Background
Objectives
Methods
Design, setting and sampling
Data management and analysis
Results
General results
N (%) | |
---|---|
Gender | |
Male | 398 (15.9%) |
Female | 2103 (84.1%) |
Age group | |
Below 30 year old | 925 (37.3%) |
Between 30 to 45 years old | 1152 (46.4%) |
Between 46 to 55 years old | 253 (10.2%) |
Above 55 years old | 151 (6.1%) |
Marital Status | |
Single | 851 (34.2%) |
Married | 1602 (64.4%) |
Divorced/ Separated | 16 (0.6%) |
Widowed | 13 (0.5%) |
Others | 6 (0.2%) |
Highest Education | |
Under High School Level | 2 (0.1%) |
High School Level | 7 (0.3%) |
Diploma Level | 836 (33.5%) |
Bachelor’s Degree | 1403 (56.2%) |
Master’s Degree | 127 (5.1%) |
Doctorate Degree | 102 (4.1%) |
Others | 19 (0.8%) |
Work Area | |
Many different hospital unit/No Specific Unit | 21 (0.8%) |
Administrative | 138 (5.4%) |
Medical | 1332 (51.9%) |
Surgical | 786 (30.6%) |
Diagnostics | 99 (3.9%) |
Other | 191 (7.4%) |
Staff Position | |
Administrator/Manager/Director | 47 (1.9%) |
Physician | 141 (5.6%) |
Specialist | 61 (2.4%) |
Coordinator | 10 (0.4%) |
Assistant/Aide | 39 (1.6%) |
Pharmacist | 36 (1.4%) |
Therapist | 1 (0%) |
Registered Nurse | 1969 (78.3%) |
Resident/PG/Intern | 64 (2.5%) |
Assistant/Clerk/Secretary/Facilitator | 28 (1.1%) |
Technician | 52 (2.1%) |
Other, please specify: | 67 (2.7%) |
Tenure in Profession | |
Less than 1 year | 133 (5.3%) |
1 to 5 years | 741 (29.6%) |
6 to 10 years | 809 (32.3%) |
11 to 15 years | 348 (13.9%) |
16 to 20 years | 222 (8.9%) |
21 years or more | 252 (10.1%) |
Hours worked per week | |
Less than 20 h per week | 25 (1%) |
20 to 39 h per week | 148 (6%) |
40 to 60 h per week | 2280 (92.9%) |
Contact with Patients | |
YES, I typically have direct interaction or contact with patients. | 2229 (90.9%) |
NO, I typically do NOT have direct interaction or contact with patients. | 224 (9.1%) |
Patient Safety Grade | |
A – Excellent | 495 (19.3%) |
B - Very Good | 1235 (48.1%) |
C – Acceptable | 650 (25.3%) |
D – Poor | 51 (2.0%) |
E – Failing | 5 (0.2%) |
Missing | 133 (5.2%) |
Frequency of Events | |
No event reports | 1352 (55.8%) |
1 to 2 event reports | 678 (28.0%) |
3 to 5 event reports | 257 (10.6%) |
6 to 10 event reports | 76 (3.1%) |
11 to 20 event reports | 30 (1.2%) |
21 event reports or more | 32 (1.3%) |
Missing | 144 (5.9%) |
Areas of strengths and areas requiring improvement
Composites and survey items | Average% positive responsea
| Mean (Standard deviation) |
---|---|---|
Overall Perception of Safety (Cronbach’s α = 0.234) | 59.5 | 3.41 (0.54) |
It is just by chance that more serious mistakes do not happen around here (R)b
| 29.4 | 2.72 (1.06) |
Patient safety is never sacrificed to get more work done | 76.6 | 3.80 (0.97) |
We have patient safety problems in this unit (R) | 49.7 | 3.19 (1.09) |
Our policies and procedures and systems are effective in preventing errors | 82.1 | 3.91 (0.75) |
Supervisor/Manager Expectations & Actions Promoting Patient Safety (Cronbach’s α = 0.395) | 60.8 | 3.44 (0.60) |
