Speaking up Behavior and Safety Climate in Saudi Public Hospitals
Keywords:
Speaking up behaviour, Speaking up climate, Patient Safety, Safety climate, Saudi Arabia, Healthcare practitioners.Abstract
OBJECTIVE: To assess the safety climate among and between health practitioners in Saudi Arabia by
identifying speaking up behavior and speaking up about the related climate.
METHODOLOGY: A cross-sectional study was conducted among 135 physicians and 434 nurses in
Saudi public hospitals using the Speaking Up about Patient Safety Questionnaire to assess various
speaking up dimensions. Study questionnaires were completed from May to June 2019. The research purpose and confidentiality and anonymity assurance were provided at the beginning of the questionnaire. The individuals' participation was regarded as informed consent.
RESULTS: A total of 569 physicians and nurses participated. Both professions perceived concerns
regarding patient safety, and nurses kept silent more yet reported a higher likelihood of speaking up than physicians. Psychological protection for speaking up was equal for both professions, but nurses reported the environment as encouraging, and physicians were more resigned.
CONCLUSION: The findings of this study support further investment into research to design
interventions and improve patient safety by enhancing speaking up behavior and speaking up climate through recognizing and eliminating the barriers in healthcare settings. Despite ongoing improvement efforts, the current findings highlighted that safety is yet to be fully established.
References
Sendlhofer G, Brunner G, Tax C, Falzberger G, Smolle J, Leitgeb K et al. Systematic implementation of clinical risk management in a large university hospital: The impact of risk managers. Wien Klin Wochenschr. 2015; 127(1-2): 1–11. doi: 10.1007/s00508-014-0620-7. Epub 2014 Nov 13.
Gershon RR, Karkashian CD, Grosch JW, Murphy LR, Escamilla-Cejudo A, Flanagan PA et al. Hospital safety climate and its relationship with safe work practices and workplace exposure incidents. Am J Infect Control. 2000; 28(3): 211-21. doi: 10.1067/mic.2000.105288.
Schwappach D, Sendlhofer G, Hasler L, Gombotz V, Leitgeb K, Hoffmann M et al. Speaking up behaviors and safety climate in an Austrian university hospital. Int J Qual Health Care. 2018; 30(9): 701-707. doi: 10.1093/intqhc/mzy089.
Alshammari MH, Mital DP. Medical errors in Saudi Arabia: Understanding the pattern and associated financial cost. Int J Med Engineer Inform. 2016; 8(1): 41-48.
doi: 10.1504/IJMEI.2016.073652.
Kohn LT, Corrigan JM, Donaldson MS, Eds. To Err is Human: Building a Safer Health System. In: Institute of Medicine (US) Committee on Quality of Health Care in America. Washington DC: National Academics Press (US); 2000.
Emanuel L, Berwick D, Conway J. What Exactly Is Patient Safety? In: Henriksen K, Battles JB, Keyes MA, eds. Advances in Patient Safety: New Directions and Alternative Approaches; 2008 (Vol. 1: Assessment). Retrieved from http://www.ncbi.nlm.nih.gov/books/NBK43629/
AHRQ Patient Safety Network. Adverse Events, Near Misses, and Errors. Retrieved September 26, 2019. Available from: https://psnet.ahrq.gov/primer/adverse-events-near-misses-and-errors
Alzahrani N, Jones R, Abdel-Latif ME. Attitudes of doctors and nurses toward patient safety within emergency departments of two Saudi Arabian hospitals. BMC Health Serv Res. 2018; 18: 736. doi: 10.1186/s12913-018-3542-7.
Alshammari F, Pasay-an E, Alboliteeh M, Alshammari MH, Susanto T, Villareal S et al. A survey of hospital healthcare professionals' perceptions toward patient safety culture in Saudi Arabia. Int J Afr Nurs Sci. 2019; 11: 100149. doi: 10.1016/j.ijans.2019.100149.
Alharbi W, Cleland J, Morrison Z. Assessment of Patient Safety Culture in an Adult Oncology Department in Saudi Arabia. Oman Med J. 2018; 33(3): 200–208. doi: 10.5001/omj.2.018.38.
