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Measuring patient safety culture in maternal and child health institutions in China: a qualitative study

INTRODUCTION: Patient safety culture (PSC) plays a critical role in ensuring safe and quality care. Extensive PSC studies have been undertaken in hospitals. However, little is known about PSC in maternal and child health (MCH) institutions in China, which provide both population-based preventive ser...

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Autores principales: Wang, Yuanyuan, Liu, Weiwei, Shi, Huifeng, Liu, Chaojie, Wang, Yan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5734290/
https://www.ncbi.nlm.nih.gov/pubmed/28706096
http://dx.doi.org/10.1136/bmjopen-2016-015458
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author Wang, Yuanyuan
Liu, Weiwei
Shi, Huifeng
Liu, Chaojie
Wang, Yan
author_facet Wang, Yuanyuan
Liu, Weiwei
Shi, Huifeng
Liu, Chaojie
Wang, Yan
author_sort Wang, Yuanyuan
collection PubMed
description INTRODUCTION: Patient safety culture (PSC) plays a critical role in ensuring safe and quality care. Extensive PSC studies have been undertaken in hospitals. However, little is known about PSC in maternal and child health (MCH) institutions in China, which provide both population-based preventive services as well as individual care for patients. OBJECTIVES: This study aimed to develop a theoretical framework for conceptualising PSC in MCH institutions in China. METHODS: The study was undertaken in six MCH institutions (three in Hebei and three in Beijing). Participants (n=118) were recruited through stratified purposive sampling: 20 managers/administrators, 59 care providers and 39 patients. In-depth interviews were conducted with the participants. The interview data were coded using both inductive (based on the existing PSC theory developed by the Agency for Healthcare Research and Quality) and deductive (open coding arising from data) approaches. A PSC framework was formulated through axial coding that connected initial codes and selective coding that extracted a small number of themes. RESULTS: The interviewees considered patient safety in relation to six aspects: safety and security in public spaces, safety of medical services, privacy and information security, financial security, psychological safety and gap in services. A 12-dimensional PSC framework was developed, containing 69 items. While the existing PSC theory was confirmed by this study, some new themes emerged from the data. Patients expressed particular concerns about psychological safety and financial security. Defensive medical practices emerged as a PSC dimension that is associated with not only medical safety but also financial security and psychological safety. Patient engagement was also valued by the interviewees, especially the patients, as part of PSC. CONCLUSIONS: Although there are some common features in PSC across different healthcare delivery systems, PSC can also be context specific. In MCH settings in China, the meaning of ‘patient safety’ goes beyond the traditional definition of patients. General well-being, health and disease prevention are important anchor points for defining PSC in such settings.
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spelling pubmed-57342902017-12-20 Measuring patient safety culture in maternal and child health institutions in China: a qualitative study Wang, Yuanyuan Liu, Weiwei Shi, Huifeng Liu, Chaojie Wang, Yan BMJ Open Health Services Research INTRODUCTION: Patient safety culture (PSC) plays a critical role in ensuring safe and quality care. Extensive PSC studies have been undertaken in hospitals. However, little is known about PSC in maternal and child health (MCH) institutions in China, which provide both population-based preventive services as well as individual care for patients. OBJECTIVES: This study aimed to develop a theoretical framework for conceptualising PSC in MCH institutions in China. METHODS: The study was undertaken in six MCH institutions (three in Hebei and three in Beijing). Participants (n=118) were recruited through stratified purposive sampling: 20 managers/administrators, 59 care providers and 39 patients. In-depth interviews were conducted with the participants. The interview data were coded using both inductive (based on the existing PSC theory developed by the Agency for Healthcare Research and Quality) and deductive (open coding arising from data) approaches. A PSC framework was formulated through axial coding that connected initial codes and selective coding that extracted a small number of themes. RESULTS: The interviewees considered patient safety in relation to six aspects: safety and security in public spaces, safety of medical services, privacy and information security, financial security, psychological safety and gap in services. A 12-dimensional PSC framework was developed, containing 69 items. While the existing PSC theory was confirmed by this study, some new themes emerged from the data. Patients expressed particular concerns about psychological safety and financial security. Defensive medical practices emerged as a PSC dimension that is associated with not only medical safety but also financial security and psychological safety. Patient engagement was also valued by the interviewees, especially the patients, as part of PSC. CONCLUSIONS: Although there are some common features in PSC across different healthcare delivery systems, PSC can also be context specific. In MCH settings in China, the meaning of ‘patient safety’ goes beyond the traditional definition of patients. General well-being, health and disease prevention are important anchor points for defining PSC in such settings. BMJ Publishing Group 2017-07-12 /pmc/articles/PMC5734290/ /pubmed/28706096 http://dx.doi.org/10.1136/bmjopen-2016-015458 Text en © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted. This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
spellingShingle Health Services Research
Wang, Yuanyuan
Liu, Weiwei
Shi, Huifeng
Liu, Chaojie
Wang, Yan
Measuring patient safety culture in maternal and child health institutions in China: a qualitative study
title Measuring patient safety culture in maternal and child health institutions in China: a qualitative study
title_full Measuring patient safety culture in maternal and child health institutions in China: a qualitative study
title_fullStr Measuring patient safety culture in maternal and child health institutions in China: a qualitative study
title_full_unstemmed Measuring patient safety culture in maternal and child health institutions in China: a qualitative study
title_short Measuring patient safety culture in maternal and child health institutions in China: a qualitative study
title_sort measuring patient safety culture in maternal and child health institutions in china: a qualitative study
topic Health Services Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5734290/
https://www.ncbi.nlm.nih.gov/pubmed/28706096
http://dx.doi.org/10.1136/bmjopen-2016-015458
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