Skip to main content
Top
Published in: BMC Health Services Research 1/2013

Open Access 01-12-2013 | Research article

Hospital survey on patient safety culture in China

Authors: Yanli Nie, Xuanyue Mao, Hao Cui, Shenghong He, Jing Li, Mingming Zhang

Published in: BMC Health Services Research | Issue 1/2013

Login to get access

Abstract

Background

Patient safety culture is an important measure in assessing the quality of health care. There is a growing recognition of the need to establish a culture of hospital focused on patient safety. This study explores the attitudes and perceptions of patient safety culture for health care workers in China by using a Hospital Survey on Patient Safety Culture (HSPSC) questionnaire and comparing it with the psychometric properties of an adapted translation of the HSPSC in Chinese hospitals with that of the US.

Method

We used the modified HSPSC questionnaire to measure 10 dimensions of patient safety culture from 32 hospitals in 15 cities all across China. The questionnaire included 1160 Chinese health-care workers who consisted of predominately internal physicians and nurses. We used SPSS 17.0 and Microsoft Excel 2007 to conduct the statistical analysis on survey data including descriptive statistics and validity and reliability of survey. All data was input and checked by two investigators independently.

Result

A total of 1500 questionnaires were distributed of which 1160 were responded validly (response rate 77%). The positive response rate for each item ranged from 36% to 89%. The positive response rate on 5 dimensions (Teamwork Within Units, Organization Learning-Continuous Improvement, Communication Openness, Non-punitive Response and Teamwork Across Units) was higher than that of AHRQ data (P < 0.05). There was a statistical difference on the perception of patient safety culture in groups of different work units, positions and qualification levels. The internal consistency of the total survey was comparatively satisfied (Cronbach’s α = 0.84).

