Topics on Patient Safety Culture in Hospitals

Authors

Jayson J. Forbes, Florida International UniversityFollow

Document Type

Dissertation

Degree

Doctor of Philosophy (PhD)

Major/Program

Public Health

First Advisor's Name

Alejandro Arrieta

First Advisor's Committee Title

Committee Chair

Second Advisor's Name

Gilbert Ramirez

Second Advisor's Committee Title

Committee Member

Third Advisor's Name

Nan Hu

Third Advisor's Committee Title

Committee Member

Fourth Advisor's Name

Nathan Hiller

Fourth Advisor's Committee Title

Committee Member

Keywords

patient safety culture, patient safety, health policy, hospitals, quality, panel data

Date of Defense

11-15-2022

Abstract

Purpose: Patient safety culture is the beliefs, values, and actions a healthcare organization has towards patient safety. For this dissertation, I analyze influences and perceptions of patient safety culture composites. First, I explore any correlations between the Medicaid expansion from the Affordable Care Act and patient safety culture responses in hospitals. Subsequently, I investigate the difference in responses for Hospital Survey on Patient Safety Culture (HSOPS) items between leaders and frontline workers. Following, I evaluate how different topics in the open-ended questions of HSOPS correlates with different composites of patient safety culture.

Methods: This dissertation used data from the Agency for Healthcare Research and Quality’s (AHRQ) HSOPS Version 1.0. When evaluating Medicaid expansion and patient safety culture, I used an unbalanced panel dataset of U. S. hospitals reporting to AHRQ from years 2008 - 2017. To analyze the data, I used a difference-in-difference approach based on linear regressions. When considering the differences between leadership and frontline workers, I used the same unbalanced panel dataset from years 2008 – 2017. For this analysis, I used a first difference estimation approach based on linear regressions. An F-test determined any differences between leadership and frontline workers. While determining if HSOPS composites captures topics based on the open-ended comments reported in the survey, I used cross-sectional data from Latin American hospitals for the years of 2018 – 2020. Topic modeling and sentiment analysis was performed to identify topics with positive and negative sentiments, and logistic regressions were used to assess correlations between topics and HSOPS components.

Findings: I found that Medicaid expansion affected hospitals based on their sizes. Additionally, I found that leaders reported more positive to all items in HSOPS compared to front-line staff. Finally, it was found that composites in HSOPS captures topics identified from the open-ended comments of the survey.

Conclusion: Policies, such as Medicaid expansion, could affect patient safety culture in hospitals. I also discovered that there is a gap in perspective between hospital leaders and frontline workers. Finally, topic modeling can be used to recognize gaps of perceptions in the quantitative components of patient safety culture surveys.

Identifier

FIDC010887

ORCID

0000-0002-2697-4837

Recommended Citation

Forbes, Jayson J., "Topics on Patient Safety Culture in Hospitals" (2022). FIU Electronic Theses and Dissertations. 5186.
https://digitalcommons.fiu.edu/etd/5186