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Healthcare
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Innovative Approaches for Safety Culture Improvement in Healthcare Systems
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Innovative Approaches for Safety Culture Improvement in Healthcare Systems

A special issue of Healthcare (ISSN 2227-9032).

Deadline for manuscript submissions: 30 September 2024 | Viewed by 3548

Special Issue Editors

Dr. Marie E. Ward

E-Mail Website
Guest Editor
1. Health Systems Learning and Research, St James’s Hospital, Dublin, Ireland
2. Centre for Innovative Human Systems (CIHS), School of Psychology, Trinity College, The University of Dublin, Dublin, Ireland
Interests: human factors ergonomics; socio-technical systems; systems thinking; system change; sustainability; quality, safety and risk in healthcare and other safety critical industries; participative action research; human-centred design; co-design and co-production
Special Issues, Collections and Topics in MDPI journals
Dr. Eva Doherty

E-Mail Website
Guest Editor
Human Factors in Patient Safety, Department of Surgical Affairs, RCSI University of Medicine and Health Sciences, 121 St Stephens Green, D0H H903 Dublin, Ireland
Interests: healthcare communication skills; high fidelity simulation team training; emotional intelligence; assessment and teaching interprofessional teams; conflict resolution; professionalism; open disclosure; psychological safety
Dr. Siobhán Corrigan

E-Mail Website
Guest Editor
Centre for Innovative Human Systems (CIHS), School of Psychology, Trinity College Dublin, The University of Dublin, Dublin 2, Ireland
Interests: organisational behaviour; organisational culture; psychology of work; leadership; human factors and action research; co-design and qualitative methods in the health sector; developing evidence-based intervention programmes

Special Issue Information

Dear Colleagues,

Improvements in patient safety have been made in some areas over the last twenty years. One area that has proved very difficult to change and improve upon is safety culture. Attempts have been made at the local and national levels to move beyond a blame culture; however, belief among healthcare workers is that blame is still very much part of their culture. There have been different approaches purported to move towards a more mature safety culture, including shifting towards just and restorative cultures. This Special Issue calls for papers that present innovative approaches to understanding and changing safety culture in healthcare. Papers that show evidence of taking a systems perspective in terms of both understanding culture as an emergent property of the system and something that shapes the system, and in attempting to improve safety culture and ultimately patient and staff safety, will be particularly welcome.  

Possible topics could include, but are not limited to, the following:

  • Systems approaches to understanding safety culture in healthcare;
  • Moving beyond surveys to analyse healthcare safety culture;
  • The influence of safety culture on health system functioning, patient and staff safety;
  • Just culture in healthcare;
  • Restorative culture in healthcare; 
  • Just culture—as being in right relationship – what would this mean in healthcare.

Dr. Marie Ward
Dr. Eva Doherty
Dr. Siobhán Corrigan
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Healthcare is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2700 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • safety culture
  • just culture
  • restorative culture
  • systems thinking
  • socio-technical systems
  • human factors ergonomics
  • right relationship

Published Papers (3 papers)

