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Introduction. Patient safety during hospitalisation is one of the biggest concerns for hospitals worldwide and one obligation of all medical professionals is to create a safe environment for patients and prevent accidents. Approximately 50% of adverse events can be prevented with a systematic approach. Aim. This study aimed to examine the underlying dimensions and psychometric properties of the Hospital Survey on Patient Safety Culture questionnaire in Croatian hospital settings, and to compare the results with the original questionnaire from the United States of America. Methods. The sample consisted of 438 nurses from four Croatian university hospitals. All participants signed an informed consent document, and the questionnaires were provided to the nurses in their units by the head nurses of their departments. Data analysis was performed using IBM SPSS 25.0. Bartlett's test of sphericity and the Kaiser-Meyer-Olkin (KMO) indicator were performed with Cronbach’s alpha test and sample standard deviation. Results. All factors explain the total of 59% of variance of the measured questionnaire. Additionally, the reliability of the entire questionnaire was determined by using the internal consistency coefficient (Cronbach’s alpha) on the Hospital Survey on Patient Safety Culture with 12 of 0.88 particles, which is high internal consistency reliability. Our results show that the particles that make up the questionnaire are very homogeneous according to their object of measurement. Conclusion. The results of our study found that the survey can be applied to Croatian settings and used in hospitals. We also believe that more research on this topic is needed and is crucial for improving patient safety in hospitals. It is necessary to emphasize continuous education of nurses regarding patient safety in hospitals.

Systems today, and more than ever before, create “tense” work situations, where complexity, contingencies and emergencies coexist (De Bovis & Baret, 2011). The hospital organization because of its specificity, caused by the combination of two characteristics: those of complexity and interactivism, joins in this respect the need to organize and manage oneself as a highly reliable organization (OHF). From the outset, the reliability of the hospital safety model is a major concern involving different levels in the organization, several actors, functions, businesses and processes. With the aim of evaluating the security model prevailing in the Mohammed VI University Hospitaller Centre in Oujda and consequently moving on to the question of how to make it reliable, The purpose of this study is to measure the safety climate of the nursing staff in the institution, in order to study how the nursing staff perceive the efforts made by their management in terms of safety and risk management. Using a quantitative tool through the questionnaire "Hospital Survey on Patient Safety Culture", administered to 389 caregivers, all specialties, it will be determined the score of the ten dimensions defining the safety climate and the way to assess the total level of safety climate prevailing at the CHU Mohammed VI-Oujda. The overall level of the safety climate was judged to be unfavorable and all the dimensions were judged to be underdeveloped, with the exception of one, "management support for safety", which was judged not to be developed. Keywords: Safety culture; safety climate; HSOPSC; nursing staff; CHU. JEL classification: J28 Paper type: Empirical research, Les systèmes aujourd’hui, et plus que jamais génèrent des situations de travail « en tension », dont la complexité, les imprévus et les urgences coexistent (De Bovis & Baret et al, 2011). L’organisation hospitalière du fait de sa spécificité, occasionnée par la combinaison de deux caractéristiques: celles de la complexité et de l’interactionnisme, rejoint à ce titre la nécessité de s’organiser et se gérer comme une organisation à haute fiabilité (OHF). D’emblée, la fiabilisation du modèle de sécurité hospitalier est une préoccupation majeure impliquant différents niveaux dans l’organisation, plusieurs acteurs, fonctions, métiers et processus. Dans l’objectif d’évaluer le modèle de sécurité régnant dans le Centre hospitalo-universitaire Mohammed VI d’Oujda et par voie de conséquence passer au questionnement sur comment le fiabiliser, cette étude vise à mesurer le climat de sécurité auprès du corps soignant dans ledit établissement, et ce, afin d’étudier comment le personnel soignant perçoit les efforts déployés par leur direction en termes de sécurité et de gestion des risques. En s’appuyant sur un outil d’ordre quantitatif par le biais du questionnaire «Hospital Survey On Patient Safety Culture», administré auprès de 389 soignants, toutes spécialités confondues,il sera question de déterminer le score des dix dimensions définissant le climat de sécurité et chemin faisant évaluer le niveau total du climat de sécurité régnant au niveau du CHU Mohammed VI-Oujda. Le niveau global du climat de sécurité y était jugé peu favorable et l’ensemble des dimensions y étaient jugées peu développées à l’exception d’une seule: celle du «soutien du management pour la sécurité» a été jugée non développée. Mots-clés: Culture de sécurité; Climat de sécurité, HSOPSC; Corps soignant; CHU. Classification JEL: J28 Type de article: Recherche appliquée

Introduction A patient safety culture (PSC) is a complex phenomenon, representing an essential part of the organizational culture and refers to the shared values, conceptions and beliefs which contribute to the formation and encouragement of safe behavioural models in a health organization. With this study, the authors wanted to delineate the attitude of hospital staff in Bulgaria regarding PSC and to document to whether attitudes differ between physicians and other healthcare professionals (HCPs). Methods A national cross-sectional survey among 384 HCPs was conducted using an online version of the Bulgarian version of Hospital Survey on Patient Safety Culture (B-HSOPSC). The data was analysed with descriptive statistics, non-parametric Mann-Whitney U and x 2 tests. Results The physicians represented 37.50% (144) of the sample and other HCPs 62.50% (240). Respondents from governmental/municipal hospitals prevailed (53.6%). The dimensions “Staffing” and “Non-punitive response to error” were most problematic, as their percentage of positive response rates (PRRs) were lowest. However, “Handoffs and transitions” and “Supervisor/manager expectations and actions promoting safety“ showed the highest mean values in both physicians and other HCPs. From all participants, 76.0% have never reported an adverse event or error. Conclusion The results of the study show that all respondents demonstrate a positive attitude regarding PSC. A comparison of the mean values and that of PRRs in the dimensions did not show any group differences, according to the type of staff position, i.e. physicians or other HCPs.

