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Multilevel Analysis of Individual, Organizational, and Regional Factors Associated With Patient Safety Culture: A Cross-Sectional Study of Maternal and Child Health Institutions in China.

journal contribution
posted on 01.02.2021, 02:35 by Yuanyuan Wang, Yanjun Fan, Xiaoli Wang, Yuanying Ma, Chunmei Wu, Huifeng Shi, Hui Han, Weiwei Liu, Chaojie Liu
© Wolters Kluwer Health, Inc. All rights reserved. Objectives The aim of this study was to assess patient safety culture (PSC) in maternal and child health (MCH) institutions in China and its individual, organizational, and regional variations. Methods Using the PSC survey for MCH institutions (PSCS-MCHI), 2021 valid respondents from 25 participating institutions were investigated in three regions (Beijing, Zhejiang, and Jiangxi) of China. Patient safety culture and its subscale scores (1-5) and factors associated with PSC as revealed by multilevel modeling. Results The respondents had an average PSC score of 3.55 (SD = 0.35), with subscale scores ranging between 2.46 ("staffing and workload") and 4.02 ("work commitment"). There were limited regional differences in PSC: a three-level regression model was only confirmed for the subscale "staff empowerment"(P = 0.006). However, significant organizational variations in PSC were evident: a two-level regression model was assumed for the PSC scale and nine subscales (P < 0.001). The fixed-effect models showed that male respondents, frontline workers, those who were in their mid-career (11-20 y), overloaded (=9 hours), and had a masters or higher degree reported worse PSC. Frontline workers were less positive than managers in ratings on "managerial response to risks"(-0.11 [-0.20 to -0.02]), "management support"(-0.18 [-0.28 to -0.07]), and "staff empowerment"(-0.23[-0.35 to -0.11]). Conclusions Patient safety culture in MCH institutions is shaped by organizational and individual characteristics. We observed a gap in perceived PSC between frontline worker, who are less positive, and managers. Actions for improving PSC should consider interventions on organizational management (such as appropriate staffing and workload management) and engagement of frontline workers in the development of management and training activities.

Funding

This study was supported by the China-US Center for Medical Professionalism, Peking University Health Science Center (PUHSC-MPC1302).

History

Publication Date

01/12/2019

Journal

Journal of Patient Safety

Volume

16

Issue

4

Pagination

8p.

Publisher

Wolters Kluwer Health

ISSN

1549-8417

Rights Statement

The Author reserves all moral rights over the deposited text and must be credited if any re-use occurs. Documents deposited in OPAL are the Open Access versions of outputs published elsewhere. Changes resulting from the publishing process may therefore not be reflected in this document. The final published version may be obtained via the publisher’s DOI. Please note that additional copyright and access restrictions may apply to the published version.

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