Patient Safety Culture Post Covid-19 Pandemic: In Perspective of Millennials Human Capital Issues

摘要

Background: Patient safety is the core task of any healthcare business. As medical harm caused by hospitalisation is still on the rise and patient safety culture is a struggle. We aim to determine the nature of patient safety culture in a private hospital and explore some unique human resource problems in Malaysia. Methods: In our case study, we use the Hospital Survey on Patient Safety Culture (HSOPSC) questionnaire to measure the 12 dimensions of patient safety culture. The survey received 281 respondents (76% response rate) from all the millennial frontline healthcare providers, including doctors, nurses and allied healthcare providers. The result of the survey was used as the basis to further explore the problems in this hospital. In-depth interviews, observation and document reviews were conducted in relation to human resource problems. This study used IBM SPSS 26 for Windows for statistical analysis and Atlas ti.8 for qualitative analysis of open comments. We used Interpretive Phenomenological Interpretation for analysis of data after triangulation. Results: The overall average positive response rate for the 12 patient safety culture dimensions of the HSOPSC survey was 64%. The result showed that the staff feels positively toward patient safety culture in this hospital. The dimension that received good performance is “Manager expectation”, “Management support for patient safety” and “Organisational learning”. The dimension with the poor performance was “Staffing”, “Frequency of error reporting”, “Teamwork across units”, and “Handoff and transitions”. The open comments indicated inadequate staffing and nursing retention issues. Interviews, observation and document reviews related to staffing reveal high turnover rates among millennial nurses, high overtime and on-call rates, chaotic units with procedures, doctors’ round, admission and discharges mainly in medical and surgical units causing distraction. Poor shared governance is the biggest challenges that need immediate attention post Covid-19 pandemic. Conclusions: The HSOPSC measurement gave valuable insights on patient safety culture in a private hospital in Malaysia. The overall perception of patient safety culture was satisfactory. The poor positive response rate for “Staffing” dimension and the open comments suggests a need for an urgent need for retention and human resource management strategies to prevent brain drain due to high turnover rates, especially among millennial nurses. The key factors causing dissatisfaction and brain drain among nurses are the lack of shared governance.