Patient safety culture is a key component of the organizational culture and a critical measure of the quality of healthcare. The aim of this study was to gain an insight into the problems concerning patient safety culture, based on the analysis of data, collected after interviewing healthcare specialists working in surgical and nonsurgical units in selected Bulgarian hospitals. This was a cross-sectional online study using a web-platform and the Bulgarian Version of Hospital Survey on Patient Safety Culture. It was conducted among healthcare workers (n = 620) in 2021. The B-HSOPSC incudes 42 scales grouped in 12 different domains. We compared the percentage of positive ratings and outcome dimensions between surgical and other hospital departments with the nonparametric Mann–Whitney U test, χ2 tests, Fisher’s Exact Test, and OR. The results showed that there are no statistically significant differences between the ratings on Patient Safety Culture given by the surgical and the nonsurgical staff except for the dimension “Hospital management support for patient safety”. Results from the study highlighted that the most important aspect of hospital patient safety is the shortage of medical staff in both surgical and nonsurgical hospital units. Communication, work shift organization, handoffs and transitions between shifts and among different hospital units, as well as communication with line managers were rated as satisfactory in Bulgarian hospitals.

Horng-Shuh Hao,1,* Han Gao,1,* Ting Li,2 Dan Zhang1 1Institute for Hospital Management, Tsinghua Shenzhen International Graduate School, Tsinghua University, Shenzhen, People’s Republic of China; 2Administrative Office, The Third People’s Hospital of Shenzhen, Shenzhen, People’s Republic of China*These authors contributed equally to this workCorrespondence: Dan ZhangInstitute for Hospital Management, Tsinghua Shenzhen International Graduate School, Tsinghua University, No. 2279 Lishui Road, Nanshan District, Shenzhen 518055, People’s Republic of ChinaTel +86-186-64555188Fax +86-755-26036425Email zhang.dan@sz.tsinghua.edu.cnPurpose: To investigate the health-care providers’ perceptions of patient safety culture in Shenzhen hospitals and to compare 2019 with 2015 data.Methods: This cross-sectional study adopted a questionnaire survey and targeted hospital staff fitting the sampling criteria (physicians, nurses, technicians, and managers). A total of 5490 staff from 13 Shenzhen hospitals were surveyed using the Hospital Survey on Patient Safety Culture (HSOPSC).Results: The average positive response rates of this study were generally higher than the data from the 2018 Agency for Healthcare Research and Quality (AHRQ) survey and the 2015 HSOPSC Shenzhen survey. Bivariate and multivariate regression showed that respondents who had direct contact with patients were less likely to report high overall patient safety grade. The probability of high overall patient safety grade was rated higher by men than by women. Compared with nurses, the probability of high overall patient safety grade was higher for both physicians and technicians.Conclusion: The overall results of the patient safety culture in Shenzhen hospitals were relatively good and have improved significantly in recent years, but some areas of weakness still need improvement. Our recommendations are to develop training programs for various positions, recruit more employees, provide management support, and establish a just culture to promote a strong patient safety culture. Regular assessment is also needed to provide valuable information to hospital leaders on areas requiring improvement and to evaluate the quality improvement plan that has been implemented.Keywords: patient safety culture, HSOPSC, public hospital

Due to the nature of their activity, anesthesia and critical care have generally well-developed patient safety cultures, which are linked to a greater level of incident awareness and reporting during clinical activity. In order to determine the status quo and identify and adopt, where appropriate, techniques and instruments for further improving patient safety, it is necessary to evaluate the culture and barriers in these departments. The main objective of our study was to assess patient safety culture in Romanian anesthesia and intensive care departments (AICDs), to pinpoint the areas that may need improvement, and to examine the correlation between the prevalence of adverse event reporting, as well as the level of self-reported patient safety culture. To determine how anesthesia and intensive care department staff perceived patient safety, the Hospital Survey on Patient Safety Culture (HSOPSC) was used in a translated Romanian version. In total, 1200 employees from 36 anesthesiology and intensive care departments across 32 hospitals in Romania received the questionnaire, representing 42.66% of all anesthesia and intensive care departments in the country. In 7 of the 12 examined dimensions, significant differences between tertiary and secondary hospitals were observed. Among all dimensions, the highest positive score was for “organizational learning and continuous development”. In general, our study revealed a positive view on patient safety in anesthesia and intensive care departments. Further studies are required to determine a threshold of the level of culture development.

Introduction. Patient safety during hospitalisation is one of the biggest concerns for hospitals worldwide and one obligation of all medical professionals is to create a safe environment for patients and prevent accidents. Approximately 50% of adverse events can be prevented with a systematic approach. Aim. This study aimed to examine the underlying dimensions and psychometric properties of the Hospital Survey on Patient Safety Culture questionnaire in Croatian hospital settings, and to compare the results with the original questionnaire from the United States of America. Methods. The sample consisted of 438 nurses from four Croatian university hospitals. All participants signed an informed consent document, and the questionnaires were provided to the nurses in their units by the head nurses of their departments. Data analysis was performed using IBM SPSS 25.0. Bartlett's test of sphericity and the Kaiser-Meyer-Olkin (KMO) indicator were performed with Cronbach’s alpha test and sample standard deviation. Results. All factors explain the total of 59% of variance of the measured questionnaire. Additionally, the reliability of the entire questionnaire was determined by using the internal consistency coefficient (Cronbach’s alpha) on the Hospital Survey on Patient Safety Culture with 12 of 0.88 particles, which is high internal consistency reliability. Our results show that the particles that make up the questionnaire are very homogeneous according to their object of measurement. Conclusion. The results of our study found that the survey can be applied to Croatian settings and used in hospitals. We also believe that more research on this topic is needed and is crucial for improving patient safety in hospitals. It is necessary to emphasize continuous education of nurses regarding patient safety in hospitals., Uvod. Sigurnost pacijenata tijekom hospitalizacije predstavlja jednu od najvećih briga bolnicama diljem svijeta. Obveza je svih medicinskih stručnjaka stvoriti sigurno okruženje za pacijente i spriječiti nesreće. Približno 50 % nuspojava može se spriječiti sustavnim pristupom. Cilj. Cilj ove studije bio je ispitati temeljne dimenzije i psihometrijska svojstva upitnika Hospital Survey on Patient Safety Culture u hrvatskim bolničkim uvjetima te usporediti rezultate s izvornim upitnikom iz Sjedinjenih Američkih Država. Metode. Uzorak se sastoji od 438 medicinskih sestara iz četiri kliničke bolnice. Svi sudionici potpisali su dokument o informiranom pristanku, a upitnike su medicinskim sestrama u njihovim jedinicama dostavile glavne sestre njihovih odjela. Analiza podataka provedena je s pomoću softvera IBM SPSS 25.0. Bartlettov test sferičnosti i Kaiser-Meyer-Olkinov (KMO) indikator izvedeni su s Cronbachovim alfa testom i standardnom devijacijom uzorka. Rezultati. Svi čimbenici objašnjavaju ukupno 59 % varijance izmjerenog upitnika. Pouzdanost upitnika određena je primjenom internog koeficijenta konzistentnosti (Cronbachov alfa) na Hospital Survey on Patient Safety Culture s 12 čestica od 0,88, što je visoka interna pouzdanost konzistencije. Naši rezultati pokazuju da su čestice koje čine upitnik vrlo homogene prema objektu mjerenja. Zaključak. Rezultati našeg istraživanja pokazali su da se upitnik može primijeniti u hrvatskim uvjetima i upotrebljavati u bolnicama. Također vjerujemo da je potrebno više istraživanja na ovu temu i da je to ključno za poboljšanje sigurnosti pacijenata u bolnicama. Potrebno je naglasiti kontinuiranu edukaciju medicinskih sestara o sigurnosti pacijenata u bolnicama.

