 | (0.95-3.46) | 0.07 |
6.35
|
(1.55-26.09)
|
0.01
†
| 1.02 | (0.14-7.53) | 0.98 |
4.75
|
(1.61-13.98)
|
0.01
†
|
Non-punitive response to error |
1.20
|
(1.02-1.41)
|
0.03
†
|
1.66
|
(1.13-2.43)
|
0.01
†
|
3.81
|
(1.61-8.99)
|
<0.01
†
| 0.83 | (0.47-1.48) | 0.52 | 2.73 | (0.70-10.57) | 0.15 | 0.43 | (0.09-2.14) | 0.30 | 0.89 | (0.33-2.42) | 0.82 |
Staffing |
1.32
|
(1.07-1.62)
|
0.01
†
|
2.02
|
(1.19-3.43)
|
0.01
†
| 0.37 | (0.13-1.10) | 0.07 | 1.29 | (0.61-2.73) | 0.50 |
4.72
|
(1.01-22.21)
|
0.05
†
| 1.30 | (0.14-12.23) | 0.82 |
9.28
|
(2.24-38.37)
|
<0.01
†
|
Hospital management support for patient safety |
1.50
|
(1.25-1.80)
|
<0.01
†
| 1.35 | (0.90-2.04) | 0.15 | 1.58 | (0.61-4.13) | 0.35 | 1.94 | (0.99-3.79) | 0.05 | 0.61 | (0.15-2.45) | 0.48 | 0.99 | (0.15-6.72) | 0.99 | 1.23 | (0.39-3.93) | 0.72 |
Teamwork across hospital units | 1.08 | (0.88-1.32) | 0.47 | 0.65 | (0.41-1.04) | 0.07 | 1.70 | (0.61-4.75) | 0.31 | 1.14 | (0.57-2.27) | 0.71 | 1.67 | (0.36-7.83) | 0.52 | 1.28 | (0.18-9.23) | 0.81 | 1.34 | (0.39-4.6) | 0.64 |
Hospital handoffs and transitions |
0.72
|
(0.61-0.86)
|
<0.01
†
| 0.71 | (0.48-1.05) | 0.09 | 0.47 | (0.19-1.15) | 0.10 |
2.18
|
(1.18-4.05)
|
0.01
†
| 0.62 | (0.15-2.57) | 0.51 | 1.76 | (0.27-11.68) | 0.56 | 0.51 | (0.17-1.49) | 0.22 |