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Jurnal Keperawatan Indonesia
Articles
VIEWS: 208
10.7454/jki.v27i2.1287
Submitted: 2023-11-09
Published: 2024-07-30

Why Did They Fail? Investigating The Eight Invalid Dimensions of Patient Safety Culture: Mixed Method Research

Department of Hospital Administration, Pelita Harapan University, Tangerang 15811
Department of Hospital Administration, Pelita Harapan University, Tangerang 15811
anonymous reporting management communication mixed method patient safety culture

Abstract

Resistance to adopting patient safety culture practices or technologies can hinder improvements in patient safety. This study contributes to enhancing the understanding of patient safety culture (PSC) assessment by identifying the specific factors that render some PSC dimensions invalid and offering actionable recommendations for improvement in healthcare settings. Primary data were gathered using a mixed method of explanatory sequential design, with quantitative data collection and analysis followed by qualitative data collection and analysis. The study was conducted in the leading Private Hospital XYZ, one of the private hospital groups internationally accredited with Joint Commission International with a 110-patient bed capacity. Among the 12 dimensions, only feedback communication about error, handoffs and transitions, and teamwork across units were determined to be valid and reliable. Therefore, eight dimensions, including communication openness, continuous improvement, frequency of error reported, management support, overall patient safety, supervisor/manager expectation, and staffing were explored further through a focus group discussion (FGD). Delving into quantitative and qualitative insights has identified critical nuances that extend beyond mere quantitative metrics. The qualitative insights gleaned from healthcare professionals through the FGD illuminated the nuanced human aspects of safety culture that traditional measurements may overlook.

Keywords: anonymous reporting, management of communication, mixed method, patient safety culture

 

Abstrak

Mengapa Penilaiannya Gagal? Menyelidiki 8 Dimensi yang Tidak Valid dari Budaya Keselamatan Pasien: Penelitian Mixed Method. Penolakan untuk mengadopsi praktik atau teknologi budaya keselamatan pasien dapat menghambat peningkatan keselamatan pasien. Penelitian ini bertujuan untuk meningkatkan pemahaman tentang penilaian budaya keselamatan pasien (Patient Safety Culture [PSC]) dengan mengidentifikasi faktor-faktor spesifik yang menyebabkan beberapa dimensi PSC tidak valid, dan memberikan rekomendasi yang dapat ditindaklanjuti untuk perbaikan di lingkungan pelayanan kesehatan. Data primer dikumpulkan dengan menggunakan mixed method of explanatory sequential design, dengan pengumpulan dan analisis data kuantitatif diikuti dengan pengumpulan dan analisis data kualitatif. Penelitian dilakukan di Rumah Sakit Swasta terkemuka XYZ, salah satu grup rumah sakit swasta yang terakreditasi internasional Joint Commission International dengan kapasitas 110 tempat tidur pasien. Diantara 12 dimensi, hanya dimensi feedback communication about error, handoffs and transitions, dan teamwork across units, yang memenuhi syarat valid dan reliabel. Oleh karena itu, 8 dimensi yaitu communication openness, continuous improvement, frequency error reported, management support, overall patient safety, supervisor/manager expectation, dan staffing didalami lebih lanjut dalam focus group discussion (FGD). Melalui penggalian wawasan kuantitatif dan kualitatif, telah teridentifikasi deskripsi penting yang melampaui metrik kuantitatif. Wawasan kualitatif yang diperoleh dari para profesional di bidang kesehatan melalui FGD telah menyingkap aspek-aspek budaya keselamatan yang bernuansa manusiawi, yang mungkin terlewatkan oleh pengukuran tradisional.

Kata Kunci: budaya keselamatan pasien, manajemen komunikasi, metode campuran, pelaporan anonim

