Background
Methods
Japan | Taiwan | U.S. | |
---|---|---|---|
Recruiting strategy | |||
Hospitals | Voluntary participation§
| Stratified sampling & Voluntary participation | Voluntary participation§
|
Respondents in the hospital | All healthcare workers | A part of the healthcare workers†
| All healthcare workers or a part of the healthcare workers††
|
Period of survey | Jan 2009–Jan 2010 | Jul 2007–Aug 2008 | Jan 2006–Jun 2009 |
Number of participated hospitals | |||
<300 beds | 3 | 23 | 702 |
300–499 beds | 7 | 13 | 117 |
≥500 beds | 4 | 38 | 65 |
Total | 14 | 74 | 884 |
Number of the subjects | |||
Distribution | 10,466 | 11,692 | 827,424 |
Recovery | 8,192 (78.3%) | 10,289 (88.0%) | 337,862 (40.8%) |
Valid data‡
| 6,963 (66.5%) | 10,019 (85.7%) | 291,341 (35.2%) |
Measures
Data analysis
Ethical concerns
Results
Japan | Taiwan | U.S. | |||||
---|---|---|---|---|---|---|---|
N | (%) | N | (%) | N | (%) | ||
Occupation | Nurse‡
| 4,047 | (58.1) | 5,714 | (57.0) | 106,710 | (36.6) |
Patient Care Assistant/Hospital Aide/Care Partner | 228 | (3.3) | 148 | (1.5) | 16,529 | (5.7) | |
Physician†
| 597 | (8.5) | 961 | (9.7) | 11,881 | (4.1) | |
Pharmacist | 171 | (2.5) | 448 | (4.5) | 5,203 | (1.8) | |
Dietician | 221 | (3.2) | 31 | (0.3) | 1,739 | (0.6) | |
Unit Assistant/Clerk/Secretary | 237 | (3.4) | 166 | (1.7) | 17,982 | (6.2) | |
Respiratory Therapist | 0 | (0.0) | 38 | (0.4) | 6,710 | (2.3) | |
Physical, Occupational, or Speech Therapist | 133 | (1.9) | 253 | (2.5) | 8,109 | (2.8) | |
Technician (e.g. EKG, Lab, Radiology) | 543 | (7.8) | 718 | (7.2) | 32,097 | (11.0) | |
Administration/Management | 562 | (8.1) | 1,029 | (10.3) | 20,292 | (7.0) | |
Others | 187 | (2.7) | 277 | (2.8) | 54,028 | (18.5) | |
No answer | 37 | (0.5) | 236 | (2.4) | 10,061 | (3.5) | |
Years in current profession | Less than 1 year | 605 | (8.7) | 896 | (8.9) | 17,977 | (6.2) |
1–5 years | 2,142 | (30.8) | 3,687 | (36.8) | 72,504 | (24.9) | |
6–10 years | 1,366 | (19.6) | 2,643 | (26.4) | 49,500 | (17.0) | |
11–15 years | 891 | (12.8) | 1,413 | (14.1) | 36,127 | (12.4) | |
16–20 years | 617 | (8.9) | 695 | (6.9) | 32,174 | (11.0) | |
21 years or more | 1,005 | (14.4) | 508 | (5.1) | 68,607 | (23.5) | |
No answer | 337 | (4.8) | 177 | (1.8) | 14,452 | (5.0) | |
Working hours in hospital | Less than 20 hours per week | 439 | (6.3) | 113 | (1.1) | 12,948 | (4.4) |
20–39 hours per week | 1,206 | (17.3) | 1,303 | (13.0) | 104,958 | (36.0) | |
40–59 hours per week | 3,936 | (56.5) | 7,380 | (73.7) | 141,250 | (48.5) | |
60–79 hours per week | 513 | (7.4) | 728 | (7.3) | 12,136 | (4.2) | |
80–99 hours per week | 80 | (1.1) | 190 | (1.9) | 7,445 | (2.6) | |
100 hours per week or more | 13 | (0.2) | 83 | (0.8) | 343 | (0.1) | |