My supervisor/manager says a good word when he/she sees a job done according to established patient safety procedures | 74.2 | 3.74 (0.94) |
My supervisor/manager seriously considers staff suggestions for improving patient safety | 76.4 | 3.80 (0.87) |
Whenever pressure builds up, my supervisor/manager wants us to work faster, even if it means taking shortcuts (R) | 52.1 | 3.27 (1.06) |
My supervisor/manager overlooks patient safety problems that happen over and over (R) | 40.4 | 2.94 (1.16) |
Organizational learning and Continuous Improvement (Cronbach’s α = 0.614) | 86.3 | 4.03 (0.53) |
We are actively doing things to improve patient safety | 94.8 | 4.31 (0.64) |
Mistake have led to positive changes here | 76.8 | 3.78 (0.78) |
After we make changes to improve patient safety, we evaluate their effectiveness | 87.4 | 4.01 (0.69) |
Teamwork within units (Cronbach’s α = 0.757) | 84.8 | 3.40 (0.60) |
Staff support one another in this unit | 90.1 | 4.11 (0.71) |
When a lot of work needs to be done quickly, we work together as a team to get the work done | 89.3 | 4.11 (0.71) |
In this unit, people treat each other with respect | 85.4 | 4.03 (0.75) |
When members of this unit get really busy, other members of the same unit help out | 74.2 | 3.75 (0.95) |
Non-punitive Response to Error (Cronbach’s α = 0.694) | 24.8 | 2.62 (0.79) |
Staff feel like their mistakes are held against them (R) | 31.4 | 2.82 (1.04) |
When an event is reported, it feels like the person is being written up, not the problem (R) | 29.3 | 2.76 (1.02) |
Staff worry that mistakes they make are kept in their personnel file (R) | 13.7 | 2.29 (0.93) |
Staffing (Cronbach’s α = 0.210) | 33.8 | 2.79 (0.57) |
We have enough staff to handle the workload | 56.1 | 3.29 (1.18) |
Staff in this unit work longer hours than is best for patient care (R) | 11.2 | 2.17 (0.89) |
We use agency/temporary staff than is best for patient care (R) | 45.2 | 3.14 (1.08) |
When the work is in “crisis mode” we try to do too much, too quickly (R) | 22.8 | 2.56 (1.01) |
Hospital Management Support for Patient Safety (Cronbach’s α = 0.519) | 75.3 | 3.76 (0.62) |
Hospital management provides a work climate that promotes patient safety | 85.3 | 3.95 (0.68) |
The actions of hospital management show that patient safety is a top priority | 86.9 | 4.07 (0.77) |
Hospital management seems interested in patient safety only after an adverse event happens (R) | 53.6 | 3.26 (1.10) |
Teamwork Across Hospital Units (Cronbach’s α = 0.627) | 67.0 | 3.59 (0.62) |
There is good cooperation among hospital units that need to work together | 73.0 | 3.69 (0.82) |
Hospital units work well together to provide the best care for patients | 85.5 | 4.03 (0.77) |
Hospital units do not coordinate well with each other and this might affect patient care (R) | 55.8 | 3.30 (1.04) |
It is often not easy to work with staff from other hospital units (R) | 53.7 | 3.35 (0.97) |
Hospital Handoffs & Transitions (Cronbach’s α = 0.783) | 55.8 | 3.39 (0.75) |
