Patient Safety Culture Assessment of a Hospital in Tehran: A Case Study

Document Type : Original Article

Authors

1 MSc. Department of Health Services Management, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran.

2 Assistant Professor, Department of Health Services Management, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran.

3 MSc. Healthcare Management, Mazandaran University of Medical Sciences, Sari, Mazandaran.

Abstract

Introduction:
Evaluating a hospital's patient safety culture (PSC) increases awareness of the various aspects of patient safety. Due to the critical role of PSC, the current study was designed and conducted to assess the level of PSC from the perspective of medical staff.
Materials and Methods:
A descriptive-analytical study was conducted in one of Tehran's hospitals in 2017. A total of 122 participants were selected as the research population from hospital clinical staff using stratified random sampling. The data collection method was a standard HSOPS questionnaire. The data were analyzed descriptively and analytically using SPSS19 software, including the T-test, analysis of variance, and Friedman test.
Results:
The most studied populations were women (80.33%), and nursing staff (54.92%), the average serving years in hospital was (45/1±42/9).The mean score for PSC was 3.41, significantly higher than the national average. Among the various aspects of PSC, the highest and lowest scores were for "managers' expectations and actions regarding patient safety" and "openness of communication channels," respectively.
Conclusion:
According to the findings, the PSC among hospital staff is generally positive and high, which may be a result of the hospital's efforts to establish accreditation standards in the hospital. It is recommended that the hospital management team place a premium on open communication channels, teamwork, organizational learning, information exchange and transmission, communication and error feedback for all medical staff. Additionally, for effective learning, it is recommended to clearly define the process of encouraging and punishing to motivate, continuously assess patient safety status, provide timely feedback on results.