References

  1. Alswat, K., Abdalla, R.A.M., Titi, M.A., Bakash, M., Mehmood, F., Zubairi, B., Jamal, D., & El-Jardali, F. (2017). Improving patient safety culture in Saudi Arabia (2012–2015): Trending, improvement and benchmarking. BMC Health Services Research, 17 (1), 516. doi: 10.1186/s12913-017-2461-3.
  2. Ammouri, A.A., Tailakh, A.K., Muliira, J.K., Geethakrishnan, R., & Al Kindi, S.N. (2015). Patient safety culture among nurses. International Nursing Review, 62 (1), 102–110. doi: 10.1111/inr.12159.
  3. Azyabi, A., Karwowski, W., & Davahli, M.R. (2021). Assessing patient safety culture in hospital settings. International Journal of Environmental Research and Public Health, 18 (5), 2466. doi: 10.3390/ijerph18052466.
  4. Barbé, B., Verdonck, K., Mukendi, D., Lejon, V., Kalo, J.-R.L., Alirol, E., Gillet, P., Horié, N., Ravinetto, R., Bottieau, E., Yansouni, C., Winkler, A.S., van Loen, H., Boelaert, M., Lutumba, P., & Jacobs, J. (2016). The art of writing and implementing Standard Operating Procedures (SOPs) for laboratories in low-resource settings: Review of guidelines and best practices. PLoS Neglected Tropical Diseases, 10 (11), e0005053. doi: 10.1371/journal.pntd.0005053.
  5. Basson, T., Montoya, A., Neily, J., Harmon, L., & Watts, B.V. (2021). Improving patient safety culture: A report of a multifaceted intervention. Journal of Patient Safety, 17 (8), e1097–e1104. doi: 10.1097/PTS.0000000000000470.
  6. Buljac-Samardzic, M., Doekhie, K.D., & van Wijngaarden, J.D.H. (2020). Interventions to improve team effectiveness within health care: A systematic review of the past decade. Human Resources for Health, 18 (1), 2. doi: 10.1186/s12960-019-0411-3.
  7. Campione, J., & Famolaro, T. (2018). Promising practices for improving hospital patient safety culture. The Joint Commission Journal on Quality and Patient Safety, 44 (1), 23–32. doi: 10.1016/j.jcjq.2017.09.001.
  8. Caruso, T.J., Steinberg, D.H., Piro, N., Walker, K., Blankenburg, R., Rassbach, C., Marquez, J.L., Katznelson, L., & Dohn, A. (2016). A strategic approach to implementation of medical mentorship programs. Journal of Graduate Medical Education, 8 (1), 68–73. doi: 10.4300/JGME-D-15-00335.1.
  9. Churruca, K., Ellis, L.A., Pomare, C., Hogden, A., Bierbaum, M., Long, J.C., Olekalns, A., & Braithwaite, J. (2021). Dimensions of safety culture: A systematic review of quantitative, qualitative and mixed methods for assessing safety culture in hospitals. BMJ Open, 11 (7), e043982. doi: 10.1136/bmjopen-2020-043982.
  10. Collins, S.A., Couture, B., Smith, A.D., Gershanik, E., Lilley, E., Chang, F., Yoon, C., Lipsitz, S., Sheikh, A., Benneyan, J., & Bates, D.W. (2020). Mixed-methods evaluation of real-time safety reporting by hospitalized patients and their care partners: The MySafeCare application. Journal of Patient Safety, 16 (2), e75–e81. doi: 10.1097/PTS.0000000000000493.
  11. Creswell, J.W., & Clark, V.L.P. (2017). Designing and conducting mixed methods research (3rd Ed.). SAGE Publications, Inc.
  12. Elliott-Mainwaring, H. (2022). A midwife’s exploration into how power & hierarchy influence both staff and patient safety. Journal of Patient Safety and Risk Management, 27 (1), 9–14. doi: 10.1177/25160435211027035.
  13. Etherington, C., Burns, J.K., Kitto, S., Brehaut, J.C., Britton, M., Singh, S., & Boet, S. (2021). Barriers and enablers to effective interprofessional teamwork in the operating room: A qualitative study using the theoretical domains framework. PLoS One, 16 (4), e0249576. doi: 10.1371/journal.pone.0249576.
  14. Farag, A., Lose, D., & Gedney-Lose, A. (2019). Nurses’ safety motivation: Examining predictors of nurses’ willingness to report medication errors. Western Journal of Nursing Research, 41 (7), 954–972. doi: 10.1177/0193945918815462.
  15. Hair, J.F., Hult, G.T.M., Ringle, C.M., & Sarstedt, M. (2022). A primer on Partial Least Squares Structural Equation Modeling (PLS-SEM) (3rd Ed.). SAGE Publications, Inc.
  16. Hair, J.F., Risher, J.J., Sarstedt, M., & Ringle, C.M. (2019). When to use and how to report the results of PLS-SEM. European Business Review, 31 (1), 2–24. doi: 10.1108/EBR-11-2018-0203.
  17. Hair, J.F., Sarstedt, M., Ringle, C.M., & Gudergan, S.P. (2024). Advanced issues in partial least squares structural equation modeling (2nd Ed.). SAGE Publications, Inc.