No answer | 776 | (11.1) | 222 | (2.2) | 12,261 | (4.2) | |
Number of events reported in the past 12 months | No event reports | 2,428 | (34.9) | 4,894 | (48.8) | 147,892 | (50.8) |
1–2 event reports | 2,609 | (37.5) | 3,201 | (31.9) | 80,018 | (27.5) | |
3–5 event reports | 1,362 | (19.6) | 1,091 | (10.9) | 35,716 | (12.3) | |
6–10 event reports | 377 | (5.4) | 349 | (3.5) | 12,552 | (4.3) | |
11–20 event reports | 73 | (1.0) | 101 | (1.0) | 4,587 | (1.6) | |
21 event reports or more | 35 | (0.5) | 71 | (0.7) | 3,021 | (1.0) | |
No answer | 79 | (1.1) | 312 | (3.1) | 7,555 | (2.6) | |
Patient safety grade††
| Failing | 66 | (0.9) | 37 | (0.4) | 2,139 | (0.7) |
Poor | 479 | (6.9) | 442 | (4.4) | 12,614 | (4.3) | |
Acceptable | 3,015 | (43.3) | 4,662 | (46.5) | 62,801 | (21.6) | |
Very Good | 2,803 | (40.3) | 3,345 | (33.4) | 130,707 | (44.9) | |
Excellent | 299 | (4.3) | 432 | (4.3) | 75,348 | (25.9) | |
No answer | 301 | (4.3) | 1,101 | (11.0) | 7,732 | (2.7) | |
Total | 6,963 | 10,019 | 291,341 |
Total Score†
| Percent Positive Score††
| ||||||
---|---|---|---|---|---|---|---|
M | SD | 95% CI | M | SD | 95% CI | ||
Frequency of events reported | Japan | 11.92 | 2.97 | (11.85–11.99) | 0.68 | 0.41 | (0.67–0.69) |
Taiwan | 9.33 | 2.50 | (9.28–9.38) | 0.33 | 0.39 | (0.32–0.33) | |
U.S. | 11.14 | 2.86 | (11.13–11.15) | 0.61 | 0.42 | (0.61–0.61) | |
Overall perceptions of patient safety | Japan | 13.83 | 2.51 | (13.77–13.89) | 0.53 | 0.35 | (0.52–0.54) |
Taiwan | 13.45 | 1.93 | (13.41–13.49) | 0.52 | 0.28 | (0.51–0.52) | |
U.S. | 14.34 | 3.14 | (14.33–14.36) | 0.63 | 0.34 | (0.63–0.63) | |
Supervisor/manager expectations and actions promoting safety | Japan | 14.68 | 2.56 | (14.62–14.74) | 0.62 | 0.31 | (0.62–0.63) |
Taiwan | 14.57 | 2.21 | (14.52–14.61) | 0.65 | 0.33 | (0.64–0.65) | |
U.S. | 15.43 | 3.19 | (15.42–15.44) | 0.74 | 0.33 | (0.74–0.74) | |
Organizational learning/continuous improvement | Japan | 10.44 | 1.85 | (10.39–10.48) | 0.55 | 0.35 | (0.54–0.56) |
Taiwan | 11.68 | 1.44 | (11.66–11.71) | 0.81 | 0.30 | (0.80–0.81) | |
U.S. | 11.32 | 2.03 | (11.31–11.33) | 0.72 | 0.34 | (0.72–0.72) | |
Teamwork within hospital units | Japan | 14.91 | 2.65 | (14.85–14.97) | 0.70 | 0.34 | (0.70–0.71) |
Taiwan | 15.50 | 2.27 | (15.46–15.55) | 0.79 | 0.30 | (0.79–0.80) | |
U.S. | 15.68 | 3.12 | (15.67–15.69) | 0.79 | 0.30 | (0.79–0.79) | |
Communication openness | Japan | 10.38 | 2.23 | (10.33–10.44) | 0.49 | 0.37 | (0.48–0.50) |
Taiwan | 9.70 | 1.90 | (9.66–9.74) | 0.38 | 0.35 | (0.37–0.39) | |
U.S. | 10.96 | 2.41 | (10.95–10.97) | 0.61 | 0.37 | (0.61–0.61) | |
Feedback and communication about error | Japan | 10.73 | 2.34 | (10.67–10.78) | 0.53 | 0.39 | (0.52–0.54) |
Taiwan | 10.16 | 1.86 | (10.12–10.20) | 0.44 | 0.33 | (0.44–0.45) | |
