Safety self-efficacy and safety performance: potential antecedents and the moderation effect of standardization.
OBJECTIVE
The purpose of this paper is to suggest a new safety self-efficacy construct and to explore its antecedents and interaction with standardization to influence in-patient safety.


METHODS
The paper used a survey of 161 nurses using a self-administered questionnaire over a 14-day period in two large Israeli general hospitals. Nurses answered questions relating to four safety self-efficacy antecedents: enactive mastery experiences; managers as safety role models; verbal persuasion; and safety priority, that relate to the perceived level of standardization and safety self-efficacy. Confirmatory factor analysis was used to assess the scale's construct validity. Regression models were used to test hypotheses regarding the antecedents and influence of safety self-efficacy.


RESULTS
Results indicate that: managers as safety role models; distributing safety information; and priority given to safety, contributed to safety self-efficacy. Additionally, standardization moderated the effects of safety self-efficacy and patient safety such that safety self-efficacy was positively associated with patient safety when standardization was low rather than high. Hospital managers should be aware of individual motivations as safety self-efficacy when evaluating the potential influence of standardization on patient safety.


CONCLUSIONS
Theoretically, the study introduces a new safety self-efficacy concept, and captures its antecedents and influence on safety performance. Also, the study suggests safety self-efficacy as a boundary condition for the influence of standardization on safety performance. Implementing standardization in healthcare is problematic because not all processes can be standardized. In this case, self-efficacy plays an important role in securing patient safety. Hence, safety self-efficacy may serve as a "substitute-for-standardization," by promoting staff behaviors that affect patient safety.
Katz-Navon
Tal
T
The Arison School of Business Administration, Interdisciplinary Center, Herzliya, Israel. katzt@idc.ac.il
Naveh
Eitan
E
Stern
Zvi
Z
D001291:Attitude of Health Personnel; D019538:Health Care Surveys; D006769:Hospitals, General / Q000458:organization & administration* / Q000592:standards; D006801:Humans; D007557:Israel; D019300:Medical Errors / Q000517:prevention & control; D017146:Models, Organizational; D009042:Motivation; D009741:Nursing Staff, Hospital / Q000523:psychology*; D017751:Safety Management / Q000458:organization & administration* / Q000592:standards; D020377:Self Efficacy; D011795:Surveys and Questionnaires