  18. Helo, S., & Moulton, C.-A.E. (2017). Complications: Acknowledging, managing, and coping with human error. Translational Andrology and Urology, 6 (4), 773–782. doi: 10.21037/tau.2017.06.28.
  19. Kang, S., Ho, T.T.T., & Lee, N.J. (2021). Comparative studies on patient safety culture to strengthen health systems among Southeast Asian countries. Frontiers in Public Health, 8, 600216. doi: 10.3389/fpubh.2020.600216.
  20. Kaur, M. (2016). Application of mixed method approach in public health research. Indian Journal of Community Medicine, 41 (2), 93-97. doi: 10.4103/0970-0218.173495.
  21. Kearns, E., Khurshid, Z., Anjara, S., De Brún, A., Rowan, B., & McAuliffe, E. (2021). Power dynamics in healthcare teams – A barrier to team effectiveness and patient safety: A systematic review. BJS Open, 5 (Supplement_1). doi: 10.1093/bjsopen/zrab032.091.
  22. Kusumawati, A.S., Handiyani, H., & Rachmi, S.F. (2019). Patient safety culture and nurses’ attitude on incident reporting in Indonesia. Enfermería Clínica, 29 (Supplement 2), 47–52. doi: 10.1016/j.enfcli.2019.04.007.
  23. Lymperopoulos, N.S., Jeevan, R., Godwin, L., Wilkinson, D., Shokrollahi, K., & James, M.I. (2015). The introduction of standard operating procedures to improve burn care in the United Kingdom. Journal of Burn Care and Research, 36 (5), 565–573. doi: 10.1097/BCR.0000000000000210.
  24. McEwan, D., Ruissen, G.R., Eys, M.A., Zumbo, B.D., & Beauchamp, M.R. (2017). The effectiveness of teamwork training on teamwork behaviors and team performance: A systematic review and meta-analysis of controlled interventions. PLoS One, 12 (1), e0169604. doi: 10.1371/journal.pone.0169604.
  25. Nygren, U.S., Tindberg, Y., Eriksson, L., Larsson, U., Sandberg, H., & Nordgren, L. (2021). Healthcare professionals’ perceptions about interprofessional teamwork: A national survey within Swedish child healthcare services. BMC Health Services Research, 21 (1), 265. doi: 10.1186/s12913-021-06139-3.
  26. Rockville, W., Sorra, J., Yount, N., Famolaro, T., & Gray, L. (2021). AHRQ hospital survey on patient safety culture version 2.0: User’s guide. Retrieved from: https://www.ahrq.gov/sites/default/files/wysiwyg/sops/surveys/hospital/AHRQ-Hospital-Survey-2.0-Users-Guide-5.26.2021.pdf
  27. Rohatinsky, N., & Jahner, S. (2016). Supporting nurses’ transition to rural healthcare environments through mentorship. Rural and Remote Health, 16, 3637. doi: 10.22605/RRH3637.
  28. Sandoval, J. (2022). Intercultural empathy of foreign nurses on patients’ safety. International Journal of Advanced Research and Publications, 5 (6), 49–61.
  29. Sreeramoju, P., Dura, L., Fernandez, M.E., Minhajuddin, A., Simacek, K., Fomby, T.B., & Doebbeling, B.N. (2018). Using a positive deviance approach to influence the culture of patient safety related to infection prevention. Open Forum Infectious Diseases, 5 (10), ofy231. doi: 10.1093/ofid/ofy231.
  30. Titi, M.A., Baksh, M.M., Zubairi, B., Abdalla, R.A.M., Alsaif, F.A., Amer, Y.S., Jamal, D., & El-Jardali, F. (2021). Staying ahead of the curve: Navigating changes and maintaining gains in patient safety culture - A mixed-methods study. BMJ Open, 11, e044116. doi: 10.1136/bmjopen-2020-044116.
  31. Toyon, M.A.S. (2021). Explanatory sequential design of mixed methods research: Phases and challenges. International Journal of Research in Business and Social Science (2147- 4478), 10 (5), 253–260. doi: 10.20525/ijrbs.v10i5.1262.
  32. Wahyudyasa, P.T.J., Hasyim, H., & Kusumapradja, R. (2023). Transformational leadership styles and mentoring functions towards a culture of patient safety moderated by competence of the nurse at Metro Hospitals Cikarang. International Journal of Nursing and Health Services (IJNHS), 6 (4), 225–231. doi: 10.35654/ijnhs.v6i4.748.
  33. Welp, A., Meier, L.L., & Manser, T. (2016). The interplay between teamwork, clinicians’ emotional exhaustion, and clinician-rated patient safety: A longitudinal study. Critical Care, 20, 110. doi: 10.1186/s13054-016-1282-9.
  34. Zwijnenberg, N.C., Hendriks, M., Hoogervorst-Schilp, J., & Wagner, C. (2016). Healthcare professionals’ views on feedback of a patient safety culture assessment. BMC Health Services Research, 16, 199. doi: 10.1186/s12913-016-1404-8.

How to Cite

Setiawan, F., & Antonio, F. (2024). Why Did They Fail? Investigating The Eight Invalid Dimensions of Patient Safety Culture: Mixed Method Research. Jurnal Keperawatan Indonesia, 27(2), 118–128. https://doi.org/10.7454/jki.v27i2.1287