Patient Safety Culture and Speaking Up Among Health Care Workers

Seung Eun Lee; V Susan Dahinten; Ja-Kyung Seo; InYoung Park; Mi Young Lee; Hye Sung Han

doi:10.1016/j.anr.2023.01.001

Patient Safety Culture and Speaking Up Among Health Care Workers

Asian Nurs Res (Korean Soc Nurs Sci). 2023 Feb;17(1):30-36. doi: 10.1016/j.anr.2023.01.001. Epub 2023 Jan 6.

Authors

Seung Eun Lee¹, V Susan Dahinten², Ja-Kyung Seo³, InYoung Park⁴, Mi Young Lee⁴, Hye Sung Han⁴

Affiliations

¹ Mo-Im KIM Nursing Research Institute, College of Nursing, Yonsei University, Seoul, South Korea. Electronic address: leese@yuhs.ac.
² School of Nursing, University of British Columbia, Vancouver, Canada.
³ Department of Psychology, Yonsei University, Seoul, South Korea.
⁴ Division of Quality Improvement, Yonsei University Gangnam Severance Hospital, Seoul, South Korea.

PMID: 36623721
DOI: 10.1016/j.anr.2023.01.001

Abstract

Purpose: Although previous research showed the importance of safety culture on health care workers' speaking up behaviors, it is not clear how particular safety culture domains are associated with the speaking up behaviors of hospital staff. Also, researchers have suggested that health care workers' speaking up behaviors vary by profession, but there has been limited research into such differences. Thus, this study examined differences in perceptions of patient safety culture and the promotive and prohibitive speaking up behaviors of health care workers by profession and investigated the relationships between patient safety culture and the two types of speaking up behaviors.

Methods: A descriptive correlational study was conducted using secondary data collected through an online survey of health care workers at a private, nonprofit, tertiary-level teaching hospital in South Korea. The sample (N = 831) consisted of nurses (54.0%), physicians (13.0%), and other licensed and unlicensed hospital personnel (33.0%). Analyses of variance were conducted to examine differences in study variables by profession. Hierarchical regression analyses were conducted to evaluate the effects of the seven patient safety culture factors on promotive and prohibitive voice after controlling for tenure and profession.

Results: Perceptions of safety culture and promotive voice behaviors were higher for physicians compared with nurses. Communication openness, reporting patient adverse events, and unit supervisors' and hospital managements' support for patient safety were significant predictors of both types of voice behaviors.

Conclusion: Hospital administrators and unit managers should create a supportive environment where staff feel free to voice their concerns and suggestions. They should also pay attention to the varying perspectives held by different groups of hospital workers and their different voice behaviors. Knowing which dimensions of patient safety culture are most strongly related to health care workers' voice behaviors can guide patient safety improvement activities in health care organizations.

Keywords: assertiveness; organizational Culture; patient Safety.

MeSH terms

Attitude of Health Personnel
Communication
Humans
Organizational Culture
Patient Safety*
Personnel, Hospital
Physicians*
Safety Management