Shahram Zaheer1,2,3, Liane Ginsburg4, Hannah J Wong4, Kelly Thomson5, Lorna Bain6,7, Zaev Wulffhart7,8. 1. School of Health Policy and Management, York University, Toronto, Canada. szaheer@yorku.ca. 2. Daphne Cockwell School of Nursing, Ryerson University, Toronto, Canada. szaheer@yorku.ca. 3. Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Canada. szaheer@yorku.ca. 4. School of Health Policy and Management, York University, Toronto, Canada. 5. School of Administrative Studies, York University, Toronto, Canada. 6. Interprofessional Collaboration and Education, Southlake Regional Health Centre, Newmarket, Canada. 7. University of Toronto, Toronto, Canada. 8. Regional Cardiac Care Program, Southlake Regional Health Centre, Newmarket, Canada.
Abstract
BACKGROUND: This study contributes to a small but growing body of literature on how context influences perceptions of patient safety in healthcare settings. We examine the impact of senior leadership support for safety, supervisory leadership support for safety, teamwork, and turnover intention on overall patient safety grade. Interaction effects of predictors on perceptions of patient safety are also examined. METHODS: In this mixed methods study, cross-sectional survey data (N = 185) were collected from nurses and non-physician healthcare professionals. Semi-structured interview data (N = 15) were collected from nurses. The study participants worked in intensive care, general medicine, mental health, or the emergency department of a large community hospital in Southern Ontario. RESULTS: Hierarchical regression analyses showed that staff perceptions of senior leadership (p < 0.001), teamwork (p < 0.01), and turnover intention (p < 0.01) were significantly associated with overall patient safety grade. The interactive effect of teamwork and turnover intention on overall patient safety grade was also found to be significant (p < 0.05). The qualitative findings corroborated the survey results but also helped expand the characteristics of the study's key concepts (e.g., teamwork within and across professional boundaries) and why certain statistical relationships were found to be non-significant (e.g., nurse interviewees perceived the safety specific responsibilities of frontline supervisors much more broadly compared to the narrower conceptualization of the construct in the survey). CONCLUSIONS: The results of the current study suggest that senior leadership, teamwork, and turnover intention significantly impact nursing staff perceptions of patient safety. Leadership is a modifiable contextual factor and resources should be dedicated to strengthen relational competencies of healthcare leaders. Healthcare organizations must also proactively foster inter and intra-professional collaboration by providing teamwork educational workshops or other on-site learning opportunities (e.g., simulation training). Healthcare organizations would benefit by considering the interactive effect of contextual factors as another lever for patient safety improvement, e.g., lowering staff turnover intentions would maximize the positive impact of teamwork improvement initiatives on patient safety.
BACKGROUND: This study contributes to a small but growing body of literature on how context influences perceptions of patient safety in healthcare settings. We examine the impact of senior leadership support for safety, supervisory leadership support for safety, teamwork, and turnover intention on overall patient safety grade. Interaction effects of predictors on perceptions of patient safety are also examined. METHODS: In this mixed methods study, cross-sectional survey data (N = 185) were collected from nurses and non-physician healthcare professionals. Semi-structured interview data (N = 15) were collected from nurses. The study participants worked in intensive care, general medicine, mental health, or the emergency department of a large community hospital in Southern Ontario. RESULTS: Hierarchical regression analyses showed that staff perceptions of senior leadership (p < 0.001), teamwork (p < 0.01), and turnover intention (p < 0.01) were significantly associated with overall patient safety grade. The interactive effect of teamwork and turnover intention on overall patient safety grade was also found to be significant (p < 0.05). The qualitative findings corroborated the survey results but also helped expand the characteristics of the study's key concepts (e.g., teamwork within and across professional boundaries) and why certain statistical relationships were found to be non-significant (e.g., nurse interviewees perceived the safety specific responsibilities of frontline supervisors much more broadly compared to the narrower conceptualization of the construct in the survey). CONCLUSIONS: The results of the current study suggest that senior leadership, teamwork, and turnover intention significantly impact nursing staff perceptions of patient safety. Leadership is a modifiable contextual factor and resources should be dedicated to strengthen relational competencies of healthcare leaders. Healthcare organizations must also proactively foster inter and intra-professional collaboration by providing teamwork educational workshops or other on-site learning opportunities (e.g., simulation training). Healthcare organizations would benefit by considering the interactive effect of contextual factors as another lever for patient safety improvement, e.g., lowering staff turnover intentions would maximize the positive impact of teamwork improvement initiatives on patient safety.
Authors: Allan Frankel; Sarah Pratt Grillo; Mary Pittman; Eric J Thomas; Lisa Horowitz; Martha Page; Bryan Sexton Journal: Health Serv Res Date: 2008-07-29 Impact factor: 3.402
Authors: Sanjay Saint; Christine P Kowalski; Jane Banaszak-Holl; Jane Forman; Laura Damschroder; Sarah L Krein Journal: Infect Control Hosp Epidemiol Date: 2010-09 Impact factor: 3.254
Authors: Jing Li; Preetham Talari; Andrew Kelly; Barbara Latham; Sherri Dotson; Kim Manning; Lisa Thornsberry; Colleen Swartz; Mark V Williams Journal: BMJ Qual Saf Date: 2018-02-14 Impact factor: 7.035
Authors: Karen Mazzocco; Diana B Petitti; Kenneth T Fong; Doug Bonacum; John Brookey; Suzanne Graham; Robert E Lasky; J Bryan Sexton; Eric J Thomas Journal: Am J Surg Date: 2008-09-11 Impact factor: 2.565