Horng-Shuh Hao,1,* Han Gao,1,* Ting Li,2 Dan Zhang1 1Institute for Hospital Management, Tsinghua Shenzhen International Graduate School, Tsinghua University, Shenzhen, People’s Republic of China; 2Administrative Office, The Third People’s Hospital of Shenzhen, Shenzhen, People’s Republic of China*These authors contributed equally to this workCorrespondence: Dan ZhangInstitute for Hospital Management, Tsinghua Shenzhen International Graduate School, Tsinghua University, No. 2279 Lishui Road, Nanshan District, Shenzhen 518055, People’s Republic of ChinaTel +86-186-64555188Fax +86-755-26036425Email zhang.dan@sz.tsinghua.edu.cnPurpose: To investigate the health-care providers’ perceptions of patient safety culture in Shenzhen hospitals and to compare 2019 with 2015 data.Methods: This cross-sectional study adopted a questionnaire survey and targeted hospital staff fitting the sampling criteria (physicians, nurses, technicians, and managers). A total of 5490 staff from 13 Shenzhen hospitals were surveyed using the Hospital Survey on Patient Safety Culture (HSOPSC).Results: The average positive response rates of this study were generally higher than the data from the 2018 Agency for Healthcare Research and Quality (AHRQ) survey and the 2015 HSOPSC Shenzhen survey. Bivariate and multivariate regression showed that respondents who had direct contact with patients were less likely to report high overall patient safety grade. The probability of high overall patient safety grade was rated higher by men than by women. Compared with nurses, the probability of high overall patient safety grade was higher for both physicians and technicians.Conclusion: The overall results of the patient safety culture in Shenzhen hospitals were relatively good and have improved significantly in recent years, but some areas of weakness still need improvement. Our recommendations are to develop training programs for various positions, recruit more employees, provide management support, and establish a just culture to promote a strong patient safety culture. Regular assessment is also needed to provide valuable information to hospital leaders on areas requiring improvement and to evaluate the quality improvement plan that has been implemented.Keywords: patient safety culture, HSOPSC, public hospital

The culture of patient safety should be considered a guiding principle for different areas of health. This research presents the results of an analysis on Patient Safety Culture (PSC), according to the perception of health professionals who work in the Psychosocial Care Network, through a descriptive observational cross-sectional study, using the Hospital Survey on Patient Safety Culture in a municipality in the Western Amazon of Brazil. Sixty-nine (69) professionals expressed that the best dimensions evaluated were: &ldquo, expectations and actions to promote the safety of supervisors and managers&rdquo, (75%) and &ldquo, support from hospital management to patient safety&rdquo, (64%). The worst evaluations were: &ldquo, non-punitive responses to errors&rdquo, (27%) and &ldquo, general perceptions about patient safety&rdquo, (35%), demonstrating that there still is a culture of fear of causing harm and the need for educational actions on patient safety. In general, all professionals have close contact with patients, regardless of the length on duty, however, the weekly workload and turnover in this sector is leading to a greater chance of errors. The analysis of the internal reliability of the dimensions ranged from 0.12 to 0.89. Only one-third of the respondents scored PSC as &ldquo, Good&rdquo, in the studied institutions and 63 out 69 professionals did not report any adverse events in the last 12 months. There are weaknesses in the observed perception of PSC and the obtained results show opportunities and challenges for improvements in the study system.

Submitted by Rivea Bispo (rivea.barros@uniceub.br) on 2021-01-28T12:04:21Z No. of bitstreams: 1 Isabella Caroline.pdf: 605432 bytes, checksum: 4d4e9177004e72670156f2d4ea1a2127 (MD5) Approved for entry into archive by Heres Pires (heres.pires@uniceub.br) on 2021-04-29T12:16:50Z (GMT) No. of bitstreams: 1 Isabella Caroline.pdf: 605432 bytes, checksum: 4d4e9177004e72670156f2d4ea1a2127 (MD5) Made available in DSpace on 2021-04-29T12:16:50Z (GMT). No. of bitstreams: 1 Isabella Caroline.pdf: 605432 bytes, checksum: 4d4e9177004e72670156f2d4ea1a2127 (MD5) Previous issue date: 2021-01-28 Trata-se de uma pesquisa descritivo-exploratório de natureza quantitativa do tipo survey, a qual objetivou a análise da cultura de segurança do paciente de acordo com a visão dos profissionais atuantes nas unidades de internação de um hospital privado do Distrito Federal. Adotou-se como N desta pesquisa os 31 formulários que preencheram os requisitos dos critérios adotados. A dimensão de segurança que obteve o maior percentual foi “Expectativas sobre o seu supervisor/chefe e ações promotoras da segurança do paciente” (87,9%), as que adquiriram as porcentagens mais baixas foram “Respostas não punitivas aos erros” (19,4%) e “Abertura da comunicação” (46,0%). Os resultados obtidos através deste estudo evidenciam uma cultura de segurança do paciente ainda enfraquecida, porém em fase de estruturação. Ressalta-se a relevância de que se realizem novos estudos na área de segurança do paciente, objetivando a expansão da temática, a capacitação de profissionais neste domínio.

