An Exploratory Study of Patient Safety Culture in Hospitals: Patient Safety Climate and its Association with Hospital Workers’ Safety Practice

• Main Authors: Chen-LingShih, 施貞伶
• Other Authors: Kuo Piao Chung
• Format: Others
• Language: zh-TW
• Published: 2005
• Online Access: http://ndltd.ncl.edu.tw/handle/50229253095783038233

碩士 === 國立臺灣大學 === 醫療機構管理研究所 === 93 === Objectives: In 2000, a medical error report published by Institute of Medicine (IOM)— “To Err is Human”, implied that at least 44,000 and perhaps as many as 98,000 Americans were dead in hospitals each year as a result of medical errors. The estimated total national costs amounted to be between 17 and 29 billion dollars in preventable adverse events. Regarding to this terrifying report, government organizations and NGOs in most advanced countries are taking actions to improve patient safety, and primary of them is to build a patient safety culture in healthcare systems. Measuring safety culture practices for years in foreign countries. As lacking applications of such instruments in relevant domestic hospital researches, this research goes with PATIENT SAFETY CLIMATE IN HEALTHCARE ORGANIZATIONS (PSCHO), which is constructed by Patient Safety Center of Inquiry at Veterans Affairs Palo Alto Health Care System and the Centers for Health Policy and Primary Care and Outcome Research at Stanford. PSCHO is adapted with permission and translated into Chinese to measure patient safety culture in hospitals in Taiwan. Association between patient safety climate and behaviors of healthcare workers is also examined. Methods: This study is a cross-sectional study. By mailing 3,010 questionnaires to the senior executives and healthcare workers of 6 hospitals, 1,098 samples responded (36.48 percent response rate). Result: Confirmatory Factor Analysis (CFA) is carried out to test the factor structure of PSCHO and self-administrated patient safety behavior scale. PSCHO, with the 3 main dimensions as “management and organization,” “individual performance,” and “blame and shame,” performed a validity asχ2(8)=14.64 (p>0.05), RMSEA=0.03, and CFI=0.99. Each item performs reliability indicator (R2) between 0.11 to 0.50. Results indicate an acceptable model fit. The validity of the three-factor structure that constructed by Singer et al. was supported by Taiwan sample of healthcare workers. Through the analyses of T-test and ANOVA, the results show that healthcare workers with seniority, religious belief, or manager position, have higher patient safety climate perception and self-report better patient safety behaviors. There are significant variations among participating hospitals, despite some of them granted the National Quality Award. With multiple regression analysis result, we find the positive correlation between healthcare workers’ patient safety behaviors and perception of patient safety climate. Conclusion: To enhance the health care workers’ participation and compliance in patient safety behaviors, the most important factor is to strengthen the supportive perception of patient safety in management and organization.