Hospital staffing patterns and safety culture perceptions: The mediating role of perceived teamwork and perceived handoffs.

Background: As hospitals are under increasing pressure to improve quality and safety, safety culture has become a focal issue for high-risk organizations, including hospitals. Prior research has examined howstructural characteristics directly impact safety culture. However, and based on Donabedian's...

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Published in:Health Care Management Review Vol. 46; no. 3; pp. 227 - 237
Main Authors: Upadhyay, Soumya, Weech-Maldonado, Robert, Lemak, Christy H., Stephenson, Amber L., Smith, Dean G.
Format: equations & formulas research tables/charts Journal Article
Published: Lippincott Williams & Wilkins Jul-Sep2021
Online Access:View this record in EBSCOhost
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      dt: Jul-Sep2021
      vid: 46
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      pub: Lippincott Williams & Wilkins
      place: Baltimore, Maryland
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        atl: Hospital staffing patterns and safety culture perceptions: The mediating role of perceived teamwork and perceived handoffs.
      aug:
        au:
          Upadhyay, Soumya
          Weech-Maldonado, Robert
          Lemak, Christy H.
          Stephenson, Amber L.
          Smith, Dean G.
        affil: Assistant Professor, Department of Healthcare Administration and Policy, School of Public Health, University of Nevada at Las Vegas
      sug:
        subj:
          Personnel Staffing and Scheduling
          Hospitals
          Organizational Culture
          Occupational Safety Psychosocial Factors
          Human
          Models, Theoretical
          Hospitalists
          Registered Nurses
          Quality of Health Care
          Teamwork
          Hand Off (Patient Safety)
          United States Agency for Healthcare Research and Quality
          Questionnaires
          Data Management
          Nonresponse Bias
          Investments
          Multivariate Analysis
          Regression
          Mediation Analysis
          Electronic Health Records
      ab: Background: As hospitals are under increasing pressure to improve quality and safety, safety culture has become a focal issue for high-risk organizations, including hospitals. Prior research has examined howstructural characteristics directly impact safety culture. However, and based on Donabedian's structure--process--outcome qualitymodel, there is a need to understand the processes that intermediate the relationship between structural characteristics and safety culture perceptions. Purpose: The processes by which registered nurse (RN) and hospitalist staffing may affect safety culture perceptions were examined in this study. Specifically, this study investigates the processes of perceived teamwork across units and perceived handoffs. Methodology: Data sources for this research included Hospital Survey on Patient Safety Culture from the Agency for Healthcare Research and Quality, the American Hospital Association's Annual Survey Data, the American Hospital Association Information Technology supplement, and the Area Health Resource File. Two separate mediation models for each process were used. Propensity weights were assigned to each hospital in the sample (N = 207) to adjust for potential nonresponse bias of hospitals that did not assess employee's safety culture perceptions. Results: Results suggest that RN staffing influences safety culture perceptions, but hospitalist staffing does not. In addition, RN staffing has an indirect effect on safety culture perceptions through better processes. Practice Implications: Our study sheds light on how staffing affects safety culture perceptions. Specifically, our findings suggest that positive perceptions of teamwork across units and handoffs are integral in the relationship between RN staffing and safety culture perceptions. Hospital managers should, therefore, invest resources in staff recruitment and retention. In addition, a targeted focus on perceived teamwork and handoffs may allow hospital managers to improve safety culture perceptions.
      pubtype: Academic Journal
      doctype:
        equations & formulas
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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