title: Applying importance-performance analysis to patient safety culture.
abstract: OBJECTIVE
  The Sexton et al.'s (2006) safety attitudes questionnaire (SAQ) has been widely used to assess staff's attitudes towards patient safety in healthcare organizations. However, to date there have been few studies that discuss the perceptions of patient safety both from hospital staff and upper management. The purpose of this paper is to improve and to develop better strategies regarding patient safety in healthcare organizations.
  
  
  METHODS
  The Chinese version of SAQ based on the Taiwan Joint Commission on Hospital Accreditation is used to evaluate the perceptions of hospital staff. The current study then lies in applying importance-performance analysis technique to identify the major strengths and weaknesses of the safety culture.
  
  
  RESULTS
  The results show that teamwork climate, safety climate, job satisfaction, stress recognition and working conditions are major strengths and should be maintained in order to provide a better patient safety culture. On the contrary, perceptions of management and hospital handoffs and transitions are important weaknesses and should be improved immediately. Research limitations/implications - The research is restricted in generalizability. The assessment of hospital staff in patient safety culture is physicians and registered nurses. It would be interesting to further evaluate other staff's (e.g. technicians, pharmacists and others) opinions regarding patient safety culture in the hospital.
  
  
  CONCLUSIONS
  Few studies have clearly evaluated the perceptions of healthcare organization management regarding patient safety culture. Healthcare managers enable to take more effective actions to improve the level of patient safety by investigating key characteristics (either strengths or weaknesses) that healthcare organizations should focus on.
authors.affiliation: Department of Human Resource Management, Cheng Ching General Hospital-Chung Kang Branch, Taichung City, Taiwan.
authors.forename: Yii-Ching
authors.initials: YC
authors.lastname: Lee
authors.forename: Hsin-Hung
authors.initials: HH
authors.lastname: Wu
authors.forename: Wan-Lin
authors.initials: WL
authors.lastname: Hsieh
authors.forename: Shao-Jen
authors.initials: SJ
authors.lastname: Weng
authors.forename: Liang-Po
authors.initials: LP
authors.lastname: Hsieh
authors.forename: Chih-Hsuan
authors.initials: CH
authors.lastname: Huang
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D004777:Environment; D005260:Female; D006126:Group Processes; D006801:Humans; D007398:Interpersonal Relations; D007588:Job Satisfaction; D008297:Male; D008875:Middle Aged; D015279:Organizational Culture; D061214:Patient Safety; D017751:Safety Management / Q000458:organization & administration*; D013315:Stress, Psychological / Q000523:psychology; D013624:Taiwan
keywords: Hospital staff; Importance-performance analysis; Patient safety; Perceptions; Quality healthcare; Safety attitudes questionnaire