A Cross-National Study on Healthcare Safety Climate and Staff Attitudes to Disclosing Adverse Events between China and Japan.
ABSTRACT The present paper reports comparative results of safety climate in healthcare and staff attitudes to error reporting and interaction
with patients between China and Japan. Using two language versions of questionnaire, we collected response data from hospital
staff in China (in 2008) and Japan (in 2006). Significant differences were observed in most dimensions of safety climate between
these two countries, though not in the same direction in terms of positive or negative nature. In contrast, there was a uniform
national difference in staff attitudes to error reporting. Chinese doctors and nurses being significantly less willing than
their Japanese colleagues to engage in any action or interaction with patients after an adverse event, regardless of the severity
of the event. Finally, we discuss possible sources of these differences in safety climate and staff attitudes between the
two countries, and some implications for improving healthcare safety climate.
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ABSTRACT: OBJECTIVES: To explore Chinese patients' views on physician disclosure actions after an adverse event and their acceptance of different types of apologies from the physician who caused the event. METHODS: A questionnaire survey was conducted in 2009, collecting 934 valid responses (52% response rate) from inpatients and families in 3 Chinese hospitals. Respondents' views on and attitudes toward physician actions after a medical error were elicited as responses to 2 fictitious adverse events (vignettes) with different levels of outcome severity. RESULTS: Chinese patients were more skeptical of physician disclosure actions after a case with a severe outcome than with a mild outcome. Recent experiences of suffering due to medical errors deteriorated patients' trust in physician disclosure actions. Chinese patients would prefer to receive a "full" apology, which included explicit words of apology and an undertaking of hospital responsibility. The results revealed the most effective apology, which was a full apology with the hospital's promise of taking preventive actions, and the least effective apology, a so-called "partial" apology in which the physician merely expresses sympathy for the event. Patient refusal of a physician's apology became stronger with an increase in the level of outcome-mild versus severe. CONCLUSIONS: Chinese patients' suspicion about health-care staff disclosure actions is rather strong. In addition, a large difference was identified in the level of patient acceptance between a physician's "full" or "partial" apology. Therefore, it is suggested that Chinese hospitals should adopt an "open" policy, which should include a "sincere" apology to the patient who experienced a medical error to maintain mutual trusts between the staff and patients.Journal of Patient Safety 06/2012; 8(4). DOI:10.1097/PTS.0b013e318257ffa0 · 0.88 Impact Factor
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ABSTRACT: The aims of this study were to analyze the behaviors of nurses in China toward reporting safety events, the barriers to reporting, and the correlations of these aspects with hospital safety culture. A convenience sampling of 1125 nurses from 8 hospitals was performed. The perceptions of nurse managers and colleagues as well as reporting procedures played key roles in the barriers to safety event reporting. To increase the safety culture and facilitate reporting, attention should be paid to job satisfaction and recognition of nurses' stress.Journal of nursing care quality 05/2014; 30(1). DOI:10.1097/NCQ.0000000000000068 · 1.09 Impact Factor