Objective: Hospital safety has emerged as a global concern, with patient safety being one of its key components. The objective of this study is to investigate the relationship between unit-level culture, hospital culture, and patient safety outcomes, with the aim of analyzing the patient safety culture at Dr. Iskak General Hospital, Tulungagung, in 2020. This stusy is also aligned with the Sustainable Development Goal 3 (Good Health and Well-Being) which emphasizes the importance of patient safety as a critical component of healthcare quality. Theoretical Framework: Patient safety culture is shaped by individual attitudes and organizational systems. A strong safety culture requires alignment between frontline unit practices and institutional values to ensure consistent patient outcomes. Method: This study employed a descriptive observational design with a cross-sectional approach. Quantitative data were collected using the 2004 Hospital Survey on Patient Safety Culture developed by the Agency for Healthcare Research and Quality (AHRQ). A total of 475 employees from both clinical and non-clinical units participated. Results and Discussion: Organizational learning received the highest positive response (91.79%), while staffing scored the lowest (60.89%). Structural Equation Modeling (SEM) indicated that unit-level culture directly influenced hospital culture (coefficient = 0.382), and hospital culture significantly affected patient safety outcomes (coefficient = 1.675). However, unit culture had no direct effect on outcomes (coefficient = –0.337). Barriers included underreporting of incidents due to concerns about blame and punitive consequences. Research Implications: Strengthening hospital culture and promoting a non-punitive environment are essential to improve patient safety outcomes. Originality/Value: This study contributes to the understanding of how safety culture dynamics at different organizational levels affect patient outcomes in a regional hospital setting, offering practical implications for health policy and leadership.
Supriyant et al. (Thu,) studied this question.
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