Exploring the Relationship Between Perceptions of Safety Culture and Patient Safety Events in Inpatient Clinical Teams

Document Type : Original Article

Authors

1 Department of Communication, Missouri State University.

2 Department of Communication, North Dakota State University, Fargo, ND, United States.

3 Department of Public Health, NDSU; Center for Biobehavioral Health, Sanford Research, Fargo, ND, United States

Abstract

Introduction:
Inpatient clinical teams in hospitals must communicate properly to maintain a culture of safety. The purpose of this study was to understand how perceptions of patient safety culture relate to the frequency of safety events in hospitals. Predicted connections were made between elements of safety culture and safety events, using Schein’s model of organizational culture as a framework.
 Materials and Methods:
The research team was able to gain access to a large sample of perceptions of safety culture from clinical teams in hospitals.
 Results:
Results showed that handoffs and transitions were a significant predictor of the reduction of safety events, whereas other predictors were not significant. Implications for communication research on clinical teams are discussed.
 Conclusion:
Implications are provided for the variables along with a discussion of the findings from the data. Practical implications for healthcare teams are also discussed for consideration of team member behaviors in the future. Suggestions for future research are identified.

Keywords

Main Subjects


  1. Neville, B., Miltner, R. S., & Shirey, M. R.. Clinical Team Training and a Structured Handoff Tool to Improve Teamwork, Communication, and Patient Safety. JHQ 2021; 43(6), 365-373.
  2. James, J. T. A new, evidence-based estimate of patient harms associated with hospital care. JPS 2013; 9(3), 122-128.
  3. Schein, E. H. Organizational culture. American Psychologist. 1990; 45(2), 109–119.
  4. Singer, S. J., Gaba, D. M., Falwell, A., Lin, S., Hayes, J., & Baker, L. Patient safety climate in 92 U.S. hospitals: Differences by work area and discipline. Medical Care. 2009; 47(1), 23-31.
  5. Schein, E. H. Organizational culture and leadership. 2010 (4th Ed.) Jossey-Bass
  6. Banka, et al. Improving patient satisfaction through physician education, feedback, and incentives. JHM 2015; 10(8), 497-502.
  7. Goffman, E. On face-work: An analysis of ritual elements of social interaction. PJSIP 1955; 18(3), 213–231.
  8. Kaldjian, L. C., Jones, E. W., Wu, B. J., Forman-Hoffman, V. L., Levi, B. H., & Rosenthal, G. E. Reporting medical errors to improve patient safety: A survey of physicians in teaching hospitals. AIM 2008; 168(1), 40-46.
  9. Pham, et al. National study on the frequency, types, causes, and consequences of voluntarily reported emergency department medication errors. JEM, 40(5), 485-492.
  10. Lewin, S., & Reeves, S. Enacting 'team' and 'teamwork': Using Goffman's theory of impression management to illuminate interprofessional practice on hospital wards. SSM 2011; 72, 1595-1602. 
  11. Detert, J. R., & Burris, E. R. Leadership behavior and employee voice: Is the door really open? AMJ 2007; 50, 869-884. 
  12. Kassing, J. W. Investigating the relationship between superior‐subordinate relationship quality and employee dissent. Communication Research Reports. 2000; 17(4), 387-396. 
  13. Garner, J. T. Open doors and iron cages: Supervisors' responses to employee dissent. IJBC 2016; 53(1), 27-54.
  14. Johnson, A., Guirguis, E., & Grace, Y. Preventing medication errors in transitions of care: A patient case approach. JAPA 2015; 55(2), e264-e276.
  15. American Pharmacists Association, & American Society of Health-System Pharmacists. Improving care transitions: optimizing medication reconciliation. JAPA 2012; 52(4), e43-e52.
  16. Tjosvold, D., Yu, Z. Y., & Hui, C. Team learning from mistakes: The contribution of cooperative goals and problem‐solving. JMS 2004; 41(7), 1223-1245.
  17. Evans, et al. Attitudes and barriers to incident reporting: A collaborative hospital study. BMJ Quality & Safety. 2006; 15(1), 39-43.
  18. Steen, S., Jaeger, C., Price, L., & Griffen, D. Increasing patient safety event reporting in an emergency medicine residency. BMJ Open Quality. 2017; 6(1), 1-5.
  19. Dunbar, et al. An improvement approach to integrate teaching teams in the reporting of safety events. Pediatrics. 2017; 139(2), 1-10.
  20. Ammouri, A. A., Tailakh, A. K., Muliira, J. K., Geethakrishnan, R., & Al Kindi, S. N. Patient safety culture among nurses. International Nursing Review. 2015; 62(1), 102-110.
  21. Lee, S. H., Phan, P. H., Dorman, T., Weaver, S. J., & Pronovost, P. J. Handoffs, safety culture, and practices: Evidence from the hospital survey on patient safety culture. BMC Health Services Research. 2016; 16(1), 1-8.
  22. Cho, S. M., & Choi, J. Patient safety culture associated with patient safety competencies among registered nurses. Journal of Nursing Scholarship. 2018; 50, 549-557.
  23. Fan, et al. Association of safety culture with surgical site infection outcomes. JACS 2016; 222(2). 122-128.
  24. Alenezi, et al. Clinical practitioners' perception of the dimensions of patient safety culture in a government hospital: A one‐sample correlational survey. JCN 2019; 28(23-24), 4496-4503.
  25. Blegen, M. A., Gearhart, S., O'Brien, R., Sehgal, N. L., & Alldredge, B. K. AHRQ's hospital survey on patient safety culture: Psychometric analyses. JPS 2009; 5(3):139-144.
  26. Leape, L. Error in medicine. JAMA. 1994; 272(23), 1851-1857
  27. Mardon, R. E., Khanna, K., Sorra, J., Dyer, N., & Famolaro, T. Exploring relationships between hospital patient safety culture and adverse events. JPS 2010; 6, 226-232.
  28. Abraham, J., Kannampallil, T. G., Almoosa, K. F., Patel, B., & Patel, V. L. Comparative evaluation of the content and structure of communication using two handoff tools: Implications for patient safety. Journal of Critical Care 2014; 29(2), 311.e1-311.e7.
  29. Feng, X. Q., Acord, L., Cheng, Y. J., Zeng, J. H., & Song, J. P. The relationship between management safety commitment and patient safety culture. INR 2011; 58(2), 249-254.
  30. Auer, C., Schwendimann, R., Koch, R., De Geest, S., & Ausserhofer, D. How hospital leaders contribute to patient safety through the development of trust. JNA 2014; 44(1), 23-29.