Things “fall between the cracks”, i.e., things might go uncontrolled and get lost (ex: medical records, medical treatment, patient information and education, discharge criteria) when transferring patients from one unit to another (R) | 45.5 | 3.18 (1.01) |
Important patient care information is often lost during shift changes (R) | 66.8 | 3.59 (0.96) |
Problems often occur in the exchange of information across hospital units (R) | 46.2 | 3.22 (0.95) |
Shift changes are problematic for patients in this hospital (R) | 64.5 | 3.56 (0.93) |
Communication Openness (Cronbach’s α = 0.533) | 45.0 | 3.36 (0.83) |
Staff will freely speak up if they see something that may negatively affect patient care | 64.5 | 3.84 (1.07) |
Staff feel free to question the decisions or actions of those with more authority | 34.3 | 3.08 (1.21) |
Staff are afraid to ask questions when something does not feel right (R) | 36.2 | 3.15 (1.15) |
Feedback and Communications About Error (Cronbach’s α = 0.732) | 71.8 | 4.04 (0.79) |
We are given feedback about changes put into place based on event reports | 56.5 | 3.69 (1.06) |
We are informed about errors that happen in this unit | 79.0 | 4.21 (0.95) |
In this unit, we discuss ways to prevent errors from happening again | 79.9 | 4.22 (0.93) |
Frequency of events reported (Cronbach’s α = 0.902) | 68.8 | 3.92 (1.10) |
When a mistake is made, but is caught and corrected affecting the patient, how often is this reported? | 65.6 | 3.83 (1.21) |
When a mistake is made, but has no potential to harm the patient, how often is this reported? | 65.9 | 3.86 (1.22) |
When a mistake is made that could harm the patient, but does not, how often is this reported? | 74.9 | 4.07 (1.17) |
Comparing results from 2015 to 2012
2012 | 2015 |
P-value | |||
---|---|---|---|---|---|
Mean | SD | Mean | SD | ||
Frequency of Event Reporting | 3.64 | 1.16 | 4.04 | 1.54 | <0.001 |
Overall Perceptions of Safety | 3.43 | 0.59 | 3.60 | 1.56 | <0.001 |
Supervisor/manager expectations and actions promoting safety | 3.46 | 0.65 | 3.57 | 1.34 | <0.001 |
Organizational Learning-Continuous Improvement | 3.89 | 0.69 | 4.16 | 1.14 | <0.001 |
Teamwork Within Hospital Units | 3.85 | 0.75 | 4.04 | 0.71 | <0.001 |
Communication Openness | 3.25 | 0.85 | 3.45 | 1.08 | <0.001 |
Feedback and Communication About Errors | 3.73 | 0.95 | 4.11 | 1.10 | <0.001 |
Non-punitive Response to Error | 2.68 | 0.81 | 2.76 | 1.26 | 0.013 |
Staffing | 2.84 | 0.62 | 3.02 | 1.19 | <0.001 |
Hospital Management Support for Patient Safety | 3.69 | 0.76 | 3.85 | 1.05 | <0.001 |
Hospital Handoffs and Transitions | 3.36 | 0.79 | 3.82 | 2.29 | <0.001 |
Teamwork Across Hospital Units | 3.52 | 0.71 | 3.76 | 1.36 | <0.001 |
Comparative against regional and international findings
Generalized estimating equations findings patient safety grade
Patient safety grade | Number of events reported | |||
---|---|---|---|---|
OR (95% CI) |
P-value | OR (95% CI) |
P-value | |
Patient Safety Culture Composites | ||||
Supervisor/Manager Expectations & Actions Promoting Patient Safety | 1.20 (1.19–1.22) | <0.001 | 1.27 (0.91–1.78) | 0.162 |
