Patient safety culture in Austrian hospitals – A qualitative study

Abstract Background Adverse events in the healthcare system often have severe consequences for the patient and healthcare institutions. Thus, various risk management tools have been recently introduced to 11 Austrian hospitals to increase patient safety. The goal of our study was to test whether the introduced risk management tools actually improved patient safety culture (PSC). Methods An exploratory research approach was used to examine the current status of five aspects from PSC in hospitals. Semi-structured expert interviews with health professionals were conducted (N = 32). The inductive content analysis and technique of content structuring were used to analyze and systemize extensive qualitative data material. Intercoder reliability (κ = .605) shows satisfactory results. Results The results of the first aspect, Critical Incident Reporting System (CIRS), show that hospitals still have potential for improvement in terms of education of employees, coordination, and communication. The data of the second issue, surgical checklist, shows that the education was insufficient and that these checklists are not handled properly and used only fragmentarily. Concerning the third aspect “transfer/report”, it can be stated that systematic transfer/reports are widely unknown. Furthermore, the fourth aspect, hand hygiene, lacks a systematic training concept and control of compliance. The fifth aspect, education of risk manager, has brought a number of general benefits (e.g. methodical knowledge) to risk managers. Conclusions The results provide valuable insights into strengths and weaknesses of the implementation of risk management tools and thus highlight opportunities on how to influence PSC through organizational development and change management. Furthermore, this study has taken the first essential step towards the understanding of the effective and efficient development of PSC by providing valuable insights into the underlying mechanisms of non-functioning PSC. Key messages The study showed where the weakness points in processes of implementing risk management tools are and offered a theoretical solution for the development of a patient safety culture. Risk management tools were not equally effective in every controlled aspect. The effective implementation of these tools requires change management as a foundation to develop PSC.