Ready for change? The effect of profession and organization on patient safety culture and organizational readiness for change – a cross-sectional study

The aim of this study was to investigate whether profession and organization is associated with patient safety culture and organizational readiness for change prior to implementing a care process aimed at improving communication and teamwork during childbirth. A cross-sectional design using a web-based survey sent to midwives, physicians and nurse assistants at seven labor wards in Sweden. The Hospital Survey On Patient Safety (HSOPS 2.0) covering ten dimensions of patient safety culture and the short version of the Swedish Organizational Readiness for Change scale (ORC-SWE-S) covering seven dimensions were used. A two-way MANOVA was conducted to assess the effects of profession and organization, and their interaction. Subsequently, a two-way ANOVA was performed to explore group-level differences by profession, labor ward, and their interaction. The relationships between HSOPS 2.0 and ORC-SWE-S dimensions were assessed using Pearson’s correlation analysis. In total 645 participants responded, yielding a response rate of 75.4%. The results of the MANOVA revealed significant differences across professions, labor wards, and their interaction for both the HSOPS 2.0 (Wilk’s Λ = 0.82–0.29, p ≤ 0.03) and ORC-Swe-S dimensions (Pillai’s trace = 0.64–0.41, p < 0.001). The two-way ANOVA showed statistically significant differences across professions and labor wards for both HSOPS 2.0 and ORC-SWE-S dimensions. While effect sizes were generally small by profession (η² < 0.05), Staffing and Work Pace and Inadequate Staffing Resources showed substantial variation by labor ward (η² = 0.43 and 0.40, respectively). Among the safety dimensions, midwives rated Teamwork highest, whereas physicians rated Staffing and Work Pace lowest. Significant interaction effects between profession and labor ward were observed in multiple dimensions. Pearson’s correlation showed strong positive correlations between Organizational Trust and Organizational Learning (r = 0.55), Leader Support for Patient Safety (r = 0.56), and Communication about Error (r = 0.53). Both profession and organization influenced staff perceptions of patient safety culture and readiness for change, with organization having the greatest impact. Teamwork received the highest ratings, while Staffing and Resource related dimensions varied most across labor wards. The findings underscore the importance of organizational context when implementing new practices.