Organizational learning and Continuous Improvement | 1.66 (1.55–1.77) | <0.001 | 1.10 (0.99–1.22) | 0.073 |
Teamwork within units | 1.61 (1.59–1.62) | <0.001 | 0.82 (0.76–0.89) | <0.001 |
Communication Openness | 1.22 (1.10–1.35) | <0.001 | 0.93 (0.90–0.97) | 0.002 |
Feedback and Communications About Error | 1.50 (1.29–1.74) | <0.001 | 0.99 (0.97–1.01) | 0.282 |
Non-punitive Response to Error | 1.09 (0.93–1.27) | 0.308 | 0.83 (0.71–0.98) | 0.029 |
Staffing | 1.04 (1.01–1.08) | 0.007 | 0.74 (0.67–0.83) | <0.001 |
Hospital Management Support for Patient Safety | 2.43 (2.09–2.83) | <0.001 | 1.15 (1.08–1.23) | <0.001 |
Hospital Handoffs & Transitions | 1.12 (1.11–1.13) | <0.001 | 1.10 (1.06–1.14) | <0.001 |
Teamwork Across Hospital Units | 1.48 (1.45–1.50) | <0.001 | 0.94 (0.90–0.98) | 0.004 |
Gender | ||||
Male | 1 | 1 | ||
Female | 0.62 (0.62–0.63) | <0.001 | 1.56 (1.45–1.67) | <0.001 |
Age | ||||
Less than 30 years of age | 1 | 1 | ||
Between 30 and 45 | 1.06 (0.92–1.23) | 0.423 | 0.96 (0.81–1.14) | 0.641 |
Between 46 and 55 | 1.00 (0.72–1.40) | 0.995 | 0.56 (0.46–0.69) | <0.001 |
Aged above 55 | 1.28 (1.14–1.42) | <0.001 | 0.40 (0.38–0.43) | <0.001 |
Experience at the hospital | ||||
1 to 2 years | 1 | 1 | ||
3 to 5 years | 0.96 (0.85–1.08) | <0.001 | 1.54 (1.21–1.94) | <0.001 |
6 to 10 years | 0.67 (0.57–0.78) | 0.291 | 1.44 (1.35–1.53) | <0.001 |
11 to 15 years | 1.07 (1.01–1.14) | 0.025 | 1.55 (1.51–1.59) | <0.001 |
16 to 20 years | 0.78 (0.49–1.24) | <0.001 | 2.38 (1.54–3.68) | <0.001 |
More or equal to 21 years | 1.58 (1.55–1.60) | 0.463 | 3.34 (2.53–4.41) | <0.001 |
Highest Degree | ||||
Under High School Level | - | - | 1 | |
High school level | - | - | 0.50 (0.19–1.28) | 0.148 |
Diploma level | - | - | 0.36 (0.12–1.09) | 0.070 |
Bachelors Degree | - | - | 0.65 (0.26–1.62) | 0.354 |
Masters Degree | - | - | 0.49 (0.30–0.81) | 0.005 |
Doctorate Degree | - | - | 0.33 (0.17–0.65) | 0.001 |
Position at the hospital | ||||
Administrator/Manager/Director | 1 | 1 | ||
Physician | 0.50 (0.40–0.64) | <0.001 | 0.43 (0.35–0.51) | <0.001 |
Specialist | 1.65 (0.74–3.67) | 0.223 | 0.32 (0.24–0.43) | <0.001 |
Coordinator | 0.65 (0.65–0.65) | <0.001 | 1.01 (0.58–1.76) | 0.964 |
Assistant/Aide | 1.89 (1.34–2.67) | <0.001 | 0.27 (0.23–0.31) | <0.001 |
Pharmacist | 0.53 (0.52–0.55) | <0.001 | 2.97 (2.30–3.84) | <0.001 |
Registered Nurse | 0.60 (0.57–0.64) | <0.001 | 0.29 (0.17–0.50) | <0.001 |
Resident/PG/Intern | 0.18 (0.14–0.22) | <0.001 | 0.14 (0.11–0.18) | <0.001 |
Assistant/Clerk/Secretary/Facilitator | 0.65 (0.65–0.65) | 0.611 | 1.02 (0.91–1.14) | 0.734 |
Technician | 2.84 (2.49–3.24) | <0.001 | 0.55 (0.53–0.58) | <0.001 |
Other | 1.04 (0.98–1.12) | 0.189 | 0.19 (0.06–0.63) | 0.006 |
Interaction with patients | ||||
No | 0.81 (0.74–0.88) | <0.001 | 0.64 (0.54–0.76) | <0.001 |
Yes | 1 | 1 | ||
Hospital Size | ||||
Small | 0.56 (0.56–0.57) | <0.001 | 0.87 (0.87–0.87) | <0.001 |
Large | 1 | 1 |
Number of events reported
Linear regression findings
Overall perception of safety
Perception of patient safety | Frequency of events reported | |||
