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

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