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PurposeThe aims of this study are to (1) evaluate physicians and nurses' perspectives on patient safety culture amid the COVID-19 pandemic and (2) integrate the emotional exhaustion of physicians and nurses into an evaluation of patient safety culture to provide insights into appropriate implications for medical care.Design/methodology/approachPatient safety culture was assessed with the Chinese version of the Safety Attitudes Questionnaire. Confirmatory factor analysis was conducted to validate the structure of the data (i.e. reliability and validity), and Pearson's correlation analysis was performed to identify relationships between safety-related dimensions.FindingsSafety climate was strongly associated with working conditions and teamwork climate. In addition, working conditions was highly correlated with perceptions of management and job satisfaction, respectively. It is worth noting that the stress and emotional exhaustion of the physicians and nurses during this epidemic were high and needed attention.Practical implicationsFor healthcare managers and practitioners, team-building activities, power of public opinions, IoT-focused service, and Employee Assistance Programs are important implications for inspiring the patient safety-oriented culture during the period of the COVID-19 pandemic.Originality/valueThis paper considers the role of emotional state into patient safety instrument, a much less understood but equally important dimension in the field of patient safety.

PurposeGender difference exists in the perception of the patient safety culture in healthcare organizations. A case from a medical center in Taiwan is presented to examine how different genders perceive the patient safety culture in practice from 2014 to 2017.Design/methodology/approachA longitudinal study using the data from 2014 to 2017 is conducted quantitatively. Mann–Whitney U test and one-way analysis of variance are employed for analyses.FindingsThe results showed that female nurses had significantly higher emotional exhaustion than male nurses in 2015 and 2016 indicating male nurses had better fatigue recovery than their female counterparts. In addition, male nurses felt a higher degree of fatigue in 2016 and 2017 than those in 2015 statistically. In contrast, female nurses felt more stressful in 2016 and 2017 than those in 2014 statistically. Female nurses had higher emotional exhaustion in 2016 and 2017 than those in 2014 and 2015 statistically.Practical implicationsTo sum up, female nurses were more stressful than before, and their recovery was also relatively poor particularly in 2016 and 2017. There is a need to reduce the degree of fatigue for female nurses in this medical center through employee assistance programs, mindfulness-based stress reduction programs, building up female nurses' positive currency and setting up their appreciative inquiry. In contrast to female nurses, male nurses recovered better from fatigue. This might encourage hospital management to deploy male nurses more effectively in this medical center.Originality/valueThe results enable the hospital management to know there is a gender difference in this case hospital. More attention on female nurses is required.

PurposeThe purpose of this study is to identify critical demographic variables that would significant influence each dimension of patient safety culture. Understanding nurses' attitudes toward patient safety is important for healthcare organizations to relentlessly improve medical quality and services for patients.Design/methodology/approachThe internal survey data sets in 2015 and 2016 from nurses' viewpoints are used. Linear regression with forward selection is applied where nine demographic variables are the input variables, while each dimension of the Chinese version of safety attitudes questionnaire (SAQ) is the dependent variable.FindingsSupervisor/manager is the most essential demographic variable that has significant impacts on six dimensions. Experience in organization is the other critical demographic variable.Practical implicationsNurses who are in charge of supervisors/managers are more satisfied in six of eight dimensions. Nurses who have much experience in an organization tend to have less satisfaction in three dimensions. Therefore, hospital management should enhance the leader's effectiveness in engaging their subordinates' commitment.Originality/valueThe results enable the hospital management to pay much attention to two major demographic variables, namely supervisor/manager and experience in organization, in order to improve the patient safety culture based on the Chinese version of SAQ in this hospital. Moreover, supervisor/manager is a more critical demographic variable for nurses due to larger absolute values of standardized coefficients by linear regression with forward selection.

Background: Extensive research on the link between the organizational characteristics of the work environment and patient safety in a healthcare organization has been conducted; yet, only a few studies have concentrated on care providers in a pediatric unit. Objectives: To determine the correlation between different work environment factors impacting patient safety in a pediatric care unit from the perspective of registered nurses working in these units. Design: Cross-sectional design. Data sources and methods: The study was conducted with 155 registered nurses from a pediatric unit in a medical center in Taiwan with the Chinese version of the Safety Attitudes Questionnaire (SAQ) 2014-2017. Results: Teamwork climate, higher job satisfaction, and better working conditions are linked to positive perceptions of patient safety culture. Emotional exhaustion is negatively related to most dimensions of patient safety. Conclusion: Teamwork climate, job satisfaction, working conditions, and emotional exhaustion were identified as critical factors impacting the patient safety climate. Implications for nursing or health policy: Investments to improve teamwork climate, job satisfaction, and working conditions and reduce emotional exhaustion may have a positive effect on patient safety in pediatric care units. This study was funded by Institute of Wuhan Studies of Jianghan University with the grant number of IWHS20192027, and Hubei University of Economics with the grant number of XJ17BS41; XJ201901; XJ201902.