---|---|---|---|---|
Beta (Standard error) |
P-value | Beta (Standard error) |
P-value | |
Patient Safety Culture Composites | ||||
Supervisor/ Manager Expectations & Actions Promoting Patient Safety | 0.131 (0.027) | <0.001 | −0.009 (0.057) | 0.880 |
Organizational learning and Continuous Improvement | 0.100 (0.034) | 0.003 | 0.133 (0.071) | 0.060 |
Teamwork within units | 0.055 (0.029) | 0.059 | −0.107 (0.061) | 0.080 |
Communication Openness | −0.026 (0.020) | 0.181 | −0.004 (0.041) | 0.922 |
Feedback and Communications About Error | 0.008 (0.022) | 0.728 | 0.431 (0.046) | <0.001 |
Non-punitive Response to Error | 0.052 (0.019) | 0.007 | −0.061 (0.04) | 0.125 |
Staffing | 0.079 (0.026) | 0.002 | −0.017 (0.054) | 0.748 |
Hospital Management Support for Patient Safety | 0.114 (0.030) | <0.001 | 0.119 (0.063) | 0.056 |
Hospital Handoffs & Transitions | 0.120 (0.023) | <0.001 | −0.031 (0.047) | 0.515 |
Teamwork Across Hospital Units | 0.003 (0.032) | 0.926 | −0.014 (0.066) | 0.834 |
Gender | ||||
Male | 0.142 (0.054) | 0.008 | 0.048 (0.11) | 0.667 |
Female | 0 | 0 | ||
Age | ||||
Less than 30 years of age | 0 | 0 | ||
Between 30 and 45 | −0.055 (0.035) | 0.122 | −0.172 (0.074) | 0.021 |
Between 46 and 55 | −0.137 (0.068) | 0.042 | 0.022 (0.143) | 0.880 |
Aged above 55 | −0.203 (0.094) | 0.031 | 0.16 (0.195) | 0.412 |
Experience at the hospital | ||||
1 to 2 years | 0 | 0 | ||
3 to 5 years | 0.038 (0.036) | 0.287 | 0.136 (0.075) | 0.071 |
6 to 10 years | 0.010 (0.045) | 0.825 | 0.202 (0.094) | 0.031 |
11 to 15 years | 0.061 (0.056) | 0.278 | 0.173 (0.117) | 0.140 |
16 to 20 years | 0.046 (0.089) | 0.607 | 0.03 (0.185) | 0.871 |
More or equal to 21 years | 0.086 (0.091) | 0.345 | 0.048 (0.19) | 0.801 |
Highest Degree | ||||
Under High School Level | 0 | 0 | ||
High school level | 0.483 (0.237) | 0.042 | −0.288 (0.493) | 0.559 |
Diploma level | 0.528 (0.237) | 0.026 | −0.326 (0.492) | 0.508 |
Bachelors Degree | 0.583 (0.247) | 0.019 | 0.076 (0.513) | 0.882 |
Masters Degree | 0.569 (0.258) | 0.027 | −0.231 (0.533) | 0.665 |
Doctorate Degree | 0.271 (0.283) | 0.339 | −0.105 (0.597) | 0.861 |
Position at the hospital | ||||
Administrator/Manager/Director | 0.229 (0.123) | 0.064 | −0.656 (0.269) | 0.015 |
Physician | −0.167 (0.099) | 0.093 | −0.597 (0.203) | 0.003 |
Specialist | −0.292 (0.128) | 0.023 | −0.858 (0.265) | 0.001 |
Coordinator | 0.152 (0.216) | 0.482 | 0.356 (0.449) | 0.429 |
Assistant/Aide | 0.001 (0.101) | 0.995 | 0.037 (0.21) | 0.860 |
Pharmacist | 0.083 (0.152) | 0.585 | −0.37 (0.332) | 0.266 |
Registered Nurse | −0.161 (0.109) | 0.143 | −0.499 (0.218) | 0.023 |
Resident/PG/Intern | 0.084 (0.181) | 0.641 | −0.279 (0.404) | 0.490 |
Assistant/Clerk/Secretary/Facilitator | 0.006 (0.121) | 0.961 | −0.478 (0.24) | 0.046 |
Technician | −0.052 (0.100) | 0.607 | −0.096 (0.213) | 0.652 |
Other | 0 | 0 | ||
Interaction with patients | ||||
No | 0 | 0 | ||
Yes | 0.068 (0.062) | 0.273 | 0.108 (0.13) | 0.406 |
Hospital Size | ||||
Small | 0 | 0 | ||
Large | −0.098 (0.034) | 0.004 | −0.087 (0.071) | 0.223 |