Alahmadi HA. Assessment of patient safety culture in Saudi Arabian hospitals. Qual Saf Health Care. 2010; 19(5): e17. doi: 10.1136/qshc.2009.033258.
Schwappach DL. Speaking up about hand hygiene failures: A vignette survey study among healthcare professionals. Am J Infect Control. 2018; 46(8): 870–875.
doi: 10.1016/j.ajic.2018.02.026. Epub 2018 Apr 9.
Morrow KJ, Gustavson AM, Jones J. Speaking up behaviours (safety voices) of healthcare workers: A metasynthesis of qualitative research studies. Int J Nurs Stud. 2016; 64: 42–51.
doi: 10.1016/j.ijnurstu.2016.09.014. Epub 2016 Sep 21.
Richard A, Pfeiffer Y, Schwappach DDL. Development and Psychometric Evaluation of the Speaking Up About Patient Safety Questionnaire. J Patient Saf. 2021; 17(7): e599-e606. Doi: 10.1097/PTS.0000000000000415.
Okuyama A, Wagner C, Bijnen B. Speaking up for patient safety by hospital-based health care professionals: A literature review. BMC Health Serv Res. 2014; 14: 61. doi: 10.1186/1472-6963-14-61
Schwappach, David LB, Gehring K. Silence That Can Be Dangerous: A Vignette Study to Assess Healthcare Professionals' Likelihood of Speaking up about Safety Concerns. PLoS One. 2014; 9(8): e104720. doi: 10.1371/journal.pone.0104720.
Hendrich A, Chow MP, Skierczynski BA, Lu Z. A 36-Hospital Time and Motion Study: How Do Medical-Surgical Nurses Spend Their Time? Perm J. 2008; 12(3): 25–34.
Westbrook JI, Duffield C, Li L, Creswick NJ. How much time do nurses have for patients? A longitudinal study quantifying hospital nurses' patterns of task time distribution and interactions with health professionals. BMC Health Serv Res. 2011; 11(1): 319. doi: 10.1186/1472-6963-11-319.
Stanley E. Public perception of the nursing image of professionalism based on the clothing worn by the nurse. Lamar University - Beaumont Proquest Dissertations Publishing, 2004. 1423118.
Masih S, Gulzar L. Nurses' Self Perception about their Public Image in a Metropolitan City, Karachi. J Dow Univ Health Sci. 2016; 10(2): 70-74.
Varaei S, Vaismoradi M, Jasper M, Faghihzadeh S. Iranian nurses self?perception–factors influencing nursing image. J Nurs Manag. 2012; 20(4): 551-60. doi: 10.1111/j.1365-2834.2012.01397.x. Epub 2012 Feb 27.
Nembhard IM, Edmondson, AC. Making it safe: the effects of leader inclusiveness and professional status on psychological safety and improvement efforts in health care teams. J Org Behav. 2006; 27(7): 941-966. doi: 10.1002/job.413.
Lyndon A, Sexton JB, Simpson KR, Rosenstein A, Lee KA, Wachter RM. Predictors of likelihood of speaking up about safety concerns in labour and delivery. BMJ Qual Saf. 2012; 21(9): 791-9. doi: 10.1136/bmjqs-2010-050211.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2023 Journal of Liaquat University of Medical & Health Sciences
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
Submission of a manuscript to the journal implies that all authors have read and agreed to the content of the undertaking form or the Terms and Conditions.
When an article is accepted for publication, the author(s) retain the copyright and are required to grant the publisher the right of first publication and other non-exclusive publishing rights to JLUMHS.
Articles published in the Journal of Liaquat University of Medical & health sciences are open access articles under a Creative Commons Attribution-Noncommercial - Share Alike 4.0 License. This license permits use, distribution and reproduction in any medium; provided the original work is properly cited and initial publication in this journal. This is in accordance with the BOAI definition of open access. In addition to that users are allowed to remix, tweak and build upon the work non-commercially as long as appropriate credit is given and the new creations are licensed under the identical terms. Or, in certain cases it can be stated that all articles and content there in are published under creative commons license unless stated otherwise.
