Revisiting hospital patient safety culture in China: a nationwide network analysis

Abstract Background Patient safety culture (PSC) is crucial for reducing medical errors and improving patient outcomes globally. This study aims to identify key improvement targets in China’s PSC to promote a safer healthcare environment. Methods Data were extracted from two national PSC surveys con...

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Main Authors: Haoning Shi, Zhiyu Chen, Xingyao Du, Jing Jiang, Ying Peng, Chunni Wang, Shuangjiang Zheng, Qi Huang, Mingzhao Xiao, Qinghua Zhao, Huanhuan Huang
Format: Article
Language:English
Published: BMC 2025-05-01
Series:Archives of Public Health
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Online Access:https://doi.org/10.1186/s13690-025-01612-5
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author Haoning Shi
Zhiyu Chen
Xingyao Du
Jing Jiang
Ying Peng
Chunni Wang
Shuangjiang Zheng
Qi Huang
Mingzhao Xiao
Qinghua Zhao
Huanhuan Huang
author_facet Haoning Shi
Zhiyu Chen
Xingyao Du
Jing Jiang
Ying Peng
Chunni Wang
Shuangjiang Zheng
Qi Huang
Mingzhao Xiao
Qinghua Zhao
Huanhuan Huang
author_sort Haoning Shi
collection DOAJ
description Abstract Background Patient safety culture (PSC) is crucial for reducing medical errors and improving patient outcomes globally. This study aims to identify key improvement targets in China’s PSC to promote a safer healthcare environment. Methods Data were extracted from two national PSC surveys conducted in 2016 and 2020 and were analyzed using the 12-dimensional Hospital Survey on Patient Safety Culture (HSOPSC) 1.0 questionnaire. Central targets were identified through strength, closeness, and betweenness centrality. Network stability was assessed using the case dropping bootstrap method. Results A total of 24,529 responses were included, with an average positive response rate of 63.92%. Teamwork within units had the highest rate, and nonpunitive response to error the lowest. Feedback and communication about errors showed the greatest strength (1.302), closeness (0.008), and betweenness (22), occupying a core node position in both genders and correlating strongly with communication openness. After the COVID-19 pandemic, the core node position of management support for patient safety has become more prominent. Conclusions While teamwork is a notable strength, there is room to enhance the nonpunitive response to errors. Improving feedback and communication practices can further bolster openness and collaboration within teams, leading to an overall healthier work environment.
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spelling doaj-art-91275ffb081342c39d7852b77a88a5742025-08-20T03:09:35ZengBMCArchives of Public Health2049-32582025-05-0183111110.1186/s13690-025-01612-5Revisiting hospital patient safety culture in China: a nationwide network analysisHaoning Shi0Zhiyu Chen1Xingyao Du2Jing Jiang3Ying Peng4Chunni Wang5Shuangjiang Zheng6Qi Huang7Mingzhao Xiao8Qinghua Zhao9Huanhuan Huang10Nursing Department, The First Affiliated Hospital of Chongqing Medical UniversityDepartment of Orthopedics, The First Affiliated Hospital of Chongqing Medical UniversityNursing Department, The First Affiliated Hospital of Chongqing Medical UniversityNursing Department, The First Affiliated Hospital of Chongqing Medical UniversityNursing Department, The First Affiliated Hospital of Chongqing Medical UniversityNursing Department, The First Affiliated Hospital of Chongqing Medical UniversityDepartment of Medical Affairs, The First Affiliated Hospital of Chongqing Medical UniversitySchool of Public Health, Chongqing Medical UniversityNursing Department, The First Affiliated Hospital of Chongqing Medical UniversityNursing Department, The First Affiliated Hospital of Chongqing Medical UniversityNursing Department, The First Affiliated Hospital of Chongqing Medical UniversityAbstract Background Patient safety culture (PSC) is crucial for reducing medical errors and improving patient outcomes globally. This study aims to identify key improvement targets in China’s PSC to promote a safer healthcare environment. Methods Data were extracted from two national PSC surveys conducted in 2016 and 2020 and were analyzed using the 12-dimensional Hospital Survey on Patient Safety Culture (HSOPSC) 1.0 questionnaire. Central targets were identified through strength, closeness, and betweenness centrality. Network stability was assessed using the case dropping bootstrap method. Results A total of 24,529 responses were included, with an average positive response rate of 63.92%. Teamwork within units had the highest rate, and nonpunitive response to error the lowest. Feedback and communication about errors showed the greatest strength (1.302), closeness (0.008), and betweenness (22), occupying a core node position in both genders and correlating strongly with communication openness. After the COVID-19 pandemic, the core node position of management support for patient safety has become more prominent. Conclusions While teamwork is a notable strength, there is room to enhance the nonpunitive response to errors. Improving feedback and communication practices can further bolster openness and collaboration within teams, leading to an overall healthier work environment.https://doi.org/10.1186/s13690-025-01612-5Patient safetyNetwork analysisStrengthClosenessBetweenness centrality
spellingShingle Haoning Shi
Zhiyu Chen
Xingyao Du
Jing Jiang
Ying Peng
Chunni Wang
Shuangjiang Zheng
Qi Huang
Mingzhao Xiao
Qinghua Zhao
Huanhuan Huang
Revisiting hospital patient safety culture in China: a nationwide network analysis
Archives of Public Health
Patient safety
Network analysis
Strength
Closeness
Betweenness centrality
title Revisiting hospital patient safety culture in China: a nationwide network analysis
title_full Revisiting hospital patient safety culture in China: a nationwide network analysis
title_fullStr Revisiting hospital patient safety culture in China: a nationwide network analysis
title_full_unstemmed Revisiting hospital patient safety culture in China: a nationwide network analysis
title_short Revisiting hospital patient safety culture in China: a nationwide network analysis
title_sort revisiting hospital patient safety culture in china a nationwide network analysis
topic Patient safety
Network analysis
Strength
Closeness
Betweenness centrality
url https://doi.org/10.1186/s13690-025-01612-5
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