Background: Patient safety culture in healthcare organizations has become an important issue globally for improving medical services. In 2016, Taiwan’s National Health Insurance (NHI) system covered 99.6% of Taiwan’s population. With the enhancement of medical quality, patients expect medical service providers to care more about safety and medical service. Understanding physicians and registered nurses’ attitudes toward patient safety is a critical issue for healthcare organizations wanting to improve the quality of the medical care they provide. Objective: The purpose of this study was to discern physicians and registered nurses’ attitudes toward patient safety using Sexton and colleagues’ Safety Attitudes Questionnaire (SAQ) in order to develop strategies for improving the quality of medical services. Methods: Pearson correlation analyses were conducted to demonstrate the relationships among six patient safety culture dimensions. Physicians and registered nurses were asked to complete the questionnaire in a case hospital in Taiwan in 2016. Results: The results of Pearson correlation analyses demonstrated a strong and positive relationship between perceptions of management and working conditions. Additionally, teamwork climate was highly correlated to safety climate. The results also illustrated that teamwork climate and job satisfaction were significantly related. Conclusion: The assessment of patient safety culture can provide a basis for hospital managers to monitor the quality of the medical care provided at their organizations. Hospital managers should put more efforts into the essentially important elements of patient safety culture, such as teamwork climate, safety climate, perceptions of management, and working conditions, so as to continuously improve the quality of medical care.

This study intends to identify critical dimension(s) of the Chinese version of the safety attitudes questionnaire (SAQ) affecting the patient safety culture from nurses' viewpoints by the internal survey data. Linear regression with forward selection approach is used where eight dimensions of the Chinese version of the SAQ are the independent variables and the overall satisfaction of the patient safety culture is the dependent variable. The results show that working conditions and job satisfaction are the two critical dimensions having significant impacts on the overall satisfaction in 2015, while working conditions, safety climate, and perceptions of management are the critical dimensions in 2016. Hospital management needs to pay much attention to improve working conditions first in order to relentlessly enhancing the patient safety culture from nurses' viewpoints in this case hospital.

Creating a better patient safety culture in hospitals has become a critical topic for providing quality medical services globally. In 2014, there were 115 thousand cases of medical disputes in China. Understanding physicians’ perceptions toward patient safety is a critical issue for hospitals to monitor safety situations for patients. This study aims to identify physicians’ attitudes toward patient safety via the investigation of Sexton et al. (2006)’s Safety Attitude Questionnaire (SAQ), to provide implications for improving medical quality. Pearson’s correlation analysis was used to demonstrate the relationships among six patient safety culture dimensions. Regression analysis was subsequently conducted to realize the degree of influence among important dimensions. Physicians was asked to answer the SAQ in a tertiary hospital in China in 2017. The results of Pearson correlation analysis demonstrate that safety climate had strong and positive relationship with working conditions and teamwork climate, respectively. Similarly, regression results illustrated that working conditions, teamwork climate, and teamwork climate had noteworthy effects on safety climate. The examination of patient safety culture from the viewpoints of physicians provides a basis for hospital managers to monitor the medical quality and service for patients. Hospital managers need to pay more efforts to the essentially important elements of patient safety, such as working conditions, teamwork climate, and job satisfaction, to continuously improve physician-patient relationship.Â

This study uses the decision-making trial and evaluation laboratory method to identify critical dimensions of the safety attitudes questionnaire in Taiwan in order to improve the patient safety culture from experts’ viewpoints. Teamwork climate, stress recognition, and perceptions of management are three causal dimensions, while safety climate, job satisfaction, and working conditions are receiving dimensions. In practice, improvements on effect-based dimensions might receive little effects when a great amount of efforts have been invested. In contrast, improving a causal dimension not only improves itself but also results in better performance of other dimension(s) directly affected by this particular dimension. Teamwork climate and perceptions of management are found to be the most critical dimensions because they are both causal dimensions and have significant influences on four dimensions apiece. It is worth to note that job satisfaction is the only dimension affected by the other dimensions. In order to effectively enhance the patient safety culture for healthcare organizations, teamwork climate, and perceptions of management should be closely monitored.

Purpose – The Sexton et al.’s (2006) safety attitudes questionnaire (SAQ) has been widely used to assess staff’s 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 staff’s (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.

