Relationship between silence behaviour, psychological empowerment, and patient safety culture among hospital staff: A multi-centre, cross-sectional study

Abstract

Abstract 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 explored some of the factors that influence patient safety culture (PSC). However, there are relatively few related studies. In this study, we explored the relationship between silence behaviour, psychological empowerment, and PSC to find factors that affect the PSC in the hospital. Our study can serve as reference for hospital managers and for improving hospital service quality and patient safety. Methods The data for this study were from a multi-centre cross-sectional survey among hospital staff from six provinces/municipalities in China (N = 1034). Using correlation analysis and regression analysis to explore the impact of silence behaviour and psychological empowerment on PSC, we used a mediation model to explore the mediation effect among these three factors. Results Hospital staff PSC was correlated with silence behaviour and psychological empowerment. Furthermore, the effect of silence behaviour on PSC was mediated entirely through psychological empowerment. We found statistically significant differences in the perception of safety culture among respondents with different residential regions, sexes, education levels, and positions (P < 0.05). Conclusions Hospital managers should create an open and safe working atmosphere for hospital staff to for patient safety; improve the work system and mechanisms and open more communication channels to enhance the influence of employees. Reducing the punishment for mistakes, promoting a non-punitive safety culture through training, increasing the reporting frequency of adverse events, paying more attention to staffing, and paying attention to safety culture education of hospital administrative staff can effectively improve PSC and enhance patient safety.