U.S. | 11.20 | 2.52 | (11.19–11.21) | 0.63 | 0.38 | (0.63–0.63) | |
Nonpunitive response to error | Japan | 9.63 | 2.34 | (9.58–9.69) | 0.43 | 0.37 | (0.42–0.44) |
Taiwan | 8.78 | 1.92 | (8.74–8.82) | 0.29 | 0.31 | (0.29–0.30) | |
U.S. | 9.42 | 2.75 | (9.41–9.43) | 0.42 | 0.39 | (0.42–0.42) | |
Staffing | Japan | 12.16 | 2.63 | (12.10–12.23) | 0.37 | 0.27 | (0.36–0.38) |
Taiwan | 12.15 | 2.57 | (12.10–12.20) | 0.36 | 0.31 | (0.36–0.37) | |
U.S. | 13.55 | 3.04 | (13.54–13.56) | 0.54 | 0.33 | (0.54–0.54) | |
Hospital management support for patient safety | Japan | 10.24 | 1.98 | (10.20–10.29) | 0.52 | 0.37 | (0.51–0.52) |
Taiwan | 10.57 | 1.81 | (10.53–10.61) | 0.58 | 0.36 | (0.58–0.59) | |
U.S. | 11.18 | 2.48 | (11.17–11.18) | 0.70 | 0.37 | (0.70–0.70) | |
Teamwork across hospital units | Japan | 13.12 | 2.49 | (13.06–13.18) | 0.44 | 0.35 | (0.43–0.45) |
Taiwan | 13.69 | 2.34 | (13.64–13.73) | 0.51 | 0.37 | (0.50–0.51) | |
U.S. | 13.66 | 3.04 | (13.65–13.67) | 0.55 | 0.37 | (0.55–0.55) | |
Hospital handoffs and transitions | Japan | 12.61 | 2.52 | (12.55–12.68) | 0.35 | 0.36 | (0.35–0.36) |
Taiwan | 12.67 | 2.52 | (12.62–12.72) | 0.39 | 0.36 | (0.39–0.40) | |
U.S. | 12.67 | 3.21 | (12.66–12.68) | 0.41 | 0.39 | (0.41–0.41) |
Comparisons of Total Scores | Comparisons of Percent Positive Scores | |||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|
Country1 | Country2 | Difference of mean score | Cohen's d
|
P
| 95% CI | Difference of mean score | Cohen's d
|
P
| 95% CI | |||
(Country1-Country2) | (Country1-Country2) | |||||||||||
Frequency of events reported | Japan | Taiwan | 2.59 | 0.96 |
†
| <0.01 | (2.48–2.69) | 0.35 | 0.88 |
†
| <0.01 | (0.34–0.37) |
Japan | U.S. | 0.78 | 0.27 | <0.01 | (0.70–0.86) | 0.07 | 0.17 | <0.01 | (0.06–0.08) | |||
Taiwan | U.S. | −1.81 | −0.63 |
†
| <0.01 | (−1.87–−1.74) | −0.28 | −0.68 |
†
| <0.01 | (−0.29–−0.27) | |
Overall perceptions of patient safety | Japan | Taiwan | 0.38 | 0.17 | <0.01 | (0.26–0.49) | 0.02 | 0.05 | <0.01 | (0.00–0.03) | ||
Japan | U.S. | −0.51 | −0.16 | <0.01 | (−0.61–−0.42) | −0.10 | −0.29 | <0.01 | (−0.11–−0.09) | |||
Taiwan | U.S. | −0.89 | −0.29 | <0.01 | (−0.97–−0.82) | −0.12 | −0.34 | <0.01 | (−0.12–−0.11) | |||
Supervisor/manager expectations and actions promoting safety | Japan | Taiwan | 0.11 | 0.05 | 0.07 | (−0.01–0.23) | −0.02 | −0.07 | <0.01 | (−0.03–−0.01) | ||
Japan | U.S. | −0.75 | −0.24 | <0.01 | (−0.84–−0.66) | −0.11 | −0.35 | <0.01 | (−0.12–−0.10) | |||
Taiwan | U.S. | −0.86 | −0.27 | <0.01 | (−0.94–−0.79) | −0.09 | −0.28 | <0.01 | (−0.10–−0.08) | |||
Organizational learning—continuous improvement | Japan | Taiwan | −1.25 | −0.77 |
†
| <0.01 | (−1.32–−1.17) | −0.26 | −0.80 |
†
| <0.01 | (−0.27–−0.24) |
Japan | U.S. | −0.88 | −0.44 | <0.01 | (−0.94–−0.83) | −0.17 | −0.50 |
