Exploring the role of managers in the development of a safety culture in seven French healthcare facilities: a qualitative study

BMC Health Services Research

Christine Cadot¹  Pierre Parneix²  Jean-Luc Quenon³  Marc Faget³  Marie Levif-Lecourt³  Catherine Pourin³  Tamara Roberts³  Isabelle Fucks⁴  Anthony Vacher⁵  Jean-Yves Bousigue⁶  Myriam Promé-Visinoni⁶  Bruno Quintard⁷ 

[1] Centre Hospitalier d’Agen;Centre d’appui pour la Prévention des Infections Associées aux Soins de Nouvelle-Aquitaine, CHU de Bordeaux, Hôpital Pellegrin - Bâtiment Le Tondu;Comité de Coordination de l’Évaluation Clinique et de la Qualité en Nouvelle Aquitaine - Hôpital Xavier Arnozan;Département Management des Risques Industriels;Institut de recherche biomédicale des armées - Unité d’Ergonomie cognitive des situations opérationnelles;Institut pour une culture de sécurité industrielle;Laboratoire EA 4136 ‘Handicap, Activité, Cognition, Santé’, Université de Bordeaux, Faculté de Psychologie;

关键词: Healthcare facility;    Manager;    Qualitative study;    Patient safety;    Professional role;    Safety culture;   

DOI  :  10.1186/s12913-020-05331-1

来源: DOAJ

【 摘 要 】

Abstract Background Numerous studies have been conducted over the past 15 years to assess safety culture within healthcare facilities; in general, these studies have shown the pivotal role that managers play in its development. However, little is known about what healthcare managers actually do to support this development, and how caregivers and managers represent managers’role. Thus the objectives of this study were to explore: i) caregivers and managers’ perceptions and representations of safety, ii) the role of managers in the development of safety culture as perceived by themselves and by caregivers, iii) managers’ activities related to the development of safety culture. Methods An exploratory, multicentre, qualitative study was conducted from May 2014 to March 2015 in seven healthcare facilities in France. Semi-structured interviews were conducted with managers (frontline, middle and top level) and caregivers (doctors, nurses and nurse assistants) and on-site observations of two managers were carried out in all facilities. A thematic analysis of semi-structured interviews was performed. Observed activities were categorised using Luthans’ typology of managerial activities. Results Participants in semi-structured interviews (44 managers and 21 caregivers) expressed positive perceptions of the level of safety in their facility. Support from frontline management was particularly appreciated, while support from top managers was identified as an area for improvement. Six main categories of safety-related activities were both observed among managers and regularly expressed by participants. However, caregivers’ expectations of their managers and managerial perceptions of these expectations only partially overlapped. Conclusions The present study highlights current categories of managerial activities that foster safety culture, and points out an important gap between caregivers’ expectations of their managers, and managerial perceptions of these expectations. The findings underline the need to allow more time for managers and caregivers to talk about safety issues. The results could be used to develop training programs to help healthcare managers to understand their role in the development of safety culture.

【 授权许可】

Unknown