This volume, developed by the Observatory together with OECD, provides an overall conceptual framework for understanding and applying strategies aimed at improving quality of care. Crucially, it summarizes available evidence on different quality strategies and provides recommendations for their implementation. This book is intended to help policy-makers to understand concepts of quality and to support them to evaluate single strategies and combinations of strategies.

How safe are hospitals? Why do some hospitals have higher rates of accident and errors involving patients? How can we accurately measure and assess staff attitudes towards safety? How can hospitals and other healthcare environments improve their safety culture and minimize harm to patients? These and other questions have been the focus of research within the area of Patient Safety Culture (PSC) in the last decade. More and more hospitals and healthcare managers are trying to understand the nature of the culture within their organisations and implement strategies for improving patient safety. The main purpose of this book is to provide researchers, healthcare managers and human factors practitioners with details of the latest developments within the theory and application of PSC within healthcare. It brings together contributions from the most prominent researchers and practitioners in the field of PSC and covers the background to work on safety culture (e.g. measuring safety culture in industries such as aviation and the nuclear industry), the dominant theories and concepts within PSC, examples of PSC tools, methods of assessment and their application, and details of the most prominent challenges for the future in the area. Patient Safety Culture: Theory, Methods and Application is essential reading for all of the professional groups involved in patient safety and healthcare quality improvement, filling an important gap in the current market.

Building on the revolutionary Institute of Medicine reports To Err is Human and Crossing the Quality Chasm, Keeping Patients Safe lays out guidelines for improving patient safety by changing nurses' working conditions and demands. Licensed nurses and unlicensed nursing assistants are critical participants in our national effort to protect patients from health care errors. The nature of the activities nurses typically perform â€" monitoring patients, educating home caretakers, performing treatments, and rescuing patients who are in crisis â€" provides an indispensable resource in detecting and remedying error-producing defects in the U.S. health care system. During the past two decades, substantial changes have been made in the organization and delivery of health care â€" and consequently in the job description and work environment of nurses. As patients are increasingly cared for as outpatients, nurses in hospitals and nursing homes deal with greater severity of illness. Problems in management practices, employee deployment, work and workspace design, and the basic safety culture of health care organizations place patients at further risk. This newest edition in the groundbreaking Institute of Medicine Quality Chasm series discusses the key aspects of the work environment for nurses and reviews the potential improvements in working conditions that are likely to have an impact on patient safety.

v. 1. Research findings -- v. 2. Concepts and methodology -- v. 3. Implementation issues -- v. 4. Programs, tools and products.

How safe are hospitals? Why do some hospitals have higher rates of accident and errors involving patients? How can we accurately measure and assess staff attitudes towards safety? How can hospitals and other healthcare environments improve their safety culture and minimize harm to patients? These and other questions have been the focus of research within the area of Patient Safety Culture (PSC) in the last decade. More and more hospitals and healthcare managers are trying to understand the nature of the culture within their organisations and implement strategies for improving patient safety. The main purpose of this book is to provide researchers, healthcare managers and human factors practitioners with details of the latest developments within the theory and application of PSC within healthcare. It brings together contributions from the most prominent researchers and practitioners in the field of PSC and covers the background to work on safety culture (e.g. measuring safety culture in industries such as aviation and the nuclear industry), the dominant theories and concepts within PSC, examples of PSC tools, methods of assessment and their application, and details of the most prominent challenges for the future in the area. Patient Safety Culture: Theory, Methods and Application is essential reading for all of the professional groups involved in patient safety and healthcare quality improvement, filling an important gap in the current market.

The purpose of this book is to provide a road map to help healthcare professionals establish a "culture of patient safety" in their facilities and practices, provide high quality healthcare, and increase patient and staff satisfaction by improving communication among staff members and between medical staff and patients. It achieves this by describing what each of six types of people will do in distress, by providing strategies that will allow healthcare professionals to deal more effectively with staff members and patients in distress, and by showing healthcare professionals how to keep themselves out of distress by getting their motivational needs met positively every day. The concepts described in this book are scientifically based and have withstood more than 40 years of scrutiny and scientific inquiry. They were first used as a clinical model to help patients help themselves, and indeed are still used clinically. The originator of the concepts, Dr. Taibi Kahler, is an internationally recognized clinical psychologist who was awarded the 1977 Eric Berne Memorial Scientific Award for the clinical application of a discovery he made in 1971. That discovery enabled clinicians to shorten significantly the treatment time of patients by reducing their resistance as a result of miscommunication between their doctors and themselves.

Background: Shared values, norms and beliefs of relevance for safety in health care can be described in terms of patient safety culture. This concept overlaps with patient safety climate, but culture represents the deeprooted values, norms and beliefs, whereas climate refers to attitudes and more superficial manifestations of culture. There may be numerous subcultures within an organization, including different professional cultures. In recent years, increased attention has been paid to patient safety culture in Sweden, and the patient safety culture/climate in health care is regularly measured based on the assumption that patient safety culture/climate can influence various patient safety outcomes. Aim: The overall aim of the thesis is to contribute to an improved understanding of patient safety culture and subcultures in Swedish health care. Design and methods: The thesis is based on four studies applying different methods. Study 1 was a survey that included 23,781 respondents. Data were analysed with quantitative methods, with primarily descriptive results. Studies 2 and 3 were qualitative studies, involving interviews with a total of 28 registered nurses, 24 nurse assistants and 28 physicians. Interview data were analysed using content analysis. Study 4 evaluated an intervention intended to influence patient safety culture and included data from a questionnaire with both fixed and open-ended questions, which was answered by 200 respondents. Results: A key result from Study 1 was that professional groups differed in terms of their views and statements about patient safety culture/ climate. Registered nurses and nurse assistants in Study 2 were found to have partially overlapping norms, values and beliefs concerning patient safety, which were identified at individual, interpersonal and organizational level. Study 3 found four categories of values and norms among physicians of potential relevance for patient safety. Predominantly positive perceptions were found in Study 4 concerning the Walk Rounds intervention among frontline staff members, local managers and top-level managers who participated in the intervention. However, there were also reflections on disadvantages and some suggestions for improvement. Conclusions: According to the results of the patient safety culture/ climate questionnaire, perceptions about safety culture/climate dimensions contribute more to the rating of overall patient safety than background characteristics (e.g. profession and years of experience). There are differences in the patient safety culture between registered nurses and nurse assistants, which imply that efforts for improved patient safety must be tailored to their respective values, norms and beliefs. Several aspects of physicians’ professional culture may have relevance for patient safety. Expectations of being infallible reduce their willingness to talk about errors they make, thus limiting opportunities for learning from errors. Walk Rounds are perceived to contribute to increased learning concerning patient safety and could potentially have a positive influence on patient safety culture.