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.

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.

This study assessed the attributes of the overall perception of (satisfaction with) patient safety culture using four categories of hospital staff, and it developed directions for the improvement of medical services. The Chinese version of the Safety Attitudes Questionnaire (CSAQ) was sent to the staff of study hospitals through an intraorganizational online survey application. Linear regression with forward selection was used to identify the essential dimensions of the CSAQ that affect overall satisfaction with patient safety culture. For physicians, nurses, and technicians, the findings indicate that overall satisfaction is highly influenced by perceptions of management. For physicians, nurses, and administrative staff, the safety climate has a significant impact on their overall satisfaction. Additionally, for technicians, emotional exhaustion is an essential factor affecting overall satisfaction. Understanding the perceptions of patient safety culture among different medical staff in a healthcare organization could help hospital management to promote policies explicitly oriented toward improving patient safety and strategies. For front-line staff, well-trained employees and concordant teams are important; higher level managers should adopt policies to improve the working environment and ameliorate the arrangement of human resources.

This study uses longitudinal data from a regional teaching hospital in Taiwan to analyze how nurses with different demographic variables perceive patient safety culture from 2010 to 2016. The results show that nurses with different demographic variables have different perceptions of patient safety from year to year. The supervisor/manager is the most essential variable influencing patient safety culture. Nurses who are supervisors/managers are more satisfied in six dimensions from 2010 to 2016. Experience in an organization is identified as the second essential variable to influence the patient safety culture. Nurses who have much experience in an organization tend to have higher satisfaction in five out of six dimensions of patient safety culture from 2012 to 2016 in general. In contrast, nurses who have less than six months of experience in an organization also have better perceptions. In summary, hospital management needs to pay attention to supervisor/manager and experience in an organization factors, both of which have significant impacts on patient safety culture from nurses’ viewpoints.

This study adds an additional question to the existing Chinese version of the safety attitudes questionnaire (SAQ) to discuss the relationships between the dimensions of the Chinese version of SAQ and the overall perception of the patient safety culture in a regional teaching hospital in Taiwan from the viewpoint of the medical staff. This study uses linear regression with forward selection to assess the perceptions from all of the medical staff by using the data sets in 2015 and 2016. The input variables are eight dimensions, whereas the dependent variable is the overall satisfaction of the patient safety culture in this hospital. The results show that four dimensions are found to significantly affect the overall satisfaction of the patient safety culture. Moreover, it is found that working conditions is the most important dimension in these two years and has the most positive impact on the overall satisfaction. Hospital management needs to pay more attention to working conditions first. In addition to working conditions, safety climate is the other essential dimension identified in both 2015 and 2016; that is, hospital management needs to have a strong and proactive organizational commitment to safety for all of the medical staff to improve the overall satisfaction of the patient safety culture.

Aims In order to pursue a better patient safety culture and provide a superior medical service for patients, this study aims to respectively investigate the perceptions of patient safety from the viewpoints of physicians and nurses in Taiwan. Background Little knowledge has clearly identified the difference of perceptions between physicians and nurses in patient safety culture. Understanding physicians and nurses' attitudes toward patient safety is a critical issue for healthcare organizations to improve medical quality. Methods Confirmatory factor analysis (CFA) is used to verify the structure of data (e.g. reliability and validity), and Pearson's correlation analysis is conducted to demonstrate the relationships among seven patient safety culture dimensions. Results Research results illustrate that more teamwork is exhibited among team members, the more safety of a patient is committed. Perceptions of management and emotional exhaustion are important components that contribute to a better patient safety. More importantly, working conditions and stress recognition are found to be negatively related from the perceptions of nurses. Compared to physicians, nurses reported higher stress and challenges which result from multi-task working conditions in the hospital. Conclusions This study focused on the contribution of a better patient safety culture from different viewpoints of physicians and nurses for healthcare organizations in Taiwan. A different attitudes toward patient safety is found between physicians and nurses. The results enable the hospital management to realize and design appropriate implications for hospital staffs to establish a better patient safety culture.

TEM Journal; Vol 5, No 4, 2016. ISSN 2217-8309, This study depicts hospitals’ need to establish an incident reporting system to avoid disputes and enhance reporting intention. A series of implement are provided, including an RCA team is partied to make improvements based on the root cause of a case, a reward system needs to be provided to encourage the employees’ intentions to report incident events, and the root causes is analyzed to deliver the improvement measures. In addition, Medical Quality and Patient Safety Committee should be organized to promote better medical quality and patient safety. Last, the promotion of patient safety culture should pay more attention to the implement process, rather than separate strategies.