Purpose To explore patient safety culture among Romanian staff, using the U.S. Hospital Survey on Patient Safety Culture (HSOPSC). Material and Methods:A cross-sectional study was carried out in six hospitals, located in four Romanian regions (Craiova, Cluj-Napoca, Bucharest and Brasov), based on staff census in the Units/hospitals which volunteered to participate in the study (N=1,184). The response rate was 84%. The original questionnaire designed by the American Agency for Healthcare Research and Quality was translated into Romanian (with back translation), pre-tested before application and psychometrically checked. It consists of 42 questions grouped in 12categories, covering multiple aspects of patient safety culture (dimensions). Percentages of positive responses (PPRs) by question and category were analyzed overall and by staff profession. Results:Most respondents were nurses (69%). The main work areas were surgery (24%) and medicine (22%). The highest PPRs were for Supervisor/Manager Expectations & Actions Promoting Safety (88%), Teamwork Within Units (86%), Handoffs and Transitions (84%), Organizational Learning-Continuous Improvement (81%), Overall Perceptions of Safety (80%), Feedback & Communication About Error (75%). The lowest PPRs were for: Staffing (39%), Frequency of Events Reported (59%) and Non-punitive Response to Errors (61%). Nurses exhibited significantly higher PPRs than doctors.Conclusions:This small-scale study of staff’s attitude towards patient safety in Romanian hospitals suggests that there is room for future improvement, especially within the doctor category. Further research should assess the relationship between patient safety culture and frequency of adverse events.

Background and aims. Patient safety culture (PSC) is an essential component of the quality of healthcare. Improving PSC is considered a priority in many developed countries. A specialized software platform for registration and evaluation of hospital patient safety culture has been developed with the support of the Medical University Plovdiv Project №11/2017. The aim of the study is to assess the status of PSC in Bulgarian hospitals and to compare it to that in USA and Croatian hospitals. Methods. The study was conducted from June 01 to July 31, 2018 using the web-based Bulgarian Version of the Hospital Survey on Patient Safety Culture Questionnaire (B-HSOPSC). Two hundred and forty-eight medical professionals from different hospitals in Bulgaria participated in the study. In order to quantify the differences of positive scores distributions for each of the 42 HSOPSC items between Bulgarian, Croatian and USA samples, the χ2-test was applied. The research hypothesis assumed that there were no significant differences between the Bulgarian, Croatian and US PSCs. Results. The results revealed 14 significant differences in the positive scores between the Bulgarian and Croatian PSCs and 15 between the Bulgarian and the USA PSC, respectively. Bulgarian medical professionals provided less positive responses to 12 items compared with Croatian and USA respondents. The Bulgarian respondents were more positive compared to Croatians on the feedback and communication of medical errors (Items - C1, C4, C5) as well as on the employment of locum staff (A7) and the frequency of reported mistakes (D1). Bulgarian medical professionals were more positive compared with their USA colleagues on the communication of information at shift handover and across hospital units (F5, F7). The distribution of positive scores on items: “Staff worry that their mistakes are kept in their personnel file” (RA16), “Things ‘fall between the cracks’ when transferring patients from one unit to another” (RF3) and “Shift handovers are problematic for patients in this hospital” (RF11) were significantly higher among Bulgarian respondents compared with Croatian and US respondents. Conclusions. Significant differences of positive scores distribution were found between Bulgarian and USA PSC on one hand and between Bulgarian and Croatian on the other. The study reveals that distribution of positive responses could be explained by the cultural, organizational and healthcare system differences.

