Perceived patient safety culture and its associated factors among clinical managers of tertiary hospitals: a cross-sectional survey

Abstract

Background: Patient safety is a global challenge influenced by perceived patient safety culture. However, limited knowledge exists regarding the patient safety culture perceived by hospital clinical managers and its associated factors. This study aims to investigate the perceptions of patient safety culture and associated factors among clinical managers of tertiary hospitals in China.

Methods: A cross-sectional survey was conducted from June 19 to July 16, 2021, involving 539 clinical managers from four tertiary hospitals in Changsha City of Hunan Province. The Hospital Survey on Patient Safety Culture (HSOPSC) was utilized to assess perceived patient safety culture. Bivariate, multivariable linear regression, and logistic regression analyses were performed.

Results: The mean score for the total HSOPSC was 72.5 ± 7.6, with dimensional scores ranging from 62.1 (14.9) to 86.6 (11.7). Three dimensions exhibited positive response rates (PRRs) < 50%, indicating areas that need to be improved: "nonpunitive response to errors" (40.5%), "staffing" (41.9%), and "frequency of events reported" (47.4%). Specialized hospitals (β = 1.744, P = 0.037), female gender (β = 2.496, P = 0.003), higher professional title (β = 1.413, P = 0.049), a higher education level (β = 1.316, P = 0.001), and shorter time delays per shift (β=-1.13, P < 0.001) were correlated with higher perceived patient safety culture. Education level, work department, "teamwork within a unit", "management support for patient safety", "communication openness", and "staffing" dimensions were associated with patient safety grades (all P < 0.05). Years worked in hospitals, occupation, education level, work department, hospital nature, professional title, "communication openness", and "handoffs & transitions" were associated with the number of adverse events reported (all P < 0.05).

Conclusions: Our study revealed a generally low level of patient safety culture perceived by clinical managers and identified priority areas requiring urgent improvement. The associated factors of patient safety culture provide important guidance for the development of targeted interventions in the future. Promoting patient safety by optimizing the patient safety culture perceived by clinical managers should be prioritized.

Keywords: Adverse events reported; Associated factor; Clinical manager; Patient safety culture; Patient safety grade; Tertiary hospital; Time delays per shift.

Fig. 1

Binary logistic regression analysis for (A) patient safety grade and (B) number of adverse events reported

Fig. 2

Multiple logistic regression analysis for (A) patient safety grade and (B) the number of adverse events reported