Determinants of Occupational Safety Culture in Hospitals and other Workplaces-Results from an Integrative Literature Review

Public perceptions of reportable safety events and risks in United States primary care

INTRODUCTION

Patients may not feel responsible for reporting safety events, and social norms may prevent patients from questioning health care providers' judgment. There is a paucity of research regarding public awareness of reportable safety events/risks. Educating the public about reporting is paramount in error prevention. Because more than 70% of errors (e.g., errors in diagnosis, communication errors, unsafe medication practices, and care fragmentation) occur in primary care settings, the purpose of this study was to explore public perceptions of when to report safety events/risks in these settings.

METHOD

System-level primary and outpatient facility safety incident scenarios conducive to safety events/risk reporting were developed and administered via online survey methodology. Following completion of the scenario questions, participants were asked a single open-text item: "As you were reading the scenarios above, what did you think makes an event/risk 'reportable'?"

RESULTS

At least one-third of participants responded incorrectly in 70% of the scenarios. The percentage of incorrect responses ranged from 5.2% to 62.3% with "unwitnessed falls" and "nursing scope of practice" queries incorrectly reported at 44.5% and 53.9%, respectively. Rationales for inappropriate events/risk reporting included "risk prediction at the management/system level," "legal repercussions/protection (e.g., negligence, legal responsibility to patient)," "violations of scope of practice/professional expectations," "degree of potential/actual lethality," and "personnel errors."

CONCLUSION

This study revealed a gap between understanding why to report an event/risk and when to correctly report (or not report) an actual healthcare issue.

PRACTICAL APPLICATIONS

Awareness of reasons for correctly reporting incidents and how correct reporting builds a culture of safety needs to be strengthened.

Exploring organizational aspects that promote health-related preventive behavior: using the example of work-related SARS-CoV-2 infection control measures in Germany, August 2020 to November 2021

Introduction

During the communicable coronavirus disease (COVID-19) pandemic, organizational infection control measures (oICMs) were introduced in the workplace. The employees' positive attitudes and active participation are relevant for full effectiveness regarding disease prevention. Therefore, we explore changes in employees' attitudes toward oICM at work from August-October 2020 (T0) over January 2021 (T1) to October-November 2021 (T2). We further investigate the role an organization can play in supporting health-related preventive behavior.

Methods

We considered repeated cross-sectional and longitudinal panel survey data from 5,554 employees of a global supplier of technology and services in Germany. A total of 16 items constitute the attitude scores toward oICM (5-point Likert scale). Via mixed-effect model, aspects associated with employees' attitudes toward oICM were explored. Via 'extreme-group' approach, we compared the 20% of participants with the largest changes into less favorable to the 20% with the largest changes into more favorable attitudes toward oICM over time.

Results

The overall positive attitudes toward work-related oICM were more favorable at T1 (mean ± SD: 4.2 ± 0.6, median (IQR): 4.3 (0.8), n = 2,515) compared to T0 (4.1 ± 0.6, 4.1 (0.8), n = 2,417) but less favorable at T2 (3.9 ± 0.7, 4.0 (0.9), n = 2,062). Among others, feeling well-informed about possible work-related risks of infection with the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), perceived psychosocial demands through work environment aspects, and perceived management's commitment to safety and health were associated with long-term positive attitudes toward oICM. Individuals developing more favorable attitudes toward oICM reported feeling well-informed about possible work-related SARS-CoV-2 infection risks and improved COVID-19-specific resilience over time. Individuals developing less favorable attitudes toward oICM reported decreased perceptions of COVID-19-associated risks.

Conclusion

oICMs in the workplace were perceived appropriate even after COVID-19 vaccines were widely available although the perceived affective risks about SARS-CoV-2 decreased. Taken together, our findings highlight how organizations can support employees in adopting health-related preventive behavior. Among others, we found that feeling well-informed about possible work-related health risks was positively associated with long-term favorable attitudes toward work-related oICM. We expect that the results contribute to the development of interventions to prepare and adapt to future global public health concerns.

Assessing Differences in Attitudes toward Occupational Safety and Health Measures for Infection Control between Office and Assembly Line Employees during the COVID-19 Pandemic in Germany: A Cross-Sectional Analysis of Baseline Data from a Repeated Employee Survey

In our study, we investigated possible differences across occupational groups regarding employees’ perceived work-related risk of infection with SARS-CoV-2, attitudes toward technical, organisational, and personal occupational safety and health (OSH) measures for infection control, and factors associated with this attitude. We analysed baseline data (10 August to 25 October 2020) from a repeated standardised online survey distributed at a worldwide leading global supplier of technology and services in Germany. 2144 employees (32.4% women; age (mean ± SD): 44 ± 11 years) who worked predominantly remotely (n = 358), at an on-site office (n = 1451), and assembly line/manufacturing (n = 335) were included. The work-related SARS-CoV-2 risk of infection differed between office employees working remotely and on-site (mean ± SD = 2.9 ± 1.5 vs. 3.2 ± 1.5; Mann-Whitney-U-Test: W = 283,346; p < 0.002; ε2 = 0.01) and between on-site office and assembly line/manufacturing employees (3.8 ± 1.7; W = 289,174; p < 0.001; ε2 = 0.02). Attitude scores toward technical OSH-measures differed between remote and on-site office (4.3 ± 0.5 vs. 4.1 ± 0.6; W = 216,787; p < 0.001; ε2 = 0.01), and between on-site office and assembly line/manufacturing employees (3.6 ± 0.9; W = 149,881; p < 0.001; ε2 = 0.07). Findings were similar for organisational and personal measures. Affective risk perception, COVID-19-specific resilience, and information about COVID-19-related risks were associated with the employees’ attitudes. To promote positive attitudes, it seems to be important to consider occupational-group-specific context factors when implementing OSH-measures for infection control.

