The association of professionalism and systems thinking with patient safety competency: A structural equation mode

2022 ◽  
Author(s):  
Edris Kakemam ◽  
Masoud Ghafari ◽  
Mahtab Rouzbahani ◽  
Hamideh Zahedi ◽  
Young Sook Roh
Keyword(s):  
Patient Safety ◽  
Systems Thinking ◽  
Structural Equation

scholarly journals Assessing the Impact of Multi-Morbidity and Related Constructs on Patient Reported Safety in Primary Care: Generalized Structural Equation Modelling of Observational Data

2021 ◽  
Vol 10 (8) ◽  
pp. 1782
Author(s):  
Ignacio Ricci-Cabello ◽  
Aina María Yañez-Juan ◽  
Maria A. Fiol-deRoque ◽  
Alfonso Leiva ◽  
Joan Llobera Canaves ◽  
...  
Keyword(s):  
Primary Care ◽  
Patient Safety ◽  
Structural Equation ◽  
Structural Equation Models ◽  
Cross Sectional ◽  
Morbidity Burden ◽  
Patient Reported ◽  
Patient Complexity ◽  
Complex Relationships ◽  
The Impact

We aimed to examine the complex relationships between patient safety processes and outcomes and multimorbidity using a comprehensive set of constructs: multimorbidity, polypharmacy, discordant comorbidity (diseases not sharing either pathogenesis nor management), morbidity burden and patient complexity. We used cross-sectional data from 4782 patients in 69 primary care centres in Spain. We constructed generalized structural equation models to examine the associations between multimorbidity constructs and patient-reported patient safety (PREOS-PC questionnaire). These associations were modelled through direct and indirect (mediated by increased interactions with healthcare) pathways. For women, a consistent association between higher levels of the multimorbidity constructs and lower levels of patient safety was observed via either pathway. The findings for men replicated these observations for polypharmacy, morbidity burden and patient complexity via indirect pathways. However, direct pathways showed unexpected associations between higher levels of multimorbidity and better safety. The consistent association between multimorbidity constructs and worse patient safety among women makes it advisable to target this group for the development of interventions, with particular attention to the role of comorbidity discordance. Further research, particularly qualitative research, is needed for clarifying the complex associations among men.

School principals’ systems thinking: antecedents and consequences

2019 ◽  
Vol 57 (2) ◽  
pp. 167-184 ◽  
Author(s):  
Pascale Benoliel ◽  
Haim Shaked ◽  
Nechama Nadav ◽  
Chen Schechter
Keyword(s):  
Job Satisfaction ◽  
Organizational Commitment ◽  
Systems Thinking ◽  
Structural Equation ◽  
Equation Modeling ◽  
Content Type ◽  
Mediating Role ◽  
Leadership Framework ◽  
Antecedents And Consequences

PurposeToday’s educational complexities require principals to adopt a more systemic perspective toward school management. Although research has emphasized the benefits associated with the holistic perspective of systems thinking, research in the educational field has been limited. The purpose of this paper is to investigate the mediating role of principals’ systems thinking (PST) in the relationships between instructional leadership (IL) and subject coordinators’ organizational commitment and job satisfaction.Design/methodology/approachData were collected by surveying a sample of 226 subject coordinators from different elementary schools randomly chosen in Israel. Subject coordinators completed questionnaires on their PST competencies, their principals’ IL, job satisfaction and organizational commitment. Structural equation modeling was used to test the research hypotheses.FindingsThe results confirmed the main hypotheses: PST did facilitate subject coordinators’ organizational commitment and job satisfaction. Findings also showed that PST mediated the relationship between IL and subject coordinators’ organizational commitment and job satisfaction.Originality/valueBy integrating research from both educational and non-educational literature, this study contributes to deepen our understanding regarding the antecedents and consequences of the PST as perceived by their subject coordinators, providing a broader leadership framework on their functions in today’s complex school systems.

scholarly journals Patient Safety, Risk Reduction, and the Law

2018 ◽  
Author(s):  
Larry I. Palmer
Keyword(s):  
Health Care ◽  
Patient Safety ◽  
Health System ◽  
Systems Thinking ◽  
Health Care System ◽  
Error Reduction ◽  
Medical Liability ◽  
Starting Point ◽  
Care System

36 Houston Law Review 1609 (1999)"Patient safety" has come of age. With the publication of several empirical studies of medical injuries and the recent Institute of Medicine Report, To Err is Human: Building a Safe Health System, scholars from a variety of disciplines are advocating "systems thinking" as a way of preventing medical accidents. These scholars have been influenced by efforts to reduce accidents in other high risk industries such as aviation and scholarship in law proposing "no fault systems" for compensating medical accident victims. This article proposes that in order to incorporate "systems thinking" about medical error reduction, legal scholarship on the health care system must move beyond its preoccupation with the medical liability system. To develop a new framework for the role of law in enhancing patient safety, this article proposes that law's interaction with the public health system is the appropriate starting point for framing the legal analysis of patient safety. This framing of the issues acknowledges that the liability system may have a role to play in error reduction in medicine, but determining what this role is requires more empirical study of legal institutions as part of the emerging system of patient safety. To discover the appropriate role of law in the prevention of medical errors, this article encourages legal scholars to learn to pose empirical questions about how various institutions interact with the health care system.

scholarly journals Reliability and validity of the Brazilian version of the HSOPSC: a reassessment study

2019 ◽  
Vol 35 (8) ◽  
Author(s):  
Cláudia Tartaglia Reis ◽  
Josué Laguardia ◽  
Cláudia Garcia de Barros ◽  
Paola Bruno de Araujo Andreoli ◽  
Mônica Martins
Keyword(s):  
Patient Safety ◽  
Structural Equation ◽  
Discriminant Validity ◽  
Reliability And Validity ◽  
Patient Safety Culture ◽  
Residual Variance ◽  
Care Hospital ◽  
Validity And Reliability ◽  
Cross Sectional ◽  
Brazilian Version