Submitted by Núcleo de Pós-Graduação Administração (npgadm@ufba.br) on 2019-09-04T16:26:47Z No. of bitstreams: 1 Dissertação de Mestrado - Lucas Gouveia de Carvalho Teixeira.pdf: 8010035 bytes, checksum: 432680636f9fcba008848c5b4f43542f (MD5) Approved for entry into archive by Maria Angela Dortas (dortas@ufba.br) on 2019-09-05T20:13:54Z (GMT) No. of bitstreams: 1 Dissertação de Mestrado - Lucas Gouveia de Carvalho Teixeira.pdf: 8010035 bytes, checksum: 432680636f9fcba008848c5b4f43542f (MD5) Made available in DSpace on 2019-09-05T20:13:54Z (GMT). No. of bitstreams: 1 Dissertação de Mestrado - Lucas Gouveia de Carvalho Teixeira.pdf: 8010035 bytes, checksum: 432680636f9fcba008848c5b4f43542f (MD5) O objetivo deste trabalho é mensurar a cultura de segurança do paciente do Hospital Geral Clériston Andrade, conforme a percepção dos trabalhadores. Foi realizado um estudo de caso com abordagem qualitativa e quantitativa, de natureza exploratória. A primeira parte consistiu na revisão de literatura em bancos de dados nacionais e internacionais. A segunda, compreende a realização de uma pesquisa exploratória survey, voltada para a aplicação do questionário sobre a Cultura de Segurança do Paciente (Hospital Survey on Patient Safety Culture, HSOPSC) da Agency for Healthcare Research and Quality (AHRQ). O Hospital locus da pesquisa é situado na cidade de Feira de Santana/Bahia e é referência para Macrorregião Centro Leste do Estado. Foi aplicado questionário como instrumento de coleta de dados com os funcionários vinculados à unidade, independente do vínculo empregatício ou modo de contato com o paciente(direto ou não). Foram encaminhados 1528 questionários e 763 respondentes devolveram os questionários preenchidos. A taxa de retorno final da pesquisa foi de 49,93%. Na análise dos dados, utilizou-se a planilha Hospital Survey on Patient Safety Culture - Data Entry and Analysis Tool - versão fevereiro de 2018, customizada pela AHRQ para produzir os resultados do questionário. Esse é o software indicado para envio padronizado dos dados da pesquisa para a base mundial da agência e processamento estatístico dos mesmos. Os resultados obtidos revelaram que das 12 dimensões avaliadas, apenas a que avaliou a supervisão imediata quanto à promoção de segurança do paciente é considerada área forte no hospital, pontuando 79% de respostas positivas. As outras 11 dimensões são áreas frágeis ou neutras (equivalendo a 91,67% do total de dimensões). O pior desempenho nos achados, ocorreu na dimensão de “resposta não punitiva ao erro” com apenas 22% de respostas positivas. Com relação ao grau de segurança do paciente, especificamente em sua área de trabalho, 43% apontam que a nota geral é regular. No que concerne ao preenchimento de relatórios de eventos adversos, 78% dos respondentes não preencheram nenhum, nos últimos 12 meses. Isto posto, conclui-se que: a) a cultura de segurança do paciente no Hospital possui todos os resultados, com valores inferiores aos encontrados nas 12 dimensões de segurança publicados nos relatórios da AHRQ em 2018; b) que a cultura de preenchimento de relatórios de eventos adversos é imatura; c) que os servidores possuem uma perspectiva sobre segurança do paciente similar, independente do nível de interação com o paciente. Assim, objetivando a melhoria da segurança do paciente e a redução dos eventos adversos, recomenda-se: o fortalecimento de uma cultura não punitiva na organização; incentivo ao preenchimento das fichas de não conformidade e a instituição de fluxos eficientes de comunicação de eventos adversos. The objective of this paper is to measure the patient safety culture of Clériston Andrade General Hospital, according to the workers’ perception. A case study with a qualitative and quantitative exploratory approach was conducted. The first part consisted of literature review in national and international databases. The second comprises an exploratory survey, aimed at applying the Survey on Patient Safety Culture (HSOPSC) questionnaire from the Agency for Healthcare Research and Quality (AHRQ). The Hospital locus of research is located in the city of Feira de Santana / Bahia and is a reference for Macroregião Centro Leste do Estado. A questionnaire was applied as a data collection instrument with employees linked to the unit, regardless of employment or contact with the patient (direct or not). 1528 questionnaires were sent and 763 respondents returned the completed questionnaires. The final return rate of the survey was 49.93%. For data analysis, the Hospital Survey on Patient Safety Culture - Data Entry and Analysis Tool - February 2018 version, customized by AHRQ, was used to produce the questionnaire results. This is the software for standardized submission of survey data to the agency’s worldwide database and statistical processing. The results showed that of the 12 dimensions evaluated, only the one that evaluated immediate supervision regarding the promotion of patient safety is considered a strong area in the hospital, scoring 79% of positive responses. The other 11 dimensions are fragile or neutral areas (equivalent to 91.67% of total dimensions). The worst performance in the findings occurred in the dimension of “non-punitive error response” with only 22% of positive responses. Regarding the degree of patient safety, specifically in their work area, 43% point out that the overall grade is fair. With regard to filing adverse event reports, 78% of respondents have not filled out any in the last 12 months. Thus, it can be concluded that: a) the patient safety culture in the hospital has all the results, with values lower than those found in the 12 safety dimensions published in the AHRQ reports in 2018; b) that the adverse event reporting culture is immature; c) that servers have a similar patient safety perspective, regardless of the level of patient interaction. Thus, aiming at improving patient safety and reducing adverse events, it is recommended: the strengthening of a non-punitive culture in the organization; encouraging the completion of non-compliance sheets and the establishment of efficient adverse event reporting flows.

Submitted by Núcleo de Pós-Graduação Administração (npgadm@ufba.br) on 2019-09-04T16:26:47Z No. of bitstreams: 1 Dissertação de Mestrado - Lucas Gouveia de Carvalho Teixeira.pdf: 8010035 bytes, checksum: 432680636f9fcba008848c5b4f43542f (MD5) Approved for entry into archive by Maria Angela Dortas (dortas@ufba.br) on 2019-09-05T20:13:54Z (GMT) No. of bitstreams: 1 Dissertação de Mestrado - Lucas Gouveia de Carvalho Teixeira.pdf: 8010035 bytes, checksum: 432680636f9fcba008848c5b4f43542f (MD5) Made available in DSpace on 2019-09-05T20:13:54Z (GMT). No. of bitstreams: 1 Dissertação de Mestrado - Lucas Gouveia de Carvalho Teixeira.pdf: 8010035 bytes, checksum: 432680636f9fcba008848c5b4f43542f (MD5) O objetivo deste trabalho é mensurar a cultura de segurança do paciente do Hospital Geral Clériston Andrade, conforme a percepção dos trabalhadores. Foi realizado um estudo de caso com abordagem qualitativa e quantitativa, de natureza exploratória. A primeira parte consistiu na revisão de literatura em bancos de dados nacionais e internacionais. A segunda, compreende a realização de uma pesquisa exploratória survey, voltada para a aplicação do questionário sobre a Cultura de Segurança do Paciente (Hospital Survey on Patient Safety Culture, HSOPSC) da Agency for Healthcare Research and Quality (AHRQ). O Hospital locus da pesquisa é situado na cidade de Feira de Santana/Bahia e é referência para Macrorregião Centro Leste do Estado. Foi aplicado questionário como instrumento de coleta de dados com os funcionários vinculados à unidade, independente do vínculo empregatício ou modo de contato com o paciente(direto ou não). Foram encaminhados 1528 questionários e 763 respondentes devolveram os questionários preenchidos. A taxa de retorno final da pesquisa foi de 49,93%. Na análise dos dados, utilizou-se a planilha Hospital Survey on Patient Safety Culture - Data Entry and Analysis Tool - versão fevereiro de 2018, customizada pela AHRQ para produzir os resultados do questionário. Esse é o software indicado para envio padronizado dos dados da pesquisa para a base mundial da agência e processamento estatístico dos mesmos. Os resultados obtidos revelaram que das 12 dimensões avaliadas, apenas a que avaliou a supervisão imediata quanto à promoção de segurança do paciente é considerada área forte no hospital, pontuando 79% de respostas positivas. As outras 11 dimensões são áreas frágeis ou neutras (equivalendo a 91,67% do total de dimensões). O pior desempenho nos achados, ocorreu na dimensão de “resposta não punitiva ao erro” com apenas 22% de respostas positivas. Com relação ao grau de segurança do paciente, especificamente em sua área de trabalho, 43% apontam que a nota geral é regular. No que concerne ao preenchimento de relatórios de eventos adversos, 78% dos respondentes não preencheram nenhum, nos últimos 12 meses. Isto posto, conclui-se que: a) a cultura de segurança do paciente no Hospital possui todos os resultados, com valores inferiores aos encontrados nas 12 dimensões de segurança publicados nos relatórios da AHRQ em 2018; b) que a cultura de preenchimento de relatórios de eventos adversos é imatura; c) que os servidores possuem uma perspectiva sobre segurança do paciente similar, independente do nível de interação com o paciente. Assim, objetivando a melhoria da segurança do paciente e a redução dos eventos adversos, recomenda-se: o fortalecimento de uma cultura não punitiva na organização; incentivo ao preenchimento das fichas de não conformidade e a instituição de fluxos eficientes de comunicação de eventos adversos. The objective of this paper is to measure the patient safety culture of Clériston Andrade General Hospital, according to the workers’ perception. A case study with a qualitative and quantitative exploratory approach was conducted. The first part consisted of literature review in national and international databases. The second comprises an exploratory survey, aimed at applying the Survey on Patient Safety Culture (HSOPSC) questionnaire from the Agency for Healthcare Research and Quality (AHRQ). The Hospital locus of research is located in the city of Feira de Santana / Bahia and is a reference for Macroregião Centro Leste do Estado. A questionnaire was applied as a data collection instrument with employees linked to the unit, regardless of employment or contact with the patient (direct or not). 1528 questionnaires were sent and 763 respondents returned the completed questionnaires. The final return rate of the survey was 49.93%. For data analysis, the Hospital Survey on Patient Safety Culture - Data Entry and Analysis Tool - February 2018 version, customized by AHRQ, was used to produce the questionnaire results. This is the software for standardized submission of survey data to the agency’s worldwide database and statistical processing. The results showed that of the 12 dimensions evaluated, only the one that evaluated immediate supervision regarding the promotion of patient safety is considered a strong area in the hospital, scoring 79% of positive responses. The other 11 dimensions are fragile or neutral areas (equivalent to 91.67% of total dimensions). The worst performance in the findings occurred in the dimension of “non-punitive error response” with only 22% of positive responses. Regarding the degree of patient safety, specifically in their work area, 43% point out that the overall grade is fair. With regard to filing adverse event reports, 78% of respondents have not filled out any in the last 12 months. Thus, it can be concluded that: a) the patient safety culture in the hospital has all the results, with values lower than those found in the 12 safety dimensions published in the AHRQ reports in 2018; b) that the adverse event reporting culture is immature; c) that servers have a similar patient safety perspective, regardless of the level of patient interaction. Thus, aiming at improving patient safety and reducing adverse events, it is recommended: the strengthening of a non-punitive culture in the organization; encouraging the completion of non-compliance sheets and the establishment of efficient adverse event reporting flows.

