Research Article: A cross-sectional survey on patient safety culture in secondary hospitals of Northeast China

Date Published: March 20, 2019

Publisher: Public Library of Science

Author(s): Kexin Jiang, Linli Tian, Cunling Yan, Ying Li, Huiying Fang, Sun Peihang, Peng Li, Haonan Jia, Yameng Wang, Zheng Kang, Yu Cui, He Liu, Siqi Zhao, Gamburg Anastasia, Mingli Jiao, Qunhong Wu, Ming Liu, Lars-Peter Kamolz.


This study aims to investigate patient safety culture in secondary hospitals of Heilongjiang, Northeast China, and explore the implications of patient safety culture and practices through the perspectives of various healthcare workers.

A cross-sectional survey using the Safety Attitude Questionnaire (SAQ) was conducted to ascertain the status of patient safety culture in nine secondary hospitals across the six dimensions of the SAQ. Among the 900 staff members who were invited to participate, 665 completed the questionnaire. Descriptive statistics were used to calculate the general means and standard deviations of the patient safety culture dimensions and other numerical variables, and F-test and a multivariate regression analysis were used to statistically analyze the differences in perceptions of safety culture considering the differences in demographic characteristics. All statistical analyses were performed using SPSS v. 22.0.

The respondents rated job satisfaction as the highest among all six dimensions of the SAQ, followed in order by teamwork climate, working conditions, and stress recognition (the lowest). There were significant differences among the dimensions of patient safety culture and other factors, such as gender, age, job position, and education. Compared with previous studies, teamwork climate and working conditions scores were quite high, while stress recognition score was very low. We also found differences in patient safety culture by demographic characteristics.

The findings revealed the patient safety culture attitudes of healthcare workers in secondary hospitals of Heilongjiang, and provided baseline data for related future research. This evidence may also help government health policymakers and hospital administrators understand related challenges and develop strategies to improve patient safety culture in secondary hospitals of China and perhaps also in other developing countries.

Partial Text

The multiple well-known reports on patient safety published by the Institute of Medicine (IOM) have induced public awareness on the problem[1]. Patient safety is unavoidably influenced by organizational culture[2], and their nexus is usually known as “patient safety culture,” which refers to the organization members’ shared values and beliefs, and the organizational norms related to patient safety[3, 4]. The increase in the awareness of patient safety has generated concern regarding patient safety culture. According to the IOM reports, improving patient safety culture is the biggest challenge in creating a safer health care system; it influences the likelihood of medical errors and personal failure[5]. Moreover, previous studies have focused more on patient safety culture in developed countries than on that in developing countries[6, 7]. In addition, it has been observed more in large general hospitals (tertiary hospitals) than in lower-level hospitals (secondary hospitals). We believe that our research in the Chinese context will help address these gaps.

The participating secondary hospitals had high rates of job satisfaction, teamwork climate, and working conditions, while perception of management and stress recognition in these hospitals was found to be low. It was observed that respondents’ perceptions differed based on their gender, work experience, position, education, and marital status. While most respondents in previous studies belonged to specific groups, such as doctors or nurses, our research contributed further by including and comparing not only doctors and nurses but also other healthcare workers such as medical technicians and managers of medical personnel; this helped us capture the perspectives of different staff members within the hospital. According to our previous research on tertiary hospitals[26], the ranking of the scores in Chinese is in the following order: work condition, teamwork climate, job satisfaction, perception of management, stress recognition, and safety climate; all scores are between 70 and 80 and are significantly higher than those observed in secondary hospitals. In addition, we found that, compared with tertiary hospitals, job satisfaction and safety climate were prioritized in secondary hospitals while work condition, perception of management, and stress recognition dimensions were given lesser importance. It is evident that further large-scale research should be conducted on secondary hospitals. The aim of the present study was to investigate the perceptions of patient safety culture among healthcare workers in secondary hospital settings.

The findings of this study revealed the attitudes of healthcare workers toward patient safety culture in secondary hospitals of Heilongjiang. Their job satisfaction, teamwork climate, and working conditions scores were all higher than those observed in previous studies, while their perception of management and stress recognition scores were comparatively lower. This highlights the need to focus more on the weaknesses of Chinese secondary hospitals in order to improve patient safety culture. There were also significant differences between the dimensions of patient safety culture and sex, age, years of experience, position, and marital status. Doctors generally scored higher in all dimensions than nurses or other healthcare workers.




Leave a Reply

Your email address will not be published.