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The relationship between organizational leadership for safety and learning from patient safety events.

ABSTRACT: To examine the relationship between organizational leadership for patient safety and five types of learning from patient safety events (PSEs).Forty-nine general acute care hospitals in Ontario, Canada.A nonexperimental design using cross-sectional surveys of hospital patient safety officers (PSOs) and patient care managers (PCMs). PSOs provided data on organization-level learning from (a) minor events, (b) moderate events, (c) major near misses, (d) major event analysis, and (e) major event dissemination/communication. PCMs provided data on organizational leadership (formal and informal) for patient safety.Hospitals were the unit of analysis. Seemingly unrelated regression was used to examine the influence of formal and informal leadership for safety on the five types of learning from PSEs. The interaction between leadership and hospital size was also examined.Formal organizational leadership for patient safety is an important predictor of learning from minor, moderate, and major near-miss events, and major event dissemination. This relationship is significantly stronger for small hospitals (<100 beds).We find support for the relationship between patient safety leadership and patient safety behaviors such as learning from safety events. Formal leadership support for safety is of particular importance in small organizations where the economic burden of safety programs is disproportionately large and formal leadership is closer to the front lines.

SUBMITTER: Ginsburg LR

PROVIDER: S-EPMC2875751 | biostudies-literature | 2010 Jun

REPOSITORIES: biostudies-literature

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The relationship between organizational leadership for safety and learning from patient safety events.

Ginsburg Liane R LR Chuang You-Ta YT Berta Whitney Blair WB Norton Peter G PG Ng Peggy P Tregunno Deborah D Richardson Julia J

Health services research 20100310 3

<h4>Objective</h4>To examine the relationship between organizational leadership for patient safety and five types of learning from patient safety events (PSEs).<h4>Study setting</h4>Forty-nine general acute care hospitals in Ontario, Canada.<h4>Study design</h4>A nonexperimental design using cross-sectional surveys of hospital patient safety officers (PSOs) and patient care managers (PCMs). PSOs provided data on organization-level learning from (a) minor events, (b) moderate events, (c) major ne ...[more]

PMID: 20337737

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Project description:In order to study the influence of different entrepreneurial psychological leadership styles on organizational learning ability and organizational performance and to provide theoretical basis for the improvement of organizational benefits of entrepreneurial enterprises in the future, 421 general managers, middle managers, and grassroots managers of 350 small- and medium-sized private enterprises in Beijing were surveyed by questionnaire in two forms: online and on-site. Then, a hypothesis model of the relationship between different entrepreneurial psychological leadership styles and organizational learning ability and organizational performance was constructed. The correlation between transformational, transactional, and laissez-faire psychological leadership styles and organizational performance and organizational learning ability was analyzed using multiple regression models. AMOS 7.0 software was used to simulate and verify the model. The results show that transformational psychological leadership style is positively correlated with organizational learning ability, financial performance, and growth performance; transactional psychological leadership style is positively correlated with organizational financial performance, growth performance, and organizational learning ability; there is no correlation between laissez-faire psychological leadership style and organizational financial performance and growth performance, but there is a significant positive correlation between laissez-faire psychological leadership style and organizational learning ability. The covariance between the error terms of the internal and external potential variables of the model is positive, and the factor load value of each potential variable and the observed variable is between 0.5 and 1, which shows that transformational and transactional psychological leadership styles have a more positive influence on organizational financial performance and learning ability than a laissez-faire psychological leadership style. The hypothesis model of the relationship between entrepreneurial psychological leadership styles and organizational learning ability and organizational performance conforms to the adaptation criteria and is feasible.

Project description:Background:Nurses play a key role in providing patient safety. It is known that patient safety requires the improvement of patient safety culture, which can be a difficult process. One of the current challenges of hospitals is to explore the ways to improve patient safety culture. Organizational citizenship behaviors are one of the factors, which can develop organizational culture including safety culture; however, its role is not well established. Methods:In this cross-sectional study, a stratified random sample of 214 nurses was selected from a largest teaching hospital in west of Iran. The institutional research board approved the study protocol. Data were collected using three self-report questionnaires: demographic information; hospital survey on patient safety culture (HSPSC); and organizational citizenship behaviors questionnaire. Data were analyzed using Spearman's correlation coefficient test in SPSS (??<?0.05). Results:Organizational citizenship behaviors were found to be at an intermediate level (56.84?±?16.22). However, some of its dimensions, including sportsmanship, civic virtue, and courtesy, were at weak levels (<?50%). The mean percentage of positive responses to the patient safety culture was 49.00?±?14.01. The patient safety culture had significant positive correlations with organizational citizenship behaviors (r?=?0.349, P?=?0.001) and dimensions of altruism (r?=?0.255, P?=?0.001), civic virtue (r?=?0.434, P?=?0.001), and courtesy (r?=?0.214, P?=?0.001). Conclusion:Our findings proposed the hypothesis that OCB has a statistical significant impact on PSC. Low levels of civic virtue, sportsmanship and courtesy behaviors may be indicative low nurses' interest in participating in organizational affairs and nurses' low attention to measures that prevent harm to their organization. It is recommended that nursing managers focus more on these dimensions, identifying influintioal factors and taking appropriate management measures to promote these behaviors. If our findings are confirmed in future studies, nursing managers can consider the development of organizational citizenship behaviors as one of the managerial approaches for promoting a patient safety culture.

Project description:OBJECTIVE:To evaluate the impact of rigorous WalkRounds on frontline caregiver assessments of safety climate, and to clarify the steps and implementation of rigorous WalkRounds. DATA SOURCES/STUDY SETTING:Primary outcome variables were baseline and post WalkRounds safety climate scores from the Safety Attitudes Questionnaire (SAQ). Secondary outcomes were safety issues elicited through WalkRounds. Study period was August 2002 to April 2005; seven hospitals in Massachusetts agreed to participate; and the project was implemented in all patient care areas. STUDY DESIGN:Prospective study of the impact of rigorously applied WalkRounds on frontline caregivers assessments of safety climate in their patient care area. WalkRounds were conducted weekly and according to the seven-step WalkRounds Guide. The SAQ was administered at baseline and approximately 18 months post-WalkRounds implementation to all caregivers in patient care areas. RESULTS:Two of seven hospitals complied with the rigorous WalkRounds approach; hospital A was an academic teaching center and hospital B a community teaching hospital. Of 21 patient care areas, SAQ surveys were received from 62 percent of respondents at baseline and 60 percent post WalkRounds. At baseline, 10 of 21 care areas (48 percent) had safety climate scores below 60 percent, whereas post-WalkRounds three care areas (14 percent) had safety climate scores below 60 percent without improving by 10 points or more. Safety climate scale scores in hospital A were 62 percent at baseline and 77 percent post-WalkRounds (t=2.67, p=.03), and in hospital B were 46 percent at baseline and 56 percent post WalkRounds (t=2.06, p=.06). Main safety issues by category were equipment/facility (A [26 percent] and B [33 percent]) and communication (A [24 percent] and B [18 percent]). CONCLUSIONS:WalkRounds implementation requires significant organizational will; sustainability requires outstanding project management and leadership engagement. In the patient care areas that rigorously implemented WalkRounds, frontline caregiver assessments of patient safety increased. SAQ results such as safety climate scores facilitate the triage of quality improvement efforts, and provide consensus assessments of frontline caregivers that identify themes for improvement.

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The relationship between organizational leadership for safety and learning from patient safety events.

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The relationship between organizational leadership for safety and learning from patient safety events.

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