Patient safety culture is a vital component in ensuring high quality and safe patient care. Assessment of staff perception on existing hospital patient safety culture (PSC) is the first step to promote PSC. This paper is aimed to assess the patient safety culture in 1 big public autonomous general hospital in Hanoi, Vietnam. This cross-sectional study surveyed 638 healthcare professional utilizing the validated (Hospital Survey on Patient Safety Culture [HSOPSC]) in an online format. This study adhered to STROBE guidelines. The positive response rate was high, with a percentage of 74.2. The strongest areas are teamwork within units (91.3%) and organizational learning/continuous improvement (88.4%). The areas for improvement are staffing (49.4%) and non-punitive response to error (53.1%). Hospital administrators should strengthen the culture of patient safety by formulating strategies and implementing interventions with emphasis on adequate staffing and promoting blame-free working environment.

Organizational culture is one of important factors that contribute to the performance of an organization, including in a hospital. In a hospital, performance can be measured by its level of patient safety. Howover, studies and research that discuss the relationship of organizational culture and patient safety are still very limited, including in Indonesia. This research is conducted to observe organizational culture that support patient safety. This research is conducted in three hospitals in Jakarta. Type of organizational culture is identified using the Organizational Culture Assessment Instrument (OCAI) questionnaire and the level of patient safety is assessed using the Hospital Survey on Patient Safety Culture (HSOPSC) questionnaire. Once the organizational culture is identified and the level of patient safety culture is observed in each hospital, correlation test and analysis is conducted between types of organizational culture with aspect of patient safety based. Results show that three hospitals do not have dominant organizational culture. However, type of organizational culture that has a significant positive correlation with aspect of patient safety the most is adhocracy culture, eventhough other organizational culture type also support patient safety. The result of this research then used as initial suggestion to make change on organizational culture so that patient safety could be improved

Background: In recent years, there has been growing concern about patient safety and this is becoming a global problem. Medication safety can be used to describe systematic assessments of healthcare professionals’ practices as related to safe use of medicines. Identification and prevention of medication errors is the key component of medication safety. This includes multiple aspects of medication practice and other factors that affect it, such as organisational structure, communication, technologies such as those used for dispensing, and strategies pursued by leadership in cultivating and promoting a culture of safety. Methods: The study adopted a mixed method approach divided into three phases. Phase I is a quantitative phase and involves an assessment of core medication safety practices in the study sites together with an assessment of patient safety culture through the use of the Hospital Survey on Patient Safety Culture (HSOPSC) developed by US Agency for Health Care Research and Quality (AHRQ). Phase II will involve semi-structured interviews with health care providers and focus group discussions with patients to explore their perspectives on medication safety and to explore their experiences concerning medication safety respectively. Phase III will be an intervention study and will utilise the World Health Organisation (WHO) Patient Safety Curriculum Guide: Multi professional edition as the intervention tool. Discussion: The study findings will offer substantial opportunity for improvements. The study will also open up an area of patient safety culture, where not much research has been conducted in Nigeria. Lay summary Exploring medication safety practices in public healthcare facilities in Kaduna State, Nigeria: a study protocol Patient safety is a global problem and there has been growing concern regarding it in recent years. Much less is known about medication safety in Nigeria. We are conducting this study in four public health facilities in Kaduna State, Nigeria in multiple phases that involve multiple stakeholders and data collection methods. In phase Ia, we assessed the presence of basic medication safety practices (such as use of information technology, transition in care practices, and others) by having structured questionnaire based interviews with the Head of Pharmacy department of each of the health facilities. In phase Ib, we are conducting a survey to assess patient safety culture amongst doctors, nurses and pharmacists of the selected health facilities. In phase IIa, we will be conducting one-on-one interviews with healthcare providers to explore their perspectives on medication safety, while phase IIb will involve group discussions with patients to explore their experiences regarding their safety in healthcare. Phase III will be the final phase, which will be an educational intervention phase that will be carried out as a pre- and post-intervention study. We will distribute a questionnaire to participants (pharmacists only), after which we will conduct seminars with the study participants using a patient safety curriculum developed by the World Health Organisation (WHO). Three (3) months later, we will distribute the same pre intervention questionnaire to participants who had responded to the earlier questionnaire and participated in the educational sessions. This study is the first to be conducted in Kaduna State that explores medication safety and patient safety culture. On completion, it will open up an area of patient safety where not much research has been conducted in Nigeria. We expect that the study findings will offer substantial opportunity for making improvements in healthcare safety and quality.