An assessment of organisational culture in Australian hospitals using employee online reviews

The aim of this study was to analyse the content of online reviews posted by hospital employees on job websites for themes of organisational culture. 103 anonymous online reviews across three job websites, posted by hospital employees of four hospitals within an Australian health network were extracted. Reviews had been posted across a period of six years, from 2014 to early 2020. Sentiment rating based on user-allotted ratings on the selected websites was calculated. The sentiment score was validated against the textual content of the review to confirm employee recommendation and sentiment. Sentiment was coded as neutral, positive, or negative. Significant keywords, associations, and usage within the context of identified sentiment were deductively coded and clustered manually against eight pre-determined safety culture themes. These themes were derived from the most used assessment tools for self-reported measures of occupational health and safety, and safety culture in healthcare. Workers across clinical roles (n = 49) and non-clinical roles (n = 50) were evenly represented in the dataset. 35.9% of commenters (n = 37) reported their length of employment in the hospitals that they reviewed. Most online employee reviews addressed broad themes related to perceptions of management (n = 98), safety climate (n = 97), teamwork climate (n = 91) and working conditions (n = 98). A significant set of reviews addressed themes related to job satisfaction (n = 49) and learning, training, and development (n = 41). 72.8% of online reviews (n = 75) expressed positive sentiment towards their employer. Reviews expressing negative sentiment were largely posted by former employees and indicated areas of discontent that reflected organisational and systemic factors. Online employee reviews posted by hospital workers on job sites provide valuable insights into healthcare organisational culture. Therefore, employee online reviews could be used as a supplementary source of data to inform organisational employee engagement initiatives.

Assessing the Mediating Role of Safety Communication Between Safety Culture and Employees Safety Performance

The main purpose of this research was to investigate the mediating role of safety communication (SCO) in the relationship between safety culture (SC) and safety performance (SP) amongst employees in the petrochemical industry. Safety communication methods not only enhance working conditions but also have a positive impact on employee's behaviors and attitudes toward safety leading toward reduced incidents in the workplace environment. A stratified sampling method was followed to collect data in the petrochemical industry in Malaysia. Structural equation modeling (SEM) was utilized to analyze the hypothesized model, using data from 320 participants. The findings reveal that safety communication partially mediates the association between safety culture and safety performance. Further, safety culture was found to have a significant and positive effect on safety performance. This -study makes a significant theoretical contribution by providing empirical evidence on the direct and indirect relationship between safety culture and safety performance in the petrochemical industry.

Work-Related Health Literacy: A Scoping Review to Clarify the Concept

The overall aim of this scoping review is to outline the current state of research on health literacy (HL) in the workplace: the primary objective is to clarify the concept of individual work-related HL; the secondary aims are to report on interventions that promote individual work-related HL and to present respective measurement instruments validated to date. A high level of work-related HL could support work ability and in the longer run employability. These topics are becoming increasingly important in current circumstances and in view of ongoing developments (e.g., digitalization and "new" work). A basic understanding and measurement of HL as an individual competence in the context of working life is necessary to develop future interventions to promote HL among people of working age. According to the participants, concept, and context (PCC) framework, we included articles on health literacy (concept) in the target group of people of working age in the workplace (population and context). Key information sources were the databases PubMed, CINAHL, PsycInfo, and PSYNDEX. A total of 30 articles were included. There are several terms for "health literacy in the workplace" (including individual work-related or occupational HL). The conceptualizations of the individual employee's competence covered all aspects of HL ("access", "understand", "appraise", and "apply" health information). The conceptualizations differed, among others, in the covered time horizon (referring either only to employees' current work situation or additionally to their employability in the lifespan) or whether they referred also to the viability of the respective company. Published interventions attempting to promote individual work-related HL seem mostly to be targeted at the promotion of mental HL. A variety of outcomes have been measured in intervention studies, while specific measurement instruments for individual work-related HL seem to be scarce. We recommend the development of country-specific instruments for the assessment of individual work-related health literacy and to measure mental and physical work-related health literacy.

Assessment of Workplace Safety Climate among Healthcare Workers during the COVID-19 Pandemic in Low and Middle Income Countries: A Case Study of Nigeria

The COVID-19 pandemic has presented several organizations with the opportunity to review their operational strategies, as well as the existing safety climate within their establishments. The healthcare sector is not an exception, especially those in Low and Middle Income Countries (LMICs), where most safety systems are not robust when compared with developed countries. The study aim is to assess the occupational safety climate among healthcare workers (HCWs) in LMICs using Nigeria as a case study. A cross-sectional study was adopted to measure safety climate perception among professionals working in healthcare establishment during the COVID-19 pandemic using a validated Nordic Safety Climate Questionnaire (NOSACQ-50). At the end of the survey period, 83% (433) of the responses were adjudged to have met the threshold criteria and were used to inform the study outcome. Worker safety commitment within the healthcare facilities (M = 3.01, SD = 0.42) was statistically significantly higher than management safety priority, commitment, and competence (M = 2.91, SD = 0.46), t(130.52), p < 0.001. A significant effect of the management role was found in regards to management safety priority, commitment, and competence (F(1, 406) = 3.99, p = 0.046, η² = 0.010). On the contrary, the managerial position does not have a significant effect on worker safety commitment (F(1, 417) = 0.59, p = 0.440, η² = 0.001). The outcome from the study showed that, where there is active promotion of a positive safety climate in healthcare sectors in LMICs, employees are more likely to engage in positive safety behaviour. To help address the identified gaps, there is the need for more effort to be made towards promoting an effective and positive safety climate across the establishment, including management and healthcare worker commitments.