INTRODUCTION: Medical errors commonly occur in medical imaging departments. These errors are frequently influenced by patient safety culture. This study aimed to develop a suitable patient safety culture assessment tool for medical imaging departments. METHODS: Staff members of a teaching hospital medical imaging department were invited to complete the generic short version of the Safety Attitude Questionnaire (SAQ). Internal consistency and reliability were evaluated using Cronbach's α. Confirmatory factor analysis (CFA) was conducted to examine model fit. A cut-off of 60% was used to define the percentage positive responses (PPR). PPR values were compared between occupational groups. RESULTS: A total of 300 complete responses were received and the response rate was 75.4%. In reliability analysis, the Cronbach's α for the original 32-item SAQ was 0.941. Six subscales did not demonstrate good fit with CFA. A modified five-subscale, 22-item model (SAQ-MI) showed better fit (goodness-to-fit index ≥0.9, comparative fit index ≥ 0.9, Tucker-Lewis index ≥0.9 and root mean square error of approximation ≤0.08). The Cronbach's α for the 22 items was 0.921. The final five subscales were safety and teamwork climate, job satisfaction, stress recognition, perception of management and working condition, with PPR of 62%, 68%, 57%, 61% and 60%, respectively. Statistically significant differences in PPR were observed between radiographers, doctors and others occupational groups. CONCLUSION The modified five-factor, 22-item SAQ-MI is a suitable tool for the evaluation of patient safety culture in a medical imaging department. Differences in patient safety culture exist between occupation groups, which will inform future intervention studies.
Humans ; Surveys and Questionnaires ; Patient Safety ; Attitude of Health Personnel ; Diagnostic Imaging ; Reproducibility of Results ; Male ; Female ; Adult ; Job Satisfaction ; Factor Analysis, Statistical ; Middle Aged ; Hospitals, Teaching ; Safety Management ; Organizational Culture ; Medical Errors/prevention & control*

PURPOSE: The purpose of this study was to investigate the relationship among nursing organizational culture, work performance, and workplace bullying of nurses, and to identify the factors that affect workplace bullying.METHODS: The design of this study was descriptive research, and the data were collected from October 26 to November 5, 2018. The research participants were 210 nurses in six general hospitals in G province. The data were analyzed by descriptive statistics, a t-test, one-way ANOVA, Scheffé post-hoc test, Pearson's correlation coefficient, and a stepwise multiple regression using SPSS 22.0.RESULTS: The workplace bullying type showed negative correlations with innovation-oriented culture, relation-oriented culture, and work performance. The workplace bullying consequence showed negative correlations with the innovation-oriented culture, relation-oriented culture, and work performance, and showed positive correlations with the workplace bullying type. The factors influencing the results of the workplace bullying consequence were workplace bullying type followed by relation-oriented culture, and unmarried status.CONCLUSION: Workplace bullying among nurses was related to the nursing organizational culture and work performance. Therefore, in order to reduce the turnover rate of nurses and to help them adapt well to the nursing organizational culture, a bullying prevention and intervention program is necessary.
Bullying ; Hospitals, General ; Humans ; Nursing ; Organizational Culture ; Single Person ; Work Performance

PURPOSE: The present research was done to examine the fundamental significance and structure of conflict experience of nurses in hospital nursing organizations.METHODS: This qualitative research was conducted by analyzing data collected through in-depth interviews based on Colaizzi's (1978) method of analysis, one of the phenomenological methods of analysis.RESULTS: Statements from the 12 study participants demonstrate two key topics “accumulation of conflicts” and “manifestation of new conflicts” as well as seven sub-topics including “being forced to comply”, “Lack of respect and consideration”, “unsatisfactory conflict management by the leaders”, “continuous and overwhelming vicious cycle”, “prevalence of self-defensive egotism”, “difficult to accept differences”, and “incapable of responding to the structural changes of nursing workforce”.CONCLUSION: Resolving the dysfunctional conflicts in hospital nursing organizations requires not only improvement in the organizational culture of individuals and nursing organizations, but also legal and institutional measures in addition to new attempts to integrate education and research findings from relevant fields of studies.
Education ; Methods ; Nursing ; Organizational Culture ; Qualitative Research

BACKGROUND: Mystery shopping is a method in which a company monitors quality of service and employee conduct and compliance with regulations using an evaluator posing as a customer. It is a typical tool of customer-centered bureaucratic control insofar as it provides overall and standardized evaluation of intangible elements of customer service as well as physical elements of service environments. The purpose of this study is to examine how mystery shopping is related to the health status of service workers in South Korea.METHODS: Data from semistructured interviews with 15 workers were collected from January to April 2019 to obtain information on service worker experiences with mystery shopping. Data were analyzed using the constant comparison method.RESULTS: Mystery shopping limits worker autonomy and stiffens the workplace environment by standardizing and monitoring labor processes for service workers. In addition, mystery shopping heightens work stress through increased labor intensity. Five mechanisms by which mystery shopping affects service worker health are identified and comprise (1) multifaceted and multilayered surveillance, (2) evaluator subjectivity and irrational requirements, (3) standardized rules combined