Background To develop a culture of patient safety in a regime that strongly focuses on saving patients from emergencies may seem counter-intuitive and challenging. Little research exists on patient safety culture in the context of Emergency Medical Services (EMS), and the use of survey tools represents an appropriate approach to improve patient safety. Research indicates that safety climate studies may predict safety behavior and safety-related outcomes. In this study we apply the Norwegian versions of Hospital Survey on Patient Safety Culture (HSOPSC) and assess the psychometric properties when tested on a national sample from the EMS. Methods This study adopted a web based survey design. The Norwegian HSOPSC has 13 dimensions, consisting of 46 items, in addition to two single-item outcome variables. SPSS (version 21) was used for descriptive data analysis, estimating internal consistency, and performing exploratory factor analysis. Confirmatory factor analysis (CFA) was applied to test the dimensional structure of the instruments using Amos (version 21). Results N = 1387 (27%) EMS employees participated in the survey. Overall, acceptable psychometric properties were observed, i.e. acceptable internal consistencies and construct validity. The patient safety climate dimensions with highest scores (number of positive answers) were “teamwork within units” and “manager expectations & actions promoting patient safety”. The dimension “hospital management support for patient safety” had the lowest score. Conclusions The results provided a validated instrument, the Prehospital Survey on Patient Safety Culture (PreHSOPSC), for measuring patient safety climate in an EMS setting. In addition, the explanatory power was strong for several of the outcome dimensions; i.e., several of the safety climate dimensions have a strong predictive effect on outcome variables related to employees’ perceptions on patient safety and safety-related attitude. Electronic supplementary material The online version of this article (10.1186/s12913-018-3576-x) contains supplementary material, which is available to authorized users.

BACKGROUND: Patient safety (PS) is one of the essential elements of health care quality and a priority of healthcare systems in most countries. Thus the creation of validated instruments and the implementation of systems that measure patient safety are considered to be of great importance worldwide.AIM: The present paper aims to illustrate the process of linguistic validation, cross-cultural verification and adaptation of the Bulgarian version of the Hospital Survey on Patient Safety Culture (B-HSOPSC) and its test-retest reliability.METHODS: The study design is cross-sectional. The HSOPSC questionnaire consists of 42 questions, grouped in 12 different subscales that measure patient safety culture. Internal con­sistency was assessed using Cronbach’s alpha. The Wilcoxon signed-rank test and the split-half method were used; the Spear­man-Brown coefficient was calculated.RESULTS: The overall Cronbach’s alpha for B-HSOPSC is 0.918. Subscales 7 Staffing and 12 Overall perceptions of safety had the lowest coefficients. The high reliability of the instrument was confirmed by the Split-half method (0.97) and ICC-coefficient (0.95). The lowest values of Spearmen-Broun coefficients were found in items A13 and A14.CONCLUSION: The study offers an analysis of the results of the linguistic validation of the B-HSOPSC and its test-retest reliability. The psychometric characteristics of the questions revealed good validity and reliability, except two questions. In the future, the instrument will be administered to the target population in the main study so that the psychometric properties of the instrument can be verified.

Objectives: Patient safety culture affects patient safety and the performance of hospitals. The Hospital Survey on Patient Safety Culture (HSOPSC) is generally used to assess the safety culture in hospitals and unit levels. However, only a few studies in China have measured surgical settings compared with other units in county hospitals using the HSOPSC. This study aims to assess the strengths and weaknesses of surgical departments compared with all other departments in county hospitals in China with HSOPSC. Design: This research is a cross-sectional study. Methods: In 2015, a Chinese translation of HSOPSC was administered to 1379 staff from sampled departments from 19 county hospitals in Xiaogan City (Hubei Province, China) using a simple random and cluster sampling method. Outcome Measures: The HSOPSC was completed by 1379 participants. The percent positive ratings (PPRs) of 12 dimensions (i.e., teamwork within units, organizational learning and continuous improvement, staffing, non-punitive response to errors, supervisor/ manager expectations and actions promoting patient safety, feedback and communication about errors, communication openness, hospital handoffs and transitions, teamwork across hospital units, hospital management support for patient safety, overall perception of safety, as well as frequency of events reported) and the positive proportion of outcome variables (patient safety grade and number of events reported) between surgical departments and other departments were compared with t-tests and X2 tests, respectively. A multiple regression analysis was conducted, with the outcome dimensions serving as dependent variables and basic characteristics and other dimensions serving as independent variables. Similarly, ordinal logistic regression was used to explore the influencing factors of two categorical outcomes. Results: A total of 56.49% of respondents were from surgical departments. The PPRs for “teamwork within units” and “organizational learning and continuous improvement” were ≥75%, which denoted strengths, and the PPRs for “staffing” and “non-punitive response to errors” were ≤50%, which denoted weaknesses in surgical units and other units. Three dimensions for surgical departments were weaker than those for other departments (p < 0.05). The staff from surgical units reported more events compared with the other units, but only a few respondents in surgical settings evaluated patient safety grade as good/excellent. Four dimensions influenced patient safety grade, and three dimensions influenced event reporting in surgical units. Conclusions: Strategies including recruiting workers, using the reporting system, and building a non-punitive culture should be adopted in the surgical units of county hospitals in China to improve safety culture. Supervisors should also prioritise patient safety.

