Similarities and differences in the associations between patient safety culture dimensions and self-reported outcomes in two different cultural settings: a national cross-sectional study in Palestinian and Belgian hospitals
Date
2018-07-31
Authors
Najjar, Shahenaz
Baillien, Elfi
Vanhaecht, Kris
Hamdan, Motasem
Euwema, Martin
Vleugels, Arthur
Sermeus, Walter
Schrooten, Ward
Hellings, Johan
Vlayen, Annemie
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Abstract
Objectives To investigate the relationships between
patient safety culture (PSC) dimensions and PSC selfreported
outcomes across different cultures and to gain
insights in cultural differences regarding PSC.
Design Observational, cross-sectional study.
Setting Ninety Belgian hospitals and 13 Palestinian
hospitals.
Participants A total of 2836 healthcare professionals
matched for profession, tenure and working hours.
Primary and secondary outcome measures The
validated versions of the Belgian and Palestinian Hospital
Survey on Patient Safety Culture were used. An exploratory
factor analysis was conducted. Reliability was tested
using Cronbach’s alpha (α). In this study, we examined
the specific predictive value of the PSC dimensions and its
self-reported outcome measures across different cultures
and countries. Hierarchical regression and bivariate
analyses were performed.
Results Eight PSC dimensions and four PSC selfreported
outcomes were distinguished in both countries.
Cronbach’s α was α≥0.60. Significant correlations were
found between PSC dimensions and its self-reported
outcome (p value range <0.05 to <0.001). Hierarchical
regression analyses showed overall perception of safety
was highly predicted by hospital management support
in Palestine (β=0.16, p<0.001) and staffing in Belgium
(β=0.24, p<0.001). The frequency of events was largely
predicted by feedback and communication in both
countries (Palestine: β=0.24, p<0.001; Belgium: β=0.35,
p<0.001). Overall grade for patient safety was predicted by
organisational learning in Palestine (β=0.19, p<0.001) and
staffing in Belgium (β=0.19, p<0.001). Number of events
reported was predicted by staffing in Palestine (β=−0.20,
p<0.001) and feedback and communication in Belgium
(β=0.11, p<0.01).
Conclusion To promote patient safety in Palestine and
Belgium, staffing and communication regarding errors
should be improved in both countries. Initiatives to improve
hospital management support and establish constructive learning systems would be especially beneficial for patient
safety in Palestine. Future research should address the
association between safety culture and hard patient safety
measures such as patient outcomes.
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Citation
Najjar S, Baillien E, Vanhaecht K, et al. Similarities and differences in the associations between patient safety culture dimensions and self-reported outcomes in two different cultural settings: a national cross-sectional study in Palestinian and Belgian hospitals. BMJ Open 2018;8:e021504. doi:10.1136/ bmjopen-2018-021504