Patient safety culture in Austria and recommendations of evidence-based instruments for improving patient safety.

This study aimed to investigate the patient safety culture in Austria. We identified factors that contributed to a higher degree of patient safety and subsequently developed evidence-based suggestions on how to improve patient safety culture in hospitals. Moreover, we examined differences in the perception of patient safety culture among different professional groups. This study used a cross-sectional design in ten Austrian hospitals (N = 1,525). We analyzed the correlation between ten patient safety culture factors, three background characteristics (descriptive variables), and three outcome variables (patient safety grade, number of adverse events reported, and influence on patient safety). We also conducted an analysis of variance to determine the differences in patient safety culture factors among the various professional groups in hospitals. The findings revealed that all ten factors have considerable potential for improvement. The most highly rated patient safety culture factors were communication openness and supervisor/manager's expectations and actions promoting safety; whereas, the lowest rated factor was non-punitive response to error. A comparison of the various professional groups showed significant differences in the perception of patient safety culture between nurses, doctors, and other groups. Patient safety culture in Austria seems to have considerable potential for improvement, and patient safety culture factors significantly contribute to patient safety. We determined evidence-based practices as recommendations for improving each of the patient safety factors.

Development of the German version of the patient safety climate inventory to the Austrian context.

OBJECTIVES: In recent years, patient safety culture (PSC) in hospitals, including its development and measurement, has increasingly received attention in Europe. Even though several instruments have been developed for PSC measurement in European countries, there is, to date, no validated measure to assess PSC in Austria. The study at hand addresses this gap in the evidence base by psychometrically assessing the German 'Patient Safety Climate Inventory' (PaSKI) in terms of its potential suitability for the Austrian healthcare system. The goal is to theoretically develop and empirically verify a separate instrument for PSC measurement in Austria. SETTING: Ten hospitals. PARTICIPANTS: Healthcare professionals (n=1202); doctors (n=142), nurse (n=645), other health workers (n=51), medical technology professions (n=170), management/administration (n=76), other (n=20), no response (n=98). PRIMARY AND SECONDARY OUTCOME MEASURES: The pretest was conducted with 101 health professionals. Psychometric evaluations, including exploratory factor analysis and confirmatory factor analysis, were performed with both an original version of the PaSKI and an adapted one. The original PaSKI and the newly adapted 'Austrian Patient Safety Climate Inventory' (A-PaSKI) were then compared. RESULTS: The A-PaSKI's factor structure developed in our study differs from the original 14-factor structure (49 items) of the PaSKI. The new instrument consists of 10 factors (30 items), comprising seven departmental factors, two hospital factors, and one outcome factor. The new instrument A-PaSKI revealed satisfactory results on the model-level and internal consistency. The confirmatory factor analysis for the A-PaSKI (χ2 (360)=1408.245, p=0.0001) showed a good model fit, and the absolute and relative fit indices showed an excellent model adjustment. The construct validity was acceptable for nine and unacceptable for one factor. CONCLUSIONS: This is the first validation study of a standardised safety culture measure in Austrian hospitals. The Austrian version of PaSKI demonstrated good psychometric properties, with acceptable to good internal consistency and construct validity for use in Austrian hospitals.

Overview of Patient Safety Culture in Bosnia and Herzegovina With Improvement Recommendations for Hospitals.

OBJECTIVES: This study investigates the patient safety culture (PSC) in Bosnia and Herzegovina (BiH). We identify factors that contribute to higher patient safety and improved reporting of adverse events, thereby developing recommendations to improve PSC. METHODS: The study used a correlation design based on cross-sectional surveys in the healthcare sector of BiH (N = 2617). We analyzed the correlation between 9 PSC factors, 4 background characteristics (explanatory variables), and 2 outcome variables (patient safety grade and number of events reported). We also analyzed the variance to determine perceived differences in PSC across the various staff roles in hospitals. RESULTS: The highest rated PSC factors were Hospital handoffs and transitions and Hospital management support for patient safety and the lowest rated factor was Nonpunitive response to error. Each of the 9 factors showed considerable potential to improve from a hospital, department, and outcome perspective. A comparison of the various employee positions shows significant differences in the PSC perceptions of managers versus nurses and doctors as well as nurses versus doctors. CONCLUSIONS: We found average scores for most PSC factors, leaving the considerable potential for improvement. Compared with the number of events reported and background characteristics, it is evident that PSC factors contribute significantly to patient safety. These factors are essential for the targeted development of PSC. We propose evidence-based practices as recommendations for improving patients' safety factors.

Adaptation of the Agency for Healthcare Research and Quality's 'Hospital Survey on Patient Safety Culture' to the Bosnia and Herzegovina context.

OBJECTIVES: Measuring staff perspectives on patient safety culture (PSC) can identify areas of concern that, if addressed, could lead to improvements in healthcare. To date, there is no validated measure to assess PSC that has been tested and adapted for use in Bosnia and Herzegovina (BiH). This research addresses the gap in the evidence through the psychometric assessment of the Agency for Healthcare Research and Quality's: 'Hospital Survey on Patient Safety Culture' (HSOPSC), to determine its suitability for the health system in BiH. SETTING: Nine hospitals. PARTICIPANTS: Healthcare professionals (n=1429); nurse (n=823), doctors (n=328), other clinical personnel (n=111), non-clinical personnel (n=60), other (n=64), no response (n=43). PRIMARY AND SECONDARY OUTCOME MEASURES: A translated version of HSOPSC was used to conduct psychometric evaluation including exploratory factor analysis and confirmatory factor analysis (CFA). Comparison between the original HSOPSC and the newly adapted 'Hospital Survey on Patient Safety Culture for Bosnia and Herzegovina' (HSOPSC-BiH) was carried out. RESULTS: Compared with the original survey, which has 12 factors (42 items), the adapted survey consisted of 9 factors (29 items). The following factors from the original survey were not included in their original form: Communication Openness, Feedback and Communications about error, Overall Perceptions of Patient Safety and Organisational learning-Continuous Improvement. The results of the CFA for HSOPSC-BiH showed a better model fit compared with the original HSOPSC. The absolute and relative fit indices showed excellent model adjustment. CONCLUSIONS: The BiH version of Hospital Survey on Patient Safety Culture demonstrated satisfactory psychometric properties, with acceptable to good internal consistency and construct validity. Therefore, we recommend the HSOPSC-BiH as a basis for assessing PSC in BiH. This survey could provide insight into patient safety concerns in BiH so that strategies to overcome these issues could be formulated and implemented.