Safety Performance of Healthcare Professionals

Abstract

Patient safety was recently declared as a global priority by the World Health Organization and the evaluation of the performance of health care systems, organizations and their actors remains a main area of challenge for research and policy, as well as for organization and management. This dissertation aimed to address three objectives to get a deeper and more complex understanding of safety performance and the behavior of healthcare professionals working in acute care in Germany to improve patient safety by 1) validation of an instrument to measure the constructs safety performance, safety knowledge and safety motivation; 2) developing and testing a new possibility to measure safety performance as actual behavior within clinical safety scenarios; 3) exploring the perspectives of healthcare professionals regarding their experiences and views on safety performance. The three publications were based on data of the project safety performance of healthcare professionals - SPOHC, which was carried out between 2018 and 2020. (1) and (2) were based on data of a cross sectional survey with 168 healthcare professionals. The following methods were used in the three publications: (1) evaluation of the internal consistency and construct validity, using exploratory and confirmatory factor analysis to test how the data fit with the original model. (2) A situational judgment test with seven items covering seven different safety scenarios was developed and tested through internal consistency and construct validity. (3) 23 healthcare professionals were interviewed using semi-structured interviews. The categories were developed deductively based on the human factors model of patient safety. Main results show that (1) Cronbachs alpha for all four dimensions was >0.7. All items were loaded on factors according to the original theoretical model. (2) The items of the SJT demonstrated Cronbach's alpha of 0.57. Moderate positive correlations were found among the seven variables in the study. (3) Results highlight the importance of safety performance as a construct of occupational health rather than of patient safety, the role of the organization and the self-responsibility of healthcare professionals. All presented data are part of an explorative study and thus are limited in terms of their generalizability. Furthermore, future research should focus on longitudinal designs to study time effects, it remains outstanding which role the organizational, sociodemographic or person- and situation-related aspects have and how they may predict and influence the safety performance of healthcare professionals.