title: The relationship between patient safety culture and the implementation of organizational patient safety defences at emergency departments.
abstract: OBJECTIVE
  The objective of this study was to investigate the association between 11 patient safety culture dimensions and the implementation of 7 organizational patient safety defences.
  
  
  METHODS
  Data were gathered within a cross-sectional, retrospective survey.
  
  
  METHODS
  Emergency departments (EDs) in the Netherlands.
  
  
  METHODS
  Thirty-three EDs of non-academic hospitals, which belong to the clientele of Dutch largest medical liability insurer.
  
  
  METHODS
  Implementation of the separate organizational patient safety defences (0 = insufficient/sufficient, 1 = good).
  
  
  RESULTS
  Analyses showed that several culture dimensions were negatively or positively associated with the implementation of the patient safety defences. A culture in which hospital handoffs and transitions were perceived adequate was related to less frequent implementation of four of seven organizational patient safety defences, whereas a culture with well-perceived hospital management support for patient safety predicted more frequent implementation of four of seven organizational patient safety defences.
  
  
  CONCLUSIONS
  Results suggest that well-perceived culture dimensions might inhibit improvements by lack of a sense of urgency as well as facilitate improvements by inducing feelings of support for organizational changes and improvements. The influence of patient safety culture appeared to be not always as straightforward as it seems to be in advance.
authors.affiliation: Department of Public and Occupational Health, VUmc-EMGO Institute for Health and Care Research, Van der Boechorststraat 7, Amsterdam, The Netherlands. i.vannoord@vumc.nl
authors.forename: Inge
authors.initials: I
authors.lastname: van Noord
authors.forename: Martine C
authors.initials: MC
authors.lastname: de Bruijne
authors.forename: Jos W R
authors.initials: JW
authors.lastname: Twisk
mesh_terms: D003430:Cross-Sectional Studies; D004636:Emergency Service, Hospital / Q000458:organization & administration*; D006801:Humans; D009426:Netherlands; D015279:Organizational Culture; D012189:Retrospective Studies; D017751:Safety Management / Q000458:organization & administration*