Assessing and Comparing Perceptions of Patient Safety Culture Among 4579 Health Care Staff in 13 General and Specialized Hospitals: A Cross-sectional Study.

Abstract

Background: Although general and specialized hospitals have distinct roles and characteristics that can lead to differences in patient safety culture, there is a limited number of studies examining these differences.

Objectives: To assess and compare health care staff's perceptions of patient safety culture between general and specialized hospitals.

Methods: A cross-sectional questionnaire-based study of 4579 health care staff members, including physicians; nurses; other health care providers; and administrative staff, was conducted at 5 general and 8 specialized public hospitals in a major city in China. The Hospital Survey on Patient Safety Culture questionnaire was used to measure 12 dimensions of patient safety culture. The differences in perception of the 12 dimensions between general and specialized hospitals were analyzed using a χ2 test.

Results: In general and specialized hospitals, positive ratings for "communication openness, overall perceptions of patient safety, teamwork across departments, and handoffs and transitions" ranged from 50% to 70%. Positive ratings for "staffing" and "nonpunitive response to errors" were <50%. Positive ratings for 8 of the dimensions analyzed were significantly lower in general hospitals than in specialized hospitals, with differences ranging from 2.23% to 4.4%. Within subgroups of health care staff, the dimensions with significant differences varied across professions. Specifically, among physicians, 9 out of 12 dimensions had lower positive ratings in general hospitals than in specialized hospitals, with differences ranging from 3.84% to 7.23%.

Conclusions: General hospitals exhibited a more negative patient safety culture than specialized hospitals and thus require more proactive efforts to enhance their patient safety culture, especially among physicians. Both types of hospitals should urgently address issues related to "staffing" and "nonpunitive response to errors."