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Research

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13 pages, 898 KiB  
Article
Speaking Up and Taking Action: Psychological Safety and Joint Problem-Solving Orientation in Safety Improvement
by Hassina Bahadurzada, Michaela Kerrissey and Amy C. Edmondson
Healthcare 2024, 12(8), 812; https://doi.org/10.3390/healthcare12080812 - 10 Apr 2024
Viewed by 721
Abstract
Healthcare organizations face stubborn challenges in ensuring patient safety and mitigating clinician turnover. This paper aims to advance theory and research on patient safety by elucidating how the role of psychological safety in patient safety can be enhanced with joint problem-solving orientation (JPS). [...] Read more.
Healthcare organizations face stubborn challenges in ensuring patient safety and mitigating clinician turnover. This paper aims to advance theory and research on patient safety by elucidating how the role of psychological safety in patient safety can be enhanced with joint problem-solving orientation (JPS). We hypothesized and tested for an interaction between JPS and psychological safety in relation to safety improvement, leveraging longitudinal survey data from a sample of 14,943 patient-facing healthcare workers. We found a moderation effect, in which psychological safety was positively associated with safety improvement, and the relationship was stronger in the presence of JPS. Psychological safety and JPS also interacted positively in predicting clinicians’ intent to stay with the organization. For theory and research, our findings point to JPS as a measurable factor that may enhance the value of psychological safety for patient safety improvement—perhaps because voiced concerns about patient safety often require joint problem-solving to produce meaningful change. For practice, our conceptual framework, viewing psychological safety and JPS as complementary factors, can help organizations adopt a more granular approach towards assessing the interpersonal aspect of their safety climate. This will enable organizations to obtain a more nuanced understanding of their safety climate and identify areas for improvement accordingly. Full article
(This article belongs to the Special Issue Innovative Approaches for Safety Culture Improvement in Healthcare Systems)
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15 pages, 716 KiB  
Article
Exploring Safety Culture in the ICU of a Large Acute Teaching Hospital through Triangulating Different Data Sources
by Ellen Liston, Enda O’Connor and Marie E. Ward
Healthcare 2023, 11(23), 3095; https://doi.org/10.3390/healthcare11233095 - 4 Dec 2023
Viewed by 1035
Abstract
Safety Culture (SC) has become a key priority for safety improvement in healthcare. Studies have identified links between positive SC and improved patient outcomes. Mixed-method measurements of SC are needed to account for diverse social, cultural, and subcultural contexts within different healthcare settings. [...] Read more.
Safety Culture (SC) has become a key priority for safety improvement in healthcare. Studies have identified links between positive SC and improved patient outcomes. Mixed-method measurements of SC are needed to account for diverse social, cultural, and subcultural contexts within different healthcare settings. The aim of the study was to triangulate data on SC from three sources in an Intensive Care Unit (ICU) in a large acute teaching hospital. A mixed-methods approach was used, including analysing the Hospital Survey for Patient Safety Culture results, retrospective chart reviews using the Global Trigger Tool (GTT) for the ICU, and staff reporting of adverse events (AE). There was a 47% (101/216) response rate for the survey. Further, 98% of respondents stated a positive patient safety rating. The GTT identified 16 AEs and 11 AEs that were reported in the same timeframe. The triangulation of the data demonstrates the complexity of understanding components of SC in particular: learning, reporting, and just culture. Full article
(This article belongs to the Special Issue Innovative Approaches for Safety Culture Improvement in Healthcare Systems)
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Other

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13 pages, 263 KiB  
Viewpoint
Why Talking Is Not Cheap: Adverse Events and Informal Communication
by Anthony Montgomery, Olga Lainidi and Katerina Georganta
Healthcare 2024, 12(6), 635; https://doi.org/10.3390/healthcare12060635 - 12 Mar 2024
Viewed by 930
Abstract
Healthcare management faces significant challenges related to upward communication. Sharing information in healthcare is crucial to the improvement of person-centered, safe, and effective patient care. An adverse event (AE) is an unintended or unexpected incident that causes harm to a patient and may [...] Read more.
Healthcare management faces significant challenges related to upward communication. Sharing information in healthcare is crucial to the improvement of person-centered, safe, and effective patient care. An adverse event (AE) is an unintended or unexpected incident that causes harm to a patient and may lead to temporary or permanent disability. Learning from adverse events in healthcare is crucial to the improvement of patient safety and quality of care. Informal communication channels represent an untapped resource with regard to gathering data about the development of AEs. In this viewpoint paper, we start by identifying how informal communication played a key factor in some high-profile adverse events. Then, we present three Critical Challenge points that examine the role of informal communication in adverse events by (1) understanding how the prevailing trends in healthcare will make informal communication more important, (2) explaining how informal communication is part of the group-level sensemaking process, and (3) highlighting the potential role of informal communication in “breaking the silence” around critical and adverse events. Gossip, as one of the most important sources of informal communication, was examined in depth. Delineating the role of informal communication and adverse events within the healthcare context is pivotal to understanding and improving team and upward communication in healthcare organizations. For clinical leaders, the challenge is to cultivate a climate of communication safety, whereby informal communication channels can be used to collect soft intelligence that are paths to improving the quality of care and patient safety. Full article
(This article belongs to the Special Issue Innovative Approaches for Safety Culture Improvement in Healthcare Systems)
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