The aim was to psychometrically test the S-HSOPSC and HSOPSC, investigate health care staff’s perceptions of patient safety culture and their suggestions for improvement. Methods: A three-time cross-sectional study with data from health care staff (N= 3721) in a Swedish county council was conducted in 2009 (N = 1,023), 2011 (N = 1,228) and 2013 (N =1,470) using the S-HSOPSC (I, II, III). Health care staff’s suggestions for improvement were analyzed in a qualitative content analysis study (IV). Results: The S-HSOPSC (14 dimensions, 51 items) is acceptable for measuring patient safety culture (I). Health care staff held a positive attitude towards their own unit’s teamwork, and a less favorable attitude towards hospital managers’ support for patient safety work (I). Managers held a more positive attitude towards patient safety than others and enrolled nurses held a more positive attitude than registered nurses and physicians (II, III). Positive attitudes towards learning, nonpunitive response and staffing was associated with positive attitudes towards overall safety (II). Health care staff’s attitudes towards patient safety decreased between 2009- 2013 for 12 dimensions (III). A diversity of approaches, nuanced in relation to the informant’s profession was suggested to improve patient safety, for example ‘Increased staffing’ ‘Teamwork and collaboration’ and ‘Committed management' (IV). Conclusions: The S-HSOPSC is suitable for measuring patient safety culture. Supporting and committed managers, teamwork and collaboration are important for patient safety improvement. RNs have an important coordinating position in patient safety work, since they work in close proximity to the patients, and strategically in teams, where decisions of importance for patient safety are made. Health care staff attitudes towards communication, nonpunitive approach, feedback and learning from mistakes have deteriorated. To prevent from organizational fatigue, actions are needed. Baksidestext: In health care, many patients are being harmed, with leads to suffering and financial costs. Health care staff’s patient safety culture reflects their attitudes towards safety for patients. The overall aim was to psychometrically test the questionnaires S-HSOPSC and HSOPSC for measuring patient safety culture, investigate health care staff’s perceptions of patient safety culture and their suggestions for improvement. In this thesis, respondents in the most common health care staff groups participated. Health care staff held a positive attitude towards patient safety culture within their own unit’s work. The perception of patient safety culture differed between professions and managers had a more positive attitude towards patient safety culture than others. Health care staff’s attitudes towards patient safety decreased during the measurement period for almost all aspects and they suggested many approaches to improve patient safety. Patient safety needs to be a responsibility for everyone. Supporting, committed managers, teamwork and collaboration are important for patient safety improvement. RNs have an important coordinating position in patient safety work. Syftet var att psykometriskt testa frågeformulären S-HSOPSC och HSOPSC och undersöka sjukvårdspersonals attityder till patientsäkerhet samt förslag till förbättringar. Metod: Tre tvärsnittsundersökningar genomfördes. Sjukhuspersonal (N = 3 721) i ett landsting besvarade enkäten Hospital Survey on Patient Safety Culture om patientsäkerhetskultur år 2009 (n = 1 023), 2011 (n = 1 228) och 2013 (n = 1 470) (I, II, III). Sjukvårdspersonalens förslag på förbättring av patientsäkerhet studerades med kvalitativ innehållsanalys (IV). Resultatet visade att den svenska versionen S-HSOPSC (14 dimensioner, 51 frågor) är acceptabel för att mäta patientsäkerhetskultur (I). Sjukvårdspersonalen hade en positiv attityd till aspekter av patientsäkerhet som handlade om arbete på den egna vårdenheten, men en mindre positiv attityd till högsta ledningens stöd för patientsäkerhetsarbetet (I). Chefer hade en mer positiv attityd till patientsäkerhet än andra och undersköterskor hade en mer positiv attityd än sjuksköterskor och läkare (II, III). Förmågan att dra lärdom av misstag, en icke-skuldbeläggande attityd vid misstag samt bemanning var positivt associerad till en positiv attityd till generell patientsäkerhet (II). Sjukvårdspersonalens attityder till patientsäkerheten försämrades under mätperioden för 12 av 14 dimensioner. (III). Sjukvårdspersonalen föreslog en mängd förbättringar av patientsäkerheten. Förslagen var nyanserade i relation till informanternas egen profession (IV). Konklusioner: Engagerade chefer är viktigt för patientsäkerheten. Teamwork och förståelse för varandras arbete är gynnsamt för patientsäkerheten. Sjuksköterskor är viktiga i patientsäkerhetsarbetet, då de både arbetar nära patienterna och i team där beslut fattas som rör patientsäkerheten. Personalens attityd till kommunikation, icke- bestraffande synsätt, återkoppling och lärande i samband med misstag har försämrats. Detta kan indikera en organisatorisk utmattning och kräver åtgärder.

Vitenskapelig, fagfellevurdert artikkel This study examined the psychometric properties of the Swedish and the original version of the Hospital Survey on Patient Safety Culture within a Swedish hospital setting and described health care staff’s per- ceptions of patient safety culture. A web-survey was used to obtain data from registered nurses, enrolled nurses and physicians (N = 1023). Psychometric properties were tested using Confirmatory Factor Analysis and internal consistency using Cronbach’s alpha coefficient. Root mean square error of ap- proximation and other fit indices indicated psycho- metric properties for both versions to be acceptable. Internal consistency for the dimensions varied be- tween 0.60 and 0.87. Staff scored the dimension “Teamwork Within Units” highest and the dimension “Hospital Management Support” the lowest. The safety was graded as very good or excellent by 58.9% of the respondents and one third had reported more than one event in the past 12 months. The question- naire is considered to be useful for measuring patient safety culture in Swedish hospital settings. Managers have a great responsibility to work with improving patient safety culture.

Hintergrund: In seinem Bericht To Err is Human aus dem Jahr 2000 betonte das Institute of Medicine (IOM)die Notwendigkeit der Etablierung einer Sicherheitskultur zur Verbesserung der Patientensicherheit im Krankenhaus. Nicht zuletzt wegen des Berichtes des IOMs gewann die Erfassung und Analyse der Sicherheitskultur[for full text, please go to the a.m. URL], 12. Deutscher Kongress für Versorgungsforschung