Patient Safety Culture and Speaking Up Among Health Care Workers

Abstract

Purpose: Although previous research showed the importance of safety culture on health care workers'

speaking up behaviors, it is not clear how particular safety culture domains are associated with the

speaking up behaviors of hospital staff. Also, researchers have suggested that health care workers’

speaking up behaviors vary by profession, but there has been limited research into such differences.

Thus, this study examined differences in perceptions of patient safety culture and the promotive and

prohibitive speaking up behaviors of health care workers by profession and investigated the relationships

between patient safety culture and the two types of speaking up behaviors.

Methods: A descriptive correlational study was conducted using secondary data collected through an

online survey of health care workers at a private, nonprofit, tertiary-level teaching hospital in South

Korea. The sample (N ¼ 831) consisted of nurses (54.0%), physicians (13.0%), and other licensed and

unlicensed hospital personnel (33.0%). Analyses of variance were conducted to examine differences in

study variables by profession. Hierarchical regression analyses were conducted to evaluate the effects of

the seven patient safety culture factors on promotive and prohibitive voice after controlling for tenure

and profession.

Results: Perceptions of safety culture and promotive voice behaviors were higher for physicians

compared with nurses. Communication openness, reporting patient adverse events, and unit supervisors'

and hospital managements’ support for patient safety were significant predictors of both types of voice

behaviors.

Conclusion: Hospital administrators and unit managers should create a supportive environment where

staff feel free to voice their concerns and suggestions. They should also pay attention to the varying

perspectives held by different groups of hospital workers and their different voice behaviors. Knowing

which dimensions of patient safety culture are most strongly related to health care workers’ voice behaviors

can guide patient safety improvement activities in health care organizations.