Predictors and outcomes of patient safety culture in hospitals

<p>Abstract</p> <p>Background</p> <p>Developing a patient safety culture was one of the recommendations made by the Institute of Medicine to assist hospitals in improving patient safety. In recent years, a multitude of evidence, mostly originating from developed countries, has been published on patient safety culture. One of the first efforts to assess the culture of safety in the Eastern Mediterranean Region was by El-Jardali et al. (2010) in Lebanon. The study entitled "The Current State of Patient Safety Culture: a study at baseline" assessed the culture of safety in Lebanese hospitals. Based on study findings, the objective of this paper is to explore the association between patient safety culture predictors and outcomes, taking into consideration respondent and hospital characteristics. In addition, it will examine the correlation between patient safety culture composites.</p> <p>Methods</p> <p>Sixty-eight hospitals and 6,807 respondents participated in the study. The study which adopted a cross sectional research design utilized an Arabic-translated version of the Hospital Survey on Patient Safety Culture (HSOPSC). The HSOPSC measures 12 patient safety composites. Two of the composites, in addition to a patient safety grade and the number of events reported, represented the four outcome variables. Bivariate and mixed model regression analyses were used to examine the association between the patient safety culture predictors and outcomes.</p> <p>Results</p> <p>Significant correlations were observed among all patient safety culture composites but with differences in the strength of the correlation. Generalized Estimating Equations for the patient safety composite scores and respondent and hospital characteristics against the patient safety grade and the number of events reported revealed significant correlations. Significant correlations were also observed by linear mixed models of the same variables against the frequency of events reported and the overall perception of safety.</p> <p>Conclusion</p> <p>Event reporting, communication, patient safety leadership and management, staffing, and accreditation were identified as major patient safety culture predictors. Investing in practices that tackle these issues and prioritizing patient safety is essential in Lebanese hospitals in order to improve patient safety. In addition, further research is needed to understand the association between patient safety culture and clinical outcomes.</p

The Intersection of Media and Policy: A Case Study

From October 2008 through 2010, journalists Charles Ornstein and Tracey Weber produced for the and a series of investigative reports on the performance of the California Board of Registered Nursing (BRN), finding that it took an average of 3.5 years to act on complaints of professional misconduct by registered nurses, including sexual assault of patients, substance use, and repeat medication errors that resulted in patients dying. In June 2009, Governor Arnold Schwarzenegger announced that he was firing members of the BRN. Its executive officer resigned shortly thereafter. This case study analyzes interviews with nine participants, including the journalists and individuals who were public and nurse members of the BRN in 2009. Four themes emerged: (1) There is a tension between what are perceived to be the public\u27s interests versus nursing\u27s interests; (2) Political naiveté about government and organizational culture can lead to the personalization of actions directed at institutions; (3) A sense of fatalism may be reinforced by organizational culture; and (4) The role and use of media in a free society may be obscured when one is the focus of investigative journalism. Nurses who seek to operate in the public sector must be grounded in the political realities of complex governmental forces that may appear to be illogical or personally offensive. Media, particularly news media, is a powerful tool for influencing these forces. Nurses should employ strategic approaches to the use of media in order to advance their voices as advocates for the public\u27s interests

The Adverse Health Outcomes, Economic Burden, and Public Health Implications of Unmanaged Attention Deficit Hyperactivity Disorder (ADHD): A Call to Action Resulting from CHADD Summit, Washington, DC, October 17, 2019

Recent research has increasingly documented the adverse effects of ADHD on physical health in addition to its well-known effects on emotional health. Responding to this concern, CHADD organized a summit meeting of health care providers, governmental and other health-related organizations, and health care payers. A White Paper generated from the meeting reviewed the adverse health outcomes, economic burden and public health implications of unmanaged ADHD. Here we summarize the resulting Calls to Action to the various stakeholder groups including: increased awareness and education of providers; development of professional guidelines for diagnosis and treatment; insurance coverage of the relevant services; support of research targeting the role of ADHD in the etiology and treatment of physical illness; and public education campaigns