Relationships between patient safety culture, organizational structure, and adverse event reporting in long-term care facilities

A fundamental pillar of healthcare institutions, including long-term care facilities (Care and Treatment Facilities; Nursing and Care Facilities), is the assurance of high-quality and safe care. This study’s primary objective is to evaluate the patient safety culture within Polish long-term care facilities as perceived by the staff employed in these settings. Specific objectives include analysing the relationship between the level of patient safety culture and factors such as the number of places for residents and medical personnel employed, as well as the presence or absence of quality certification. Additionally, the study aims to determine the method of reporting adverse events and to identify the types of events that are reported. A cross-sectional study was conducted across long-term care facilities in the Mazovian Province of Poland. The study employed a tool intended for independent completion by medical staff, namely the Nursing Home Survey on Patient Safety Culture (NHSOPSC). Furthermore, a proprietary questionnaire was administered to management staff, which included inquiries regarding the number of places for residents, the number of doctors, nurses, and medical caregivers employed, the existence of a quality certification, the functioning of the adverse event registry, the method of reporting events, and the total number of events reported over the preceding 12 months. The overall perceptions of patient safety culture levels among staff in the surveyed facilities were moderate. Notably, the staffing dimension received the lowest rating in the NHSOPSC, with only 50.2% of respondents providing positive responses. Larger facilities with a greater number of medical staff reported a diminished level of patient safety culture. Of the 26 facilities assessed, directors and managers acknowledged maintaining an adverse event register in 24 facilities, but only 11 reported any adverse events in the past year. The suboptimal findings from this study highlight a pressing need to enhance the knowledge of medical staff and management regarding the factors that influence patient safety culture. It is essential to maintain adequate staffing levels and implement strategies that encourage the reporting of adverse events.