†
| <0.01 | (−0.18–−0.16) | ||
Taiwan | U.S. | 0.36 | 0.18 | <0.01 | (0.32–0.41) | 0.09 | 0.26 | <0.01 | (0.08–0.10) | |||
Teamwork within hospital units | Japan | Taiwan | −0.59 | −0.24 | <0.01 | (−0.71–−0.48) | −0.09 | −0.27 | <0.01 | (−0.10–−0.08) | ||
Japan | U.S. | −0.77 | −0.25 | <0.01 | (−0.85–−0.68) | −0.09 | −0.28 | <0.01 | (−0.09–−0.08) | |||
Taiwan | U.S. | −0.17 | −0.06 | <0.01 | (−0.25–−0.10) | 0.00 | 0.00 | 0.99 | (−0.01–0.01) | |||
Communication openness | Japan | Taiwan | 0.68 | 0.33 | <0.01 | (0.59–0.77) | 0.11 | 0.32 | <0.01 | (0.10–0.13) | ||
Japan | U.S. | −0.58 | −0.24 | <0.01 | (−0.65–−0.51) | −0.12 | −0.32 | <0.01 | (−0.13–−0.11) | |||
Taiwan | U.S. | −1.26 | −0.53 |
†
| <0.01 | (−1.32–−1.21) | −0.23 | −0.63 |
†
| <0.01 | (−0.24–−0.22) | |
Feedback and communication about error | Japan | Taiwan | 0.57 | 0.27 | <0.01 | (0.47–0.66) | 0.09 | 0.24 | <0.01 | (0.07–0.10) | ||
Japan | U.S. | −0.47 | −0.19 | <0.01 | (−0.54–−0.40) | −0.10 | −0.25 | <0.01 | (−0.11–−0.09) | |||
Taiwan | U.S. | −1.03 | −0.41 | <0.01 | (−1.09–−0.97) | −0.18 | −0.48 | <0.01 | (−0.19–−0.17) | |||
Nonpunitive response to error | Japan | Taiwan | 0.85 | 0.41 | <0.01 | (0.75–0.95) | 0.13 | 0.40 | <0.01 | (0.12–0.15) | ||
Japan | U.S. | 0.21 | 0.08 | <0.01 | (0.13–0.29) | 0.00 | 0.01 | 0.59 | (−0.01–0.02) | |||
Taiwan | U.S. | −0.64 | −0.24 | <0.01 | (−0.71–−0.58) | −0.13 | −0.33 | <0.01 | (−0.14–−0.12) | |||
Staffing | Japan | Taiwan | 0.01 | 0.01 | 0.96 | (−0.10–0.13) | 0.01 | 0.02 | 0.39 | (−0.01–0.02) | ||
Japan | U.S. | −1.39 | −0.46 | <0.01 | (−1.48–−1.30) | −0.17 | −0.52 |
†
| <0.01 | (−0.18–−0.16) | ||
Taiwan | U.S. | −1.41 | −0.46 | <0.01 | (−1.48–−1.33) | −0.18 | −0.54 |
†
| <0.01 | (−0.18–−0.17) | ||
Hospital management support for patient safety | Japan | Taiwan | −0.32 | −0.17 | <0.01 | (−0.42–−0.23) | −0.07 | −0.19 | <0.01 | (−0.08–−0.06) | ||
Japan | U.S. | −0.93 | −0.38 | <0.01 | (−1.00–−0.86) | −0.19 | −0.51 |
†
| <0.01 | (−0.20–−0.18) | ||
Taiwan | U.S. | −0.61 | −0.25 | <0.01 | (−0.67–−0.55) | −0.12 | −0.32 | <0.01 | (−0.13–−0.11) | |||
Teamwork across hospital units | Japan | Taiwan | −0.56 | −0.23 | <0.01 | (−0.68–−0.45) | −0.07 | −0.19 | <0.01 | (−0.08–−0.05) | ||
Japan | U.S. | −0.54 | −0.18 | <0.01 | (−0.63–−0.45) | −0.11 | −0.29 | <0.01 | (−0.12–−0.10) | |||
Taiwan | U.S. | 0.03 | 0.01 | 0.68 | (−0.05–0.10) | −0.04 | −0.11 | <0.01 | (−0.05–−0.03) | |||
Hospital handoffs and transitions | Japan | Taiwan | −0.05 | −0.02 | 0.55 | (−0.18–0.07) | −0.04 | −0.11 | <0.01 | (−0.05–−0.02) | ||
Japan | U.S. | −0.06 | −0.02 | 0.35 | (−0.15–0.04) | −0.05 | −0.14 | <0.01 | (−0.07–−0.04) | |||
Taiwan | U.S. | 0.00 | 0.00 | 1.00 | (−0.08–0.07) | −0.02 | −0.04 | <0.01 | (−0.03–−0.01) |