When Illegitimate Tasks Threaten Patient Safety Culture: A Cross-Sectional Survey in a Tertiary Hospital

Abstract

Objectives: The current study investigates the prevalence of illegitimate tasks in a hospital setting and their association with patient safety culture outcomes, which has not been previously investigated. Methods: We conducted a cross-sectional survey in a tertiary referral hospital. Patient safety culture outcomes were measured using the Hospital Survey on Patient Safety Culture questionnaire; the primary outcome measures were a low safety rating for the respondent's unit and whether the respondent had completed one or more safety event reports in the last 12 months. Analyses were adjusted for hospital department and staff member characteristics relating to work and health. Results: A total of 2,276 respondents answered the survey (participation rate: 35.0%). Overall, 26.2% of respondents perceived illegitimate tasks to occur frequently, 8.1% reported a low level of safety in their unit, and 60.3% reported having completed one or more safety event reports. In multivariable analyses, perception of a higher frequency of illegitimate tasks was associated with a higher risk of reporting a low safety rating and with a higher chance of having completed event reports. Conclusion: The prevalence of perceived illegitimate tasks was rather high. A programme aiming to reduce illegitimate tasks could provide support for a causal effect of these tasks on safety culture outcomes.

Keywords: illegitimate tasks; patient care management; patient safety; safety culture; teamwork.

FIGURE 1

Box plot of emotional exhaustion, satisfaction with work, self-rated health and self-esteem among healthcare professionals at Geneva University Hospitals (Switzerland, 2016).

FIGURE 2

Box plots of emotional exhaustion, satisfaction with work, self-esteem, and self-rated health, by prevalence of frequent (quite/very often) illegitimate tasks (French version of the Bern illegitimate tasks questionnaire), low patient safety in the unit or service and having completed one or more safety event reports (French version of the Hospital Survey on Patient Safety Culture questionnaire version 1), (Switzerland, 2016).