title: Survey on patient safety climate in public hospitals in China.
abstract: BACKGROUND
  Patient safety climate has been recognized as a core determinant for improving safety in hospitals. Describing workforce perceptions of patient safety climate is an important part of safety climate management. This study aimed to describe staff's perceptions of patient safety climate in public hospitals in Shanghai, China and to determine how perceptions of patient safety climate differ between different types of workers in the U.S. and China.
  
  
  METHODS
  Survey of employees of 6 secondary, general public hospitals in Shanghai conducted during 2013 using a modified version of the U.S. Patient Safety Climate in Health Care Organizations (PSCHO) tool. The percentage of "problematic responses" (PPRs) was used to measure safety climate, and the PPRs were compared among employees with different job types, using χ (2) tests and multivariate regression models.
  
  
  RESULTS
  Perceptions of patient safety climate were relatively positive among hospital employees and similar to those of employees in U.S. hospitals along most dimensions. For workers in Chinese hospitals, the scales of "fear of blame" and "fear of shame" had the highest PPRs, whereas in the United States the scale of "fear of shame" had among the lowest PPRs. As in the United States, hospital managers in China perceived a more positive patient safety climate overall than other types of personnel.
  
  
  CONCLUSIONS
  "Fear of shame" and "fear of blame" may be important barriers to improvement of patient safety in Chinese hospitals. Research on the effect of patient safety climate on outcomes is necessary to implement effective polices to improve patient safety and quality outcomes in China.
authors.affiliation: Key Laboratory of Health Technology Assessment (MOH); School of Public Health, Fu Dan University, Shanghai, 200032, P.R. China. zhouping@fudan.edu.cn.
authors.forename: Ping
authors.initials: P
authors.lastname: Zhou
authors.affiliation: Department of Health Research and Policy, Stanford University School of Medicine, Stanford, USA. bundorf@stanford.edu.
authors.forename: M Kate
authors.initials: MK
authors.lastname: Bundorf
authors.affiliation: Commission of Health and Family Planning of Pudong New Area, Shanghai, P.R. China. gujj2228@yahoo.com.cn.
authors.forename: Jianjun
authors.initials: J
authors.lastname: Gu
authors.affiliation: Key Laboratory of Health Technology Assessment (MOH); School of Public Health, Fu Dan University, Shanghai, 200032, P.R. China. 11111020022@fudan.edu.cn.
authors.forename: Xiaoyan
authors.initials: X
authors.lastname: He
authors.affiliation: Key Laboratory of Health Technology Assessment (MOH); School of Public Health, Fu Dan University, Shanghai, 200032, P.R. China. xuedi@shmu.edu.cn.
authors.forename: Di
authors.initials: D
authors.lastname: Xue
mesh_terms: D000328:Adult; D002681:China; D005260:Female; D019538:Health Care Surveys; D006779:Hospitals, Public; D006801:Humans; D008297:Male; D008875:Middle Aged; D015279:Organizational Culture; D061214:Patient Safety; D010564:Personnel, Hospital; D017751:Safety Management / Q000458:organization & administration; D011795:Surveys and Questionnaires; D014481:United States; D055815:Young Adult