Patient safety climate in general public hospitals in China: differences associated with department and job type based on a cross-sectional survey

OBJECTIVE: This study analysed differences in the perceived patient safety climate among different working departments and job types in public general hospitals in China. DESIGN: Cross-sectional survey. SETTING: Eighteen tertiary hospitals and 36 secondary hospitals from 10 areas in Shanghai, Hubei Province and Gansu Province, China. PARTICIPANTS: Overall, 4753 staff, including physicians, nurses, medical technicians and managers, were recruited from March to June 2015. MAIN OUTCOME MEASURE: The Patient Safety Climate in Healthcare Organisations (PSCHO) tool and the percentages of ‘problematic responses’ (PPRs) were used as outcome measures. Multivariable two-level random intercept models were applied in the analysis. RESULTS: A total of 4121 valid questionnaires were collected. Perceptions regarding the patient safety climate varied among departments and job types. Physicians responded with relatively more negative evaluations of ‘organisational resources for safety’, ‘unit recognition and support for safety efforts’, ‘psychological safety’, ‘problem responsiveness’ and overall safety climate. Paediatrics departments, intensive care units, emergency departments and clinical auxiliary departments require more attention. The PPRs for ‘fear of blame and punishment’ were universally significantly high, and the PPRs for ‘fear of shame’ and ‘provision of safe care’ were remarkably high, especially in some departments. Departmental differences across all dimensions and the overall safety climate primarily depended on job type. CONCLUSIONS: The differences suggest that strategies and measures for improving the patient safety climate should be tailored by working department and job type.