Hospital staff perceptions

Several instruments have been developed to assess hospital staff s perceptions of aspects of workplace safety culture and a number of studies have reported associations between hospital safety culture and safety outcome measures (Jackson et al. 2010). Profiling the hospital safety culture scores is relatively straightforward but finding safety outcome measures for patients or workers is more challenging (Flin 2007). Different types of safety outcome data can be collected, e.g. (i) hospital incident records for staff or patients or clinical data for patients, (ii) self-reports of incidents and injuries by workers or patients and (iii) workers safety behaviours (self-reported or observed). 

The measurement of safety culture has now become a core component of patient safety and additional patient safety culture assessment instruments will be needed to accommodate organisational sehings that cover the continuum of care in multiple settings. It will also be necessaiy to examine differences, as well as similarities, in staff perceptions of patient safety culture across different settings of care. In addition, it is necessary to examine in these other healthcare settings the relationships between patient safety culture and patient perceptions of care, as well as clinical outcome measures, as has been done in the hospital setting. 

The principle of benchmarking safety cultrrre perceptions in Belgian hospitals is based on the respondents positive attitude towards patient safety. As such, the comparative report only considers explicitly positive answers of hospital staff towards differerrt safely culture dimensions. This approach has the lirrritation that neutral or negative perceptions are not separately taken into accormt. 

According to a study in the Journal for Healthcare Quality, hospital nursing measures, including staff turnover and workload, are associated with staffs perceptions of a safety culture. Researchers examined the relationship between staff perceptions of a safety culture and nursing-sensitive measures of hospital performance at nine California hospitals and 37 nursing units. The measures of skill mix, staff turnover, and workload intensity accounted for 22 percent to 45 percent of the variance in safety culture perceptions between units. 

Within emergency medicine, it is a common perception that chemical incidents are rare events. It has often been quoted in the past that there are approximately 1000 acute chemical incidents per year in England and Wales that may impact human health and that the majority of these events involve less than four casualties. For the purposes of public health, a chemical incident is defined as an event in which there is, or could be, exposure of the public to chemical substances that cause, or have the potential to cause, ill health . Hospital staff and emergency services personnel are considered to be members of the public in this definition. In 2005, the UK Health Protection Agency recorded more than 1000 chemical incidents, and it was estimated that approximately 27,000 people may have been exposed, of whom about 3000 reported with symptoms. It is thought that the actoal numbers may be considerably higher. 

Wolfgang AP, Wolfgang CF. 1992. Hospital pharmacy directors perceptions of job stress in stafF pharmacists. Am JHosp Pharm 49 1955. 

While constmcting the focns gronp agenda, it was important to cover both positive and negative perceptions of the cnltnre. Conseqnently, based on the results of the two hospitals in this stndy, the most favonrable and most nnfavourable items were derived from their own snrvey data (a total of fonr items). The safety culture profiles of both hospitals were very similar and therefore the same items were presented to the staff members of each hospital in order to allow comparisons... 

Thomas et al. (2005) and Frankel et al. (2005) have examined the impact of EWRs on perceptions of safety chmate. While hospitals typically implement EWRs differently, EWRs share some common features - 1) they are led by hospital executives, 2) executives solicit input from frontline staff about improvement opportunities on the unit, 3) executives ask frontline staff about methods to improve unit safety and 4) executive leaders reiterate their focus on improving... 

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