Keywords

Main Subjects


  1. Pradhan M, Saadah F, Sparrow R. Did the health card program ensure access to medical care for the poor during Indonesia's economic crisis? The World Bank Economic Review. 2007;21(1):125-50.
  2. Buttell P, Hendler R, Daley J. Quality in healthcare: concepts and practice. The business of healthcare. 2008;3:61-95.
  3. Smits M, Christiaans-Dingelhoff I, Wagner C, van der Wal G, Groenewegen PP. The psychometric properties of the 'Hospital Survey on Patient Safety Culture' in Dutch hospitals. BMC health services research. 2008;8(1):230.
  4.  Jalalifar F, Sepehri Mm. Process mining of medication, error recognition, and contributory factor in creation of errors. Quarterly Journal of Nursing Management. 2016;4(4):67-81.
  5. Fleming M, Wentzell N. Patient safety culture improvement tool: development and guidelines for use. Healthc Q. 2008;11(3):10-5.
  6. McLennan S, Engel S, Ruhe K, Leu A, Schwappach D, Elger B. Implementation status of error disclosure standards reported by Swiss hospitals. Swiss medical weekly. 2013; 14 3:w 13820.
  7. Feng X, Bobay K, Weiss M. Patient safety culture in nursing: a dimensional concept analysis. Journal of advanced nursing. 2008;63(3):310-9.
  8. Soad Mahfoozpour, Elaheh Ainy, Farzaneh Mobasheri, Ahmad Faramarzi. Patients' safety culture status among educational hospitals of Shahid Beheshti University of Medical Sciences in 2011. Pajoohande. 2012;17(3):134-41.
  9. Abdi z, Maleki MR, Khosravi a. Perceptions of patient safety culture among the staff of selected hospitals affiliated to Tehran University of Medical Sciences. 2011.
  10. Shahrabadi R, Moeini B, Roshanai G, Dashti S, Kafami V, Haghighi M. Assessing Hamadans nurses perceptions of patient safety cultures dimensions. Journal of Hospital. 2014;12(4):83-90.
  11. P A, M PR, A FM. Evaluation of Patient Safety Culture Based on the Viewpoint of Nurses and Physicians Employed in a Military Hospital. Military Caring Sciences. 2018;5(1):26-33.
  12. Eslami S, Abu-Hanna A, De Keizer NF. Evaluation of outpatient computerized physician medication order entry systems: a systematic review. Journal of the American Medical Informatics Association. 2007;14(4):400-6.
  13. Sari AB, Cracknell A, Sheldon TA. Incidence, preventability, and consequences of adverse events in older people: results of a retrospective case-note review. Age and ageing. 2008; 37(3): 265-9.
  14. Alizadeh AM, Davari F, Mansouri M, Mohammadnia M. Analysis of medical errors: a case study. Medical Ethics Journal. 2017; 10(38): 59-68.
  15. Shekari M, Shirali G, Hosseinzadeh T. Safety culture assessment among laboratory personnel of a petrochemical company. Health and Safety at Work. 2014;4(1):65-72.
  16. Anderson DJ. Creating a culture of safety: Leadership, teams, and tools. Nurse Leader. 2006; 4(5):38-41.
  17. Schutz AL, Counte MA, Meurer S. Development of a patient safety culture measurement tool for ambulatory health care settings: analysis of content validity. Health Care Management Science. 2007;10(2):139-49.
  18. Rezaie t, ghahramanian a, abdollahzadeh f, Asghari-jafarabadi M, sheykhalipoor z, fadaei z. Patient safety culture and the factors influencing from the perspective of nurses of Medical Center of Imam Reza (AS) Tabriz. Journal of Nursing and Midwifery Urmia University of Medical Sciences. 2018;15(10):767-76.
  19. Tabibi J, Nasiripour A, Maleki M ,Raessi P, Mahmmoudi M, Azimi L. Survey of employees' safety attitude in a teaching hospital Tehran 2010. Iran Occupational Health. 2011;7(4):5-0.
  20. Mohebi Far R, Alijan zade M, Safari Variani A, Khoshtarkib H, Ghanati E, Teymouri F, et al. Studying patient safety culture from the viewpoint of staffs in educational hospitals in Tehran City. Journal of Health and Safety at Work. 2015;5(1):57-64.
  21. Matsubara S, Hagihara A, Nobutomo K. Development of a patient safety climate scale in Japan. International Journal for Quality in Health Care. 2008;20(3):211-20.
  22. Alqattan H, Cleland J, Morrison Z. An evaluation of patient safety culture in a secondary care setting in Kuwait. Journal of Taibah University Medical Sciences. 2018; 13(3): 272-80.
  23. Sammer CE, Lykens K, Singh KP, Mains DA, Lackan NA. What is patient safety culture? A review of the literature. Journal of Nursing Scholarship. 2010;42(2):156-65.
  24. Hellings J, Schrooten W, Klazinga N, Vleugels A. Challenging patient safety culture: survey results. International journal of health care quality assurance. 2007;20(7):620-32.
  25. Bodur S, Filiz E. Validity and reliability of Turkish version of" Hospital Survey on Patient Safety Culture" and perception of patient safety in public hospitals in Turkey. BMC health services research. 2010;10(1):28.
  26. Chen I-C, Li H-H. Measuring patient safety culture in Taiwan using the Hospital Survey on Patient Safety Culture (HSOPSC). BMC health services research. 2010;10(1):152.
  27. Moghri J, Arab M, Saari AA, Nateqi E, Forooshani AR, Ghiasvand H, et al. The psychometric properties of the Farsi version of "Hospital survey on patient safety culture" in Iran's hospitals. Iranian journal of public health. 2012;41(4):80.
  28. Moghri J, Ghanbarnezhad A, Moghri M, Rahimi Forooshani A, Akbari Sari A, Arab M. Validation of Farsi version of hospital survey on patient safety culture questionnaire, using confirmatory factor analysis method. Hospital. 2012;11(2):19-30.
  29. Rezaei T, Abdullahzadeh F, Ghahramanian A, Asghari Jafarabadi M, Fadaei Z, Sheikhalipour Z. Patient safety culture and the factors influencing from the perspective of nurses of Medical Center of Imam Reza (AS) Tabriz. The J Urmia Nurs Midwifery Fac. 2018;15(10):767-76.
  30. Mostafaei D, Aryankhesal A, Dastoorpoor M, Rahimikhalifekandi Z, Estebsari F. Patient Safety Culture Assessment of Clinical and Paraclinical Staff Perspective in Selected University of Medical Sciences Hospitals in Tehran. Iranian Journal of Health Education and Health Promotion. 2018;6(3):293-301.
  31. Pour RM, Fatemi MA. Evaluation of Patient Safety Culture Based on the Viewpoint of Nurses and Physicians Employed in a Military Hospital. 2018.
  32. Jahangiri M, Haghshenas H, Maleki S, ghorbaniM, delikhoon M. Survey of patient safety culture in a hospital in Shiraz, Iran, in 2015
  33. Mohebbifar R, Alijanzadeh M. Studying patient safety culture from the viewpoint of staffs in educational hospitals in Tehran City. Journal of health and safety at work. 2015.
  34. Saber M, Tehrani H, Kabootarkhani MH, Sabagh MG, Bagheri M. Acquaintance of Kerman hospitals' staff about patient safety culture. Journal of Health and Development. 2015; 4(2): 124-32.
  35.  Izadi ar, Drikvand j, Ebrazeh a. The patient safety culture in Fatemeh Zahra hospital of Najafabad, Iran. 2013.
  36. Kabodi S, Ghanbari M, Ashtarian H, Bagheri F, Ajamin E. Assessing elements of patient safety culture in Kermanshah health care and educational centers. Health and Safety at Work. 2016; 6(4):63-74.
  37. Shahri S, Kebriaee A, Seyedi H, Sarafraz Z. Patient safety climate in medical centers of Kashan. Journal of Health Promotion Management. 2012;1(1):62-72.
  38. Mahfoozpour S, Ainy E, Mobasheri F, Faramarzi A. Patients' safety culture status among educational hospitals of Shahid Beheshti University of Medical Sciences in 2011. Pajoohandeh Journal. 2012;17(3):134-41.
  39. Fathi M. Survey of the status of security in the hospitals treatment health services of Kurdistan university of medical sciences in 2003. 2003.
  40. Mohebi Far R. Alijan zade M, Safari Variani A, Khoshtarkib H, Ghanati E, Teymouri F, et al. Studying patient safety culture from the viewpoint of staffs in educational hospitals in Tehran City. J Health Saf Work. 2015;5:57-64.
  41. Rezapoor A, Tanoomand Khoushehmehr A, Bayat R, Arabloo J, Rezapoor Z. Study of patients' safety culture in Selected Training hospitals affiliated with Tehran University of medical sciences. Journal of Hospital. 2012;11(2):55-64.
  42. Davati A, Vatankhah S, Sharifi K. Assessment of patient safety culture at Shahid Mostafa Khomeini Hospital: nurses' perspective. Journal of Health Administration (JHA). 2018;20(70).
  43. Zaroshani V, Sheykhi S, Amini M, Mohamadizeydi M, editors. Investigation of safety attitude among operating room staff of educational hospital of Qazvin university of medical sciences. Selected Proceedings of Safe Community Conference in Tehran; 2009.
  44. Haghighi M, Zinat Motlagh K, Zinat Motlagh F, Taghdisi M. Assessment of patient safety culture among employees of healthcare providers hospitals in Tehran. Health Sys Res. 2014; 10(1):49-57.