Understanding safety culture in long-term care: a case study

Area of Science:

• Healthcare Management
• Patient Safety
• Organizational Culture

Background:

• Long-term care (LTC) facilities house vulnerable populations requiring robust safety protocols.
• Understanding safety culture is crucial for preventing adverse events in high-risk units.

Purpose of the Study:

• To assess safety culture maturity in a secured unit for cognitively impaired LTC residents.
• To identify barriers impacting safety culture and propose improvement strategies.

Main Methods:

• A mixed-methods approach was employed in a Canadian LTC facility.
• Data collection included semistructured interviews, a focus group, and a patient safety culture survey.
• The Patient Safety Culture Improvement Tool (PSCIT) was adapted for LTC settings.

Main Results:

• The unit exhibited a reactive safety culture, with systems developed post-incident.
• Significant barriers included a punitive regulatory environment, resource inadequacy, and heavy workloads.
• Poor interdisciplinary collaboration and limited resident safety training capacity were also identified.

Conclusions:

• The PSCIT is a valuable tool for assessing and enhancing safety culture maturity in LTC.
• Mixed methods provide a robust model for future healthcare safety research and practice.
• Addressing identified barriers is essential for fostering a proactive safety culture.