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Research article
Karin Pukk Harenstam
Karolinska Universitetssjukhuset
Corresponding Author
ORCiD: https://orcid.org/0000-0002-5502-2237
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Abstract
Background: Safety culture can be described and understood through its manifestations in the organisation as artefacts, espoused values and basic underlying assumptions and is strongly related to leadership-yet it remains elusive as a concept. Even if the literature points to leadership as an important factor for creating and sustaining a mature safety culture, little is known about how the safety work of first line managers’ actually is done and how they balance the different and often conflicting organizational goals in everyday practice. The purpose of this study was to explore how health care first line managers perceive their role and how they promote patient safety and patient safety culture in their units. Methods: Interview study with first line managers in intensive care units in eight different hospitals located in the middle of Sweden. An inductive qualitative content analysis approach was used, this was then followed by a deductive analysis of the strategies informed by constructs from High reliability organizations. Results: We present how first line managers view their role in patient safety and exemplify concrete strategies by which managers promote patient safety in everyday work. Conclusions: Our study shows the central role of front-line managers in organizing for safe care and creating a culture for patient safety. Although promoted widely in Swedish healthcare at the time for the interviews, the HSOPSC was not mentioned by the managers as a central source of information on the unit’s safety culture.
Keywords
First line managers, patient safety, patient safety culture, intensive care, hospital survey on patient safety culture
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CURRENT STATUS: Published
View the published article at BMC Health Services Research.
Version 4
Posted 04 Jan, 2021
No community comments so far
Editorial decision: Accept
On 21 Dec, 2020
Editor assigned
On 16 Dec, 2020
Submission checks complete
On 16 Dec, 2020
Editor invited
On 16 Dec, 2020
No comments provided
Editorial decision: Minor revision
On 08 Dec, 2020
Reviewers invited
Invitations sent on 02 Dec, 2020
Reviewer #1 agreed
On 02 Dec, 2020
Review #1 received
Received 02 Dec, 2020
Editor assigned
On 30 Nov, 2020
Submission checks complete
On 30 Nov, 2020
Editor invited
On 30 Nov, 2020
No comments provided
Editorial decision: Major revision
On 23 Oct, 2020
Review #2 received
Received 21 Oct, 2020
Reviewer #2 agreed
On 21 Sep, 2020
Review #1 received
Received 04 Sep, 2020
Reviewer #1 agreed
On 16 Aug, 2020
Reviewers invited
Invitations sent on 15 Aug, 2020
Editor assigned
On 03 Aug, 2020
Submission checks complete
On 02 Aug, 2020
Editor invited
On 02 Aug, 2020
No comments provided
Editorial decision: Major revision
On 26 May, 2020
Review #1 received
Received 06 May, 2020
Reviewers invited
Invitations sent on 15 Apr, 2020
Reviewer #1 agreed
On 15 Apr, 2020
Editor assigned
On 09 Apr, 2020
Submission checks complete
On 08 Apr, 2020
Editor invited
On 08 Apr, 2020
First submitted
On 26 Mar, 2020
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A new preprint design is coming!
We have improved readability, clarity, accessibility, and opportunities for engagement.
See the published version of this preprint at BMC Health Services Research.
This is a preprint, a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research article
Karin Pukk Harenstam
Karolinska Universitetssjukhuset
Corresponding Author
ORCiD: https://orcid.org/0000-0002-5502-2237
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Published
View the published article at BMC Health Services Research.
Version 4
Posted 04 Jan, 2021
No community comments so far
Editorial decision: Accept
On 21 Dec, 2020
Editor assigned
On 16 Dec, 2020
Submission checks complete
On 16 Dec, 2020
Editor invited
On 16 Dec, 2020
No comments provided
Editorial decision: Minor revision
On 08 Dec, 2020
Reviewers invited
Invitations sent on 02 Dec, 2020
Reviewer #1 agreed
On 02 Dec, 2020
Review #1 received
Received 02 Dec, 2020
Editor assigned
On 30 Nov, 2020
Submission checks complete
On 30 Nov, 2020
Editor invited
On 30 Nov, 2020
No comments provided
Editorial decision: Major revision
On 23 Oct, 2020
Review #2 received
Received 21 Oct, 2020
Reviewer #2 agreed
On 21 Sep, 2020
Review #1 received
Received 04 Sep, 2020
Reviewer #1 agreed
On 16 Aug, 2020
Reviewers invited
Invitations sent on 15 Aug, 2020
Editor assigned
On 03 Aug, 2020
Submission checks complete
On 02 Aug, 2020
Editor invited
On 02 Aug, 2020
No comments provided
Editorial decision: Major revision
On 26 May, 2020
Review #1 received
Received 06 May, 2020
Reviewers invited
Invitations sent on 15 Apr, 2020
Reviewer #1 agreed
On 15 Apr, 2020
Editor assigned
On 09 Apr, 2020
Submission checks complete
On 08 Apr, 2020
Editor invited
On 08 Apr, 2020
First submitted
On 26 Mar, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published article at BMC Health Services Research.
Abstract
Background: Safety culture can be described and understood through its manifestations in the organisation as artefacts, espoused values and basic underlying assumptions and is strongly related to leadership-yet it remains elusive as a concept. Even if the literature points to leadership as an important factor for creating and sustaining a mature safety culture, little is known about how the safety work of first line managers’ actually is done and how they balance the different and often conflicting organizational goals in everyday practice. The purpose of this study was to explore how health care first line managers perceive their role and how they promote patient safety and patient safety culture in their units. Methods: Interview study with first line managers in intensive care units in eight different hospitals located in the middle of Sweden. An inductive qualitative content analysis approach was used, this was then followed by a deductive analysis of the strategies informed by constructs from High reliability organizations. Results: We present how first line managers view their role in patient safety and exemplify concrete strategies by which managers promote patient safety in everyday work. Conclusions: Our study shows the central role of front-line managers in organizing for safe care and creating a culture for patient safety. Although promoted widely in Swedish healthcare at the time for the interviews, the HSOPSC was not mentioned by the managers as a central source of information on the unit’s safety culture.
This is a list of supplementary files associated with this preprint. Click to download.
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