Abstract: This study aimed to reassess the psychometric properties of the Hospital Survey on Patient Safety Culture (HSOPSC) adapted to Portuguese for use in the Brazilian context. An observational, cross-sectional study was performed in a large, private, non-profit, acute care hospital, reference in patient safety, in a major Brazilian metropolis. Participants were selected from a non-probability sample of all eligible personnel in the various hospital departments invited to participate in the study. Reliability of the HSOPSC was assessed by estimating Cronbach’s alpha for each dimension. confirmatory factor analysis (CFA), a matrix of correlations between the dimensions, and exploratory structural equation modelling (ESEM) were used in exploratory and confirmatory analyses of the structural validity of the construct. The overall response rate was 18.7% (n = 1,439). Four dimensions (“overall perceptions of patient safety”; “staffing”; “teamwork across units”; and “non-punitive response to error”) returned problems of internal consistency. CFA returned acceptable fit with the original 12-dimension model. Correlations between the dimensions of the original 12-dimension model indicated discriminant validity problems, while residual variance was greater than 0.70 in 13 items. The ESEM of the original 12-dimension model returned good fit, with the following indices: CFI = 0.985; TLI = 0.968, and RMSEA = 0.026 (90%CI: 0.024-0.029). Although better than those of the first evaluation, the results obtained in this validity and reliability reassessment of the Brazilian version of the HSOPSC require further research.

scholarly journals Structural equation modeling for identification of patient safety antecedents in primary care

2020 ◽  
Author(s):  
Katarzyna Kosiek ◽  
Iwona Staniec ◽  
Maciej Godycki-Cwirko ◽  
Adam Depta ◽  
Anna Kowalczyk
Keyword(s):  
Primary Care ◽  
Patient Safety ◽  
Structural Equation Modeling ◽  
Structural Equation ◽  
Safety Management ◽  
Improve Patient Safety ◽  
Equation Modeling ◽  
Number Of Factors ◽  
Safety Interventions ◽  
Improve Patient

Abstract Background:. Patient safety is defined as an activity that minimizes and removes possible errors and injuries to patients. A number of factors have been found to influence patient safety management, including the facilities available in the practice, communication and collaboration, education regarding patient safety and generic conditions. This study tested a theoretical model of patient safety interventions based on safety antecedents. Methods: Medical professionals were surveyed using a questionnaire developed by Gaal et al. The results were analyzed with SPSS 20 and AMOS. A hypothetical model of direct and indirect effects on patient safety in a primary care environment was created and analyzed using structural equation modeling (SEM). Results: SEM proved to be an effective tool to analyse safety in primary care. The facilities in the practice appear to have no significant influence on patient safety management in the case of female respondents, those below mean age, those who are not GPs (general practitioner) and respondents not working in counselling centres.Conclusions: The integrated safety model described in the study can improve patient safety management.

scholarly journals An empirical application of “broken windows” and related theories in healthcare: examining disorder, patient safety, staff outcomes, and collective efficacy in hospitals

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Louise A. Ellis ◽  
Kate Churruca ◽  
Yvonne Tran ◽  
Janet C. Long ◽  
Chiara Pomare ◽  
...  
Keyword(s):  
Job Satisfaction ◽  
Patient Safety ◽  
Collective Efficacy ◽  
Outcome Measures ◽  
Social Behaviour ◽  
Structural Equation ◽  
Physical Disorder ◽  
Broken Windows ◽  
The Relationship ◽  
Neighbourhood Disorder

Abstract Background Broken windows theory (BWT) proposes that visible signs of crime, disorder and anti-social behaviour – however minor – lead to further levels of crime, disorder and anti-social behaviour. While we acknowledge divisive and controversial policy developments that were based on BWT, theories of neighbourhood disorder have recently been proposed to have utility in healthcare, emphasising the potential negative effects of disorder on staff and patients, as well as the potential role of collective efficacy in mediating its effects. The aim of this study was to empirically examine the relationship between disorder, collective efficacy and outcome measures in hospital settings. We additionally sought to develop and validate a survey instrument for assessing BWT in hospital settings. Methods Cross-sectional survey of clinical and non-clinical staff from four major hospitals in Australia. The survey included the Disorder and Collective Efficacy Survey (DaCEs) (developed for the present study) and outcome measures: job satisfaction, burnout, and patient safety. Construct validity was evaluated by confirmatory factor analysis (CFA) and reliability was assessed by internal consistency. Structural equation modelling (SEM) was used to test a hypothesised model between disorder and patient safety and staff outcomes. Results The present study found that both social and physical disorder were positively related to burnout, and negatively related to job satisfaction and patient safety. Further, we found support for the hypothesis that the relationship from social disorder to outcomes (burnout, job satisfaction, patient safety) was mediated by collective efficacy (social cohesion, willingness to intervene). Conclusions As one of the first studies to empirically test theories of neighbourhood disorder in healthcare, we found that a positive, orderly, productive culture is likely to lead to wellbeing for staff and the delivery of safer care for patients.

A New Era for Safety Measurement

2015 ◽  
pp. 219-246
Author(s):  
Sarahjane Jones ◽  
Mairi Macintyre
Keyword(s):  
Patient Safety ◽  
Systems Thinking ◽  
Critical Review ◽  
New Era ◽  
Cultural Perspectives ◽  
Current Systems

This chapter presents current systems thinking concerning patient safety and explores what patient safety actually means, allowing a foundation for a critical review of tools used for safety measurement. Content considers a range of content from hard measures to softer cultural perspectives, thus ensuring that the patient view is not forgotten.

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