Accident and Emergency Care Made High Reliable: Perception of Staff on Factors Affecting Application of High-Reliability Organization Principles in Accident Emergency Units

Abstract

There is a growing concern regarding patient safety and high reliability which made more intense with this ongoing pandemic.

Aim of this study is to assess the organizational factors affecting the practice of High-Reliability Organization (HRO) Principles as perceived by staff in selected Accident and Emergency Units.

Methodology: A hospital based cross-sectional study in three Accident and Emergency care setting, among healthcare staff, conducted using a self-administered questionnaire.

Results: Out of the five factors affecting HRO practices as perceived by staff, “Organizational Safety Culture” (Mean-4.27., SD-0.49) has the highest mean value followed by Leadership (Mean: 3.96, SD: 0.44) and Teamwork (Mean: 3.95, SD: 0.5). “Work Environment” (Mean: 3.94, SD: 0.46) has the lowest score. All independent and dependent variables have a significant positive correlation with HRO principles (Correlation is significant at the 0.01 level-1-tailed). Multivariate analysis was carried out to assess the proportion variability of the dependent variable. The linear regression model explains 22% of the variability of the HRO practices (dependent variable) by factors affecting HRO practices (independent variables) if all the factors operate together.

The distribution of Coefficients, Standardized B value is 0.29 (significant at the 0.01 level), showing if “Organizational Safety Culture” operates together with the other four independent variables 29% of the variability of the HRO practices (dependent variable) can be explained by Organizational Safety Culture.

Conclusion: Organizational safety culture shows significant (< 0.01) effect on determining HRO practices.