Yii-Ching Lee

Applying importance-performance analysis to patient safety culture

PURPOSE The Sexton et al.s (2006) safety attitudes questionnaire (SAQ) has been widely used to assess staffs attitudes towards patient safety in healthcare organizations. However, to date there have been few studies that discuss the perceptions of patient safety both from hospital staff and upper management. The purpose of this paper is to improve and to develop better strategies regarding patient safety in healthcare organizations. DESIGN/METHODOLOGY/APPROACH The Chinese version of SAQ based on the Taiwan Joint Commission on Hospital Accreditation is used to evaluate the perceptions of hospital staff. The current study then lies in applying importance-performance analysis technique to identify the major strengths and weaknesses of the safety culture. FINDINGS The results show that teamwork climate, safety climate, job satisfaction, stress recognition and working conditions are major strengths and should be maintained in order to provide a better patient safety culture. On the contrary, perceptions of management and hospital handoffs and transitions are important weaknesses and should be improved immediately. Research limitations/implications - The research is restricted in generalizability. The assessment of hospital staff in patient safety culture is physicians and registered nurses. It would be interesting to further evaluate other staffs (e.g. technicians, pharmacists and others) opinions regarding patient safety culture in the hospital. ORIGINALITY/VALUE Few studies have clearly evaluated the perceptions of healthcare organization management regarding patient safety culture. Healthcare managers enable to take more effective actions to improve the level of patient safety by investigating key characteristics (either strengths or weaknesses) that healthcare organizations should focus on.

A New Approach to Identify High Burnout Medical Staffs by Kernel K-Means Cluster Analysis in a Regional Teaching Hospital in Taiwan

This study uses kernel k-means cluster analysis to identify medical staffs with high burnout. The data collected in October to November 2014 are from the emotional exhaustion dimension of the Chinese version of Safety Attitudes Questionnaire in a regional teaching hospital in Taiwan. The number of effective questionnaires including the entire staffs such as physicians, nurses, technicians, pharmacists, medical administrators, and respiratory therapists is 680. The results show that 8 clusters are generated by kernel k-means method. Employees in clusters 1, 4, and 5 are relatively in good conditions, whereas employees in clusters 2, 3, 6, 7, and 8 need to be closely monitored from time to time because they have relatively higher degree of burnout. When employees with higher degree of burnout are identified, the hospital management can take actions to improve the resilience, reduce the potential medical errors, and, eventually, enhance the patient safety. This study also suggests that the hospital management needs to keep track of medical staffs’ fatigue conditions and provide timely assistance for burnout recovery through employee assistance programs, mindfulness-based stress reduction programs, positivity currency buildup, and forming appreciative inquiry groups.

A Longitudinal Study of Identifying Critical Factors of Patient Safety Culture in Taiwan

We used importance-agreement analysis to identify critical factors of the hospital survey on patient safety culture from the perceptions of physicians and nurses of a regional teaching hospital in terms of major strengths, minor strengths, minor weaknesses, and major weaknesses. In addition, we collected the raw data from 2011 to 2013 such that the advantages and deficiencies can be traced on a timely basis to enhance patient safety culture. The results show that there are 22, 21, and 21 items belonging to major strengths in 2011, 2012, and 2013, respectively. In contrast, there are 4, 5, and 5 items classified into major weaknesses in 2011, 2012, and 2013, respectively. This study also summarized the similarities and differences in this three-year period. Twenty items are the major strengths. On the contrary, only three items belonged to major weaknesses. Another viewpoint was also provided by taking into account genders in this three-year period. In summary, the hospital management can organize strategic adaptations to improve patient safety by observing the trends of strengths and weaknesses, as well as the similarities and differences in this three-year period. Therefore, hospital management can take appropriate actions to maintain the advantages and address deficiencies in order to enhance patient safety culture in this case hospital.

Revisit employee satisfaction scale: a case study of the regional teaching hospital

This study aimed to construct an updated employee satisfaction scale especially focusing on hospitals. A critical literature review is done to screen potential determinants of employee satisfaction from recognizable journals. Pretest was conducted with 250 samples and 150 valid questionnaires to implement item analysis and exploratory factor analysis. A total of 906 samples (excluding 250 pretest ones) were distributed with 524 valid ones returned (57.84% valid returned rates). Multivariate normality test, confirmatory factor analysis, and various indices of model fit were adopted to ensure the appropriateness of the employee satisfaction model. The results indicate that there are 7 factors, including 34 items confirmed as the measurements of employee satisfaction, especially for the use in the healthcare industry.

Analyzing Patient Safety Culture From Viewpoints of Physicians and Nurses—A Case of a Regional Teaching Hospital in Taiwan

Abstract: The Chinese version of safety attitudes questionnaire is used to evaluate patient safety culture from the viewpoints of physicians and nurses of a regional teaching hospital in Taiwan in 2014. This study applies Mann–Whitney U test for two independent samples test and analysis of variance to observe if different demographic variables are perceived differently in patient safety culture in terms of eight dimensions. In addition, linear regression models are applied to take into account the confounding effects of demographic variables in eight dimensions. The results show that none of the eight dimensions is more important. Besides, supervisor/manager and experience in position are the two critical demographic variables to influence the patient safety culture. The results imply that the hospital management needs to pay much attention to the employees who are not supervisors/managers and/or more experienced in position because they are less satisfied in patient safety culture.

Assessing patient safety culture in healthcare organizations: A case of applying importance-performance analysis

Patient safety culture in healthcare organizations has received increasing attention. The current study attempts to improve and to develop better strategies regarding patient safety in healthcare organizations. The Sexton et al.s (2006) Safety Attitudes Questionnaire (SAQ) is used to evaluate the perceptions of patient safety both from hospital staff and upper management. The importance-performance analysis (IPA) was applied to identify the major strengths and weaknesses of the safety culture. The results indicate that teamwork climate and stress recognition are major strengths and should be maintained in order to enhance patient safety culture. It is worth to note that the hospital staffs stress conditions need monitoring regularly and a unique program for stress management should be developed in order to arouse a positive attitude toward patient safety. By contrast, perception of management is an essential weakness and should be addressed immediately. Hospital management should create an atmosphere in the work environment that supports open dialogue about staffs opinions non-punitively in order to cause a positive impact on patient safety.