Conclusion

The results show that amongst the health care workers surveyed in China there was a positive attitude towards the patient safety culture within their organizations. The differences between China and the US in patient safety culture suggests that cultural uniqueness should be taken into consideration whenever safety culture measurement tools are applied in different culture settings.
Literature
1.
go back to reference Aspden P, Corrigan J, Wolcott J: Patient Safety, Achieving a New Standard for Care. 2004, Washington, D.C.: The National Academies Press Aspden P, Corrigan J, Wolcott J: Patient Safety, Achieving a New Standard for Care. 2004, Washington, D.C.: The National Academies Press
2.
go back to reference Reid PR, Compton WD, Grossman JH, Fanjiang G: Building a better delivery system. A new engineering/health care partnership. 2005, Washington, D.C.: National Academies Press, 15. Reid PR, Compton WD, Grossman JH, Fanjiang G: Building a better delivery system. A new engineering/health care partnership. 2005, Washington, D.C.: National Academies Press, 15.
3.
go back to reference Hughes RG, Clancy CM: Working conditions that support patient safety. J Nurs Care Qual. 2005, 20 (4): 289-292. 10.1097/00001786-200510000-00001.CrossRefPubMed Hughes RG, Clancy CM: Working conditions that support patient safety. J Nurs Care Qual. 2005, 20 (4): 289-292. 10.1097/00001786-200510000-00001.CrossRefPubMed
4.
go back to reference Kohn LT, Corrigan JM, Donaldson MS: To err is human: building a safer health system. 1999, Washington D.C.: National Academy Press Kohn LT, Corrigan JM, Donaldson MS: To err is human: building a safer health system. 1999, Washington D.C.: National Academy Press
5.
go back to reference Schein E: Organizational Culture and Leadership San Francisco. 1985, San Francisco: Jossey-Basss Schein E: Organizational Culture and Leadership San Francisco. 1985, San Francisco: Jossey-Basss
6.
go back to reference Ronald GS: Developing and operationalizing a culture of safety. Chinese Hospitals. 2005, 9 (12): 7-8. Ronald GS: Developing and operationalizing a culture of safety. Chinese Hospitals. 2005, 9 (12): 7-8.
7.
go back to reference Clarke S: Perceptions of organizational safety: implications for the development of safety culture. J Org Behavior. 1999, 20 (2): 185-198. 10.1002/(SICI)1099-1379(199903)20:2<185::AID-JOB892>3.0.CO;2-C.CrossRef Clarke S: Perceptions of organizational safety: implications for the development of safety culture. J Org Behavior. 1999, 20 (2): 185-198. 10.1002/(SICI)1099-1379(199903)20:2<185::AID-JOB892>3.0.CO;2-C.CrossRef
8.
go back to reference Zohar D: Safety climate in industrial organizations: theoretical and applied implications. J Appl Psychol. 1980, 65 (1): 96-102.CrossRefPubMed Zohar D: Safety climate in industrial organizations: theoretical and applied implications. J Appl Psychol. 1980, 65 (1): 96-102.CrossRefPubMed
9.
go back to reference Zohar D: A group-level model of safety climate: testing the effect of group climate on microaccidents in manufacturing jobs. J Appl Psychol. 2000, 85 (4): 587-596.CrossRefPubMed Zohar D: A group-level model of safety climate: testing the effect of group climate on microaccidents in manufacturing jobs. J Appl Psychol. 2000, 85 (4): 587-596.CrossRefPubMed
10.
go back to reference Chen IC, Li HH: Measuring patient safety culture in Taiwan using the Hospital Survey on Patient Safety Culture (HSOPSC). BMC Health Serv Res. 2010, 10: 152-162. 10.1186/1472-6963-10-152.CrossRefPubMedPubMedCentral Chen IC, Li HH: Measuring patient safety culture in Taiwan using the Hospital Survey on Patient Safety Culture (HSOPSC). BMC Health Serv Res. 2010, 10: 152-162. 10.1186/1472-6963-10-152.CrossRefPubMedPubMedCentral
11.
go back to reference Matsubara S, Hagihara A, Nobutomo K: Development of a patient safety climate scale in Japan. Int J Quality in Health Care. 2008, 20 (3): 211-220. 10.1093/intqhc/mzn003.CrossRef Matsubara S, Hagihara A, Nobutomo K: Development of a patient safety climate scale in Japan. Int J Quality in Health Care. 2008, 20 (3): 211-220. 10.1093/intqhc/mzn003.CrossRef
12.
go back to reference Haugen AS, Søfteland E, Eide GE, Nortvedt MW, Karina Aase K, Harthug S: Patient safety in surgical environments: cross-countries comparison of psychometric properties and results of the Norwegian version of the hospital survey on patient safety. BMC Health Serv Res. 2010, 10: 279-10.1186/1472-6963-10-279.CrossRefPubMedPubMedCentral Haugen AS, Søfteland E, Eide GE, Nortvedt MW, Karina Aase K, Harthug S: Patient safety in surgical environments: cross-countries comparison of psychometric properties and results of the Norwegian version of the hospital survey on patient safety. BMC Health Serv Res. 2010, 10: 279-10.1186/1472-6963-10-279.CrossRefPubMedPubMedCentral
13.
go back to reference 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 Serv Res. 2010, 10: 28-10.1186/1472-6963-10-28.CrossRefPubMedPubMedCentral 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 Serv Res. 2010, 10: 28-10.1186/1472-6963-10-28.CrossRefPubMedPubMedCentral
14.
go back to reference 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 Serv Res. 2008, 8: 1-9. 10.1186/1472-6963-8-1.CrossRef 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 Serv Res. 2008, 8: 1-9. 10.1186/1472-6963-8-1.CrossRef
15.
go back to reference El-Jardali F, Jaafar M, Dimassi H, Jamal D, Hamdan R: The current state of patient safety culture in Lebanese hospitals: a study at baseline. Int J Qual Health Care. 2010, 22: 386-395. 10.1093/intqhc/mzq047.CrossRefPubMed El-Jardali F, Jaafar M, Dimassi H, Jamal D, Hamdan R: The current state of patient safety culture in Lebanese hospitals: a study at baseline. Int J Qual Health Care. 2010, 22: 386-395. 10.1093/intqhc/mzq047.CrossRefPubMed
16.
go back to reference Lee WC, Wung HY, Liao HH, Lo CM, Chang FL, Wang PC, Fan A, Chen HH, Yang HC, Hou SM: Hospital safety culture in Taiwan: a nationwide survey using Chinese version safety attitude questionnaire. BMC Health Serv Res. 2010, 10: 234-10.1186/1472-6963-10-234.CrossRefPubMedPubMedCentral Lee WC, Wung HY, Liao HH, Lo CM, Chang FL, Wang PC, Fan A, Chen HH, Yang HC, Hou SM: Hospital safety culture in Taiwan: a nationwide survey using Chinese version safety attitude questionnaire. BMC Health Serv Res. 2010, 10: 234-10.1186/1472-6963-10-234.CrossRefPubMedPubMedCentral
17.
go back to reference Hellings J, Schrooten W, Klazinga N, Vleugels A: Challenging patient safety culture: survey results. Int J Health Care Qual Assur. 2007, 20 (7): 620-632. 10.1108/09526860710822752.CrossRefPubMed Hellings J, Schrooten W, Klazinga N, Vleugels A: Challenging patient safety culture: survey results. Int J Health Care Qual Assur. 2007, 20 (7): 620-632. 10.1108/09526860710822752.CrossRefPubMed
19.
go back to reference Zhu J, Li LP, Shi MY, Lu HY, Garnick DW, Weingart SN: What constitutes patient safety culture in Chinese hospitals?. Int J Qual Health Care. 2012, 2012: 2012. Zhu J, Li LP, Shi MY, Lu HY, Garnick DW, Weingart SN: What constitutes patient safety culture in Chinese hospitals?. Int J Qual Health Care. 2012, 2012: 2012.
22.
go back to reference Grant MJ, Donaldson AE, Larsen GY: The safety culture in a children’s hospital. J Nurs Care Qual. 2006, 21 (3): 223-229. 10.1097/00001786-200607000-00006.CrossRefPubMed Grant MJ, Donaldson AE, Larsen GY: The safety culture in a children’s hospital. J Nurs Care Qual. 2006, 21 (3): 223-229. 10.1097/00001786-200607000-00006.CrossRefPubMed
23.
go back to reference Cheng B: Chinese culture and organizational leadership: From phenomenological description to theory testing. Indigenous Psychol Res Chinese Soc. 2002, 22: 3-48. Cheng B: Chinese culture and organizational leadership: From phenomenological description to theory testing. Indigenous Psychol Res Chinese Soc. 2002, 22: 3-48.
24.
go back to reference de Pablos PO: Western and Eastern views on social networks. Learning Org. 2005, 12 (5): 436-456. 10.1108/09696470510611393.CrossRef de Pablos PO: Western and Eastern views on social networks. Learning Org. 2005, 12 (5): 436-456. 10.1108/09696470510611393.CrossRef
25.
go back to reference Johnstone MJ, Kanitsaki O: Culture, language, and patient safety: making the link. Int J Qual Health Care. 2006, 18 (5): 383-388. 10.1093/intqhc/mzl039.CrossRefPubMed Johnstone MJ, Kanitsaki O: Culture, language, and patient safety: making the link. Int J Qual Health Care. 2006, 18 (5): 383-388. 10.1093/intqhc/mzl039.CrossRefPubMed
26.
go back to reference Triandis HC, Bontempo R, Villareal MJ, Asai M, Lucca N: Individualism and collectivism: Cross-cultural perspectives on self-ingroup relationships. J Personal Soc Psychol. 1988, 54 (2): 323-338.CrossRef Triandis HC, Bontempo R, Villareal MJ, Asai M, Lucca N: Individualism and collectivism: Cross-cultural perspectives on self-ingroup relationships. J Personal Soc Psychol. 1988, 54 (2): 323-338.CrossRef
27.
go back to reference Simpson RL: Patient and nurse safety: how information technology makes a difference. Nurs Adm Q. 2005, 29 (1): 97-101. 10.1097/00006216-200501000-00015.CrossRefPubMed Simpson RL: Patient and nurse safety: how information technology makes a difference. Nurs Adm Q. 2005, 29 (1): 97-101. 10.1097/00006216-200501000-00015.CrossRefPubMed
28.
go back to reference Bodur S, Filiz E: A survey on patient safety culture in primary healthcare services in Turkey. Int J Qual Health Care. 2009, 21 (5): 348-355. 10.1093/intqhc/mzp035.CrossRefPubMed Bodur S, Filiz E: A survey on patient safety culture in primary healthcare services in Turkey. Int J Qual Health Care. 2009, 21 (5): 348-355. 10.1093/intqhc/mzp035.CrossRefPubMed
30.
go back to reference Cao RG: Medical quality and patient safety in China. Chinese Hospitals. 2007, 11 (11): 1-4. Cao RG: Medical quality and patient safety in China. Chinese Hospitals. 2007, 11 (11): 1-4.
31.
go back to reference Sorra JS, Dyer N: Multilevel psychometric properties of the AHRQ hospital survey on patient safety culture. BMC Health Serv Res. 2010, 10: 199-10.1186/1472-6963-10-199.CrossRefPubMedPubMedCentral Sorra JS, Dyer N: Multilevel psychometric properties of the AHRQ hospital survey on patient safety culture. BMC Health Serv Res. 2010, 10: 199-10.1186/1472-6963-10-199.CrossRefPubMedPubMedCentral
Metadata
Title
Hospital survey on patient safety culture in China
Authors
Yanli Nie
Xuanyue Mao
Hao Cui
Shenghong He
Jing Li
Mingming Zhang
Publication date
01-12-2013
Publisher
BioMed Central
Published in
BMC Health Services Research / Issue 1/2013
Electronic ISSN: 1472-6963
DOI
https://doi.org/10.1186/1472-6963-13-228

Other articles of this Issue 1/2013

BMC Health Services Research 1/2013 Go to the issue