Assessing patient and client safety culture across integrated health and social care services: a cross-sectional study in Finland
TL;DR
The NSS is a valid and practical tool for capturing staff perceptions of safety and can complement broader safety culture assessments, supporting continuous improvement in healthcare safety.
Abstract
Abstract Background Patient safety culture is a critical component of healthcare quality, influencing both staff behaviour and patient outcomes. While it has been widely studied in hospital settings, less is known about its variation across integrated health and social care systems. Objective To examine patient and client safety culture within a well-being services county in Finland from the perspective of employees. Methods A cross-sectional survey was conducted using the Finnish version of the Hospital Survey on Patient Safety Culture (SOPS 2.0) and the Net Safety Score (NSS). The sample included 2623 staff members from hospital, social and health and elderly services. Descriptive statistics, analysis of variance, Pearson correlations and linear regressions were used to analyse differences and associations. Results Among the SOPS dimensions, teamwork received the highest positive ratings (71.1%), whereas handoffs and information exchange scored the lowest (22.6%). Significant differences were observed across service areas, with elderly services consistently reporting lower scores. All safety culture dimensions were significantly correlated with the NSS. Regression analysis identified teamwork, staffing and work pace and organisational learning as the strongest significant predictors of the NSS in all the service areas. The overall proportion of positive responses for NSS was 52.6%. The model explained 47.4% of the variance in NSS in hospital services, 47.0% in elderly services and 35.8% in social and health services. Conclusions Patient and client safety culture varies significantly across service areas, with elderly services requiring targeted support. The NSS is a valid and practical tool for capturing staff perceptions of safety and can complement broader safety culture assessments. Its simplicity enables frequent monitoring and timely interventions, supporting continuous improvement in healthcare safety.