Aspects of Patient Safety Culture Most Associated With Employees' Overall Rating of Patient Safety and Whether Employees Reported Safety Events: Overall and for hospitals Predominantly Serving Black Patients.

IF 1.7 3区 医学 Q3 HEALTH CARE SCIENCES & SERVICES
Denise D Quigley, Lucy Schulson, Flora Sheng, Marc N Elliott, Andrew W Dick
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引用次数: 0

Abstract

Objectives: Care for black patients in the United States is concentrated in relatively few hospitals-known as black serving hospitals (BSHs). BSHs have high rates of safety events. Yet, it is unknown what aspects of patient safety culture are associated with employee assessments of patient safety or reporting safety events, and whether these patterns differ for hospitals predominantly serving black patients.

Methods: We identified hospitals as BSH if their proportion of admitted black patients exceeded the national average (12.1%). We linked BSH status to the 2021-2022 Hospital Survey on Patient Safety Culture 2.0 (HSOPS) data, identifying 128 BSHs and 243 non-BSHs (with 107,224 and 138,028 HSOPS respondents, respectively). We examined the associations of 10 aspects of patient safety culture with 2 summary measures: employee's overall rating of patient safety and whether employees reported safety events. We fit respondent-level models, overall and stratified by BSH status, controlling for respondent characteristics. We used weights accounting for hospital HSOPS observations and to make results nationally representative. t tests were obtained from a model fully interacted with BSH status to test whether the associations for BSHs and non-BSHs were different.

Results: Positive patient safety ratings were most associated with staffing/work pace, communication openness, management support of safety, and organizational learning-continuous improvement. Reporting any event was most positively associated with response to error and most negatively associated with management support. Patterns were similar for BSHs and non-BSHs, except for 4 associations: stronger positive association of organizational learning-continuous improvement with positive patient safety ratings in BSHs. Stronger negative association of staffing/work pace and communication openness with reporting any event in BSHs. Stronger positive association of communication openness with reporting any events in non-BSHs.

Conclusions: Key aspects of creating hospital workplace cultures that engage in identifying events and learning from them to support patient safety differed in BSHs and non-BSHs, warranting further investigation. This knowledge may help mitigate differences in patient safety across hospitals.

与员工对患者安全的总体评价和员工是否报告安全事件最相关的患者安全文化方面:总体而言,主要为黑人患者服务的医院。
目的:在美国,对黑人患者的护理集中在相对较少的医院-被称为黑人服务医院(BSHs)。bsh的安全事件发生率很高。然而,尚不清楚患者安全文化的哪些方面与员工对患者安全的评估或安全事件的报告有关,以及这些模式是否在主要为黑人患者服务的医院有所不同。方法:如果住院黑人患者的比例超过全国平均水平(12.1%),我们将医院确定为BSH。我们将BSH状况与2021-2022年医院患者安全文化2.0 (hops)调查数据联系起来,确定了128名BSH和243名非BSH(分别有107,224和138,028名hops受访者)。我们通过两项总结措施检查了患者安全文化的10个方面的关联:员工对患者安全的总体评级和员工是否报告了安全事件。我们拟合受访者水平模型,根据BSH状态进行整体和分层,控制受访者特征。我们使用加权计算医院hsop观察结果,并使结果具有全国代表性。从一个与BSH状态完全相互作用的模型中获得t检验,以检验BSH和非BSH的关联是否不同。结果:积极的患者安全评分与人员配置/工作节奏、沟通开放性、管理支持安全以及组织学习持续改进密切相关。报告任何事件与对错误的反应呈正相关,与管理支持负相关。除了4项关联外,bsh和非bsh的模式相似:bsh的组织学习-持续改进与阳性患者安全评分有更强的正相关。在BSHs中,人员配置/工作节奏和沟通开放性与报告任何事件有较强的负相关。在非bshs中,沟通开放性与报告任何事件有更强的正相关。结论:创建医院工作场所文化的关键方面,即参与识别事件并从中学习以支持患者安全,在BSHs和非BSHs中存在差异,需要进一步调查。这方面的知识可能有助于减轻医院之间患者安全方面的差异。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Journal of Patient Safety
Journal of Patient Safety HEALTH CARE SCIENCES & SERVICES-
CiteScore
4.60
自引率
13.60%
发文量
302
期刊介绍: Journal of Patient Safety (ISSN 1549-8417; online ISSN 1549-8425) is dedicated to presenting research advances and field applications in every area of patient safety. While Journal of Patient Safety has a research emphasis, it also publishes articles describing near-miss opportunities, system modifications that are barriers to error, and the impact of regulatory changes on healthcare delivery. This mix of research and real-world findings makes Journal of Patient Safety a valuable resource across the breadth of health professions and from bench to bedside.
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