Unravelling the relationship between national culture and patient safety culture

The perceptions, attitudes and behaviour of healthcare personnel play a significant role in determining patient safety culture (PSC). Although organisations encourage good patient safety culture, factors external to the organisation still shape the perceptions, attitudes and behaviour of employees (e.g. national cultural orientation of staff). Patient safety culture has been shown to differ between countries and nationalities within a culturally diverse environment; however, little is known about the influence of national culture on PSC. The overall aim of the thesis is to probe deeper into the relationship between national culture and patient safety culture. This research used the multi-method approach to explore deeper into the relationship between national culture and patient safety culture. [Continues.

Getting to Zero Preventable Falls: An Exploratory Study

Objective: The objective of this study is to examine relations between patient safety culture and processes of care, specifically, how patient safety culture influences the prevention of patient falls. The purpose of this inquiry is to identify the barriers and facilitators that can advance an inpatient rehabilitation facility to become a high reliability organization and advance interdisciplinary teamwork. Method: A qualitative phenomenological approach was conducted and an interpretive phenomenological analysis explored the experiences of frontline staff with regard to patient safety culture and fall prevention. The study utilized semi-structured interviews with 24 frontline staff from three inpatient rehabilitation hospitals. Participants were selected using purposive sampling and individually interviewed. Results: Findings revealed barriers and facilitators for each dimension of patient safety culture that drive fall prevention. Teamwork within and across disciplines, such as between nursing and therapy, affect how they communicate with one another. Issues related to staffing were the most common concerns amongst nursing staff; especially the issue of staffing ratio and patient acuity. Leadership played a role in supporting the culture of safety and holding staff accountable. Conclusion: Fall prevention requires collaborative efforts between nursing and therapy in an inpatient rehabilitation setting. Dimensions of patient safety culture such as good teamwork, effective communication, adequate staffing, nonpunitive response to errors, and strong leadership support are essential in maintaining a high reliability process for adaptive learning and reliable performance

Determining Perceived Barriers Affecting Physicians\u27 Readiness to Disclose Major Medical Errors

Medical errors have been detrimental in the field of medicine. They have impacted both patients and doctors. While physicians recognized that error disclosure was an ethical and professional obligation, most remained silent when mistakes happened for different reasons. Guided by the theory of planned behavior and Kant\u27s deontological theory, the purpose of this quantitative study was to investigate the perceived barriers affecting physicians\u27 willingness to report major medical errors. An association was tested between the independent variables physician fear of disclosure of errors, organizational culture toward patient safety, physician apology, professional ethics and transparency, physician education, and the dependent variable physician willingness to disclose major medical errors. Using a cross-sectional method, 122 doctors out of 483 surveyed, completed the online and paper-based survey. Multiple linear regression and descriptive statistics models were used to analyze and summarize the data. The results showed there was a statistically significant relationship between the independent variables organizational culture toward patient safety, physician apology, professional ethics and transparency, and physician education and the dependent variable physician willingness to disclose major medical errors. There was no relationship between the independent variable fear of disclosure of errors and the dependent variable. The findings added to the knowledge base regarding barriers to physicians\u27 medical errors disclosure. The results and recommendations could provide positive social change by helping hospitals raising doctors\u27 awareness regarding major medical errors disclosure

Three Essays on Culture and Whistleblowing: A Multimethod Comparative Study of the United States and Japan.

Ph.D. Thesis. University of Hawaiʻi at Mānoa 2017

Supporting mental health professionals in making decisions about disclosure of lived experience: Acceptability and preliminary outcomes of a guided self-help intervention.

Overview: People with concealable stigmatised identities, such as those who experience mental health problems, LGBTQ+ individuals, and people with certain infections or chronic diseases, are regularly faced with the decision of whether or not to disclose to others around them, as disclosure can have both positive and negative outcomes. Research suggests that this decision is also one faced by many mental health professionals, who are often reluctant to disclose their own lived experience of mental health problems within their professional circle and workplace. Reluctance to disclose has been associated with fear of negative consequences, shame and stigma. Whilst the impact of stigma on disclosure has been explored in the literature, it has been less clear what the evidence suggests with regards to the effects of disclosure on self-stigma. The purpose of this thesis was to gain a better understanding of the effects of disclosure on self-stigma, and to develop an intervention to support mental health professionals with lived experience in carefully weighing up disclosure decisions. This volume is comprised of three parts. Part one is a literature review which set out to explore the literature on the impact of disclosure on self-stigma in people with a concealable stigmatised identity (people living with human immunodeficiency virus [HIV]). Part two consists of an empirical paper of a study which aimed to: a) adapt an existing group intervention into a guided self-help intervention for mental health professionals with lived experience to support them in making disclosure-related decisions in ways that are personally meaningful, and b) to evaluate the acceptability and preliminary outcomes of the adapted intervention. Part three presents a critical appraisal of the research process, including personal reflections and an exploration of challenges that arose, and expands upon the discussion in the empirical paper in terms of study limitations and implications. This was a joint project with Harriet Mills (see Appendix A)

The COVID-19 Clinician Cohort (CoCCo) Study: Empirically Grounded Recommendations for Forward-Facing Psychological Care of Frontline Doctors

In this book, we focus on health and wellbeing in the workforce within the context of the global COVID-19 pandemic, and the post-pandemic era. We begin by exploring the impacts of the pandemic on diverse occupational groups, considering the broader mental health impacts of the pandemic, reactions to national lockdowns and behavioural strategies to control the spread of the virus, such as social distancing and self-isolation, attitudes towards infection control and work presenteeism. Next, we explore the relationship between job factors, working conditions and psychological wellbeing of employees. The papers that follow examine changes in work patterns and locations, such as remote, hybrid, and on-site working, the impact of organizational climate on mental wellbeing, and organizational approaches to return-to-work after lockdown. Finally, we present innovative organizational- and individual-level pandemic mitigation interventions, including SARS-CoV-2 testing services and infection control approaches, digital mental health support, and COVID-19 Vaccine Education. This collection demonstrates the breadth of research on work, health and wellbeing, during and beyond the COVID-19 pandemic, covering workforce impacts and workforce interventions in various countries and settings. Learning from this research will help to build global preparedness for future pandemics and foster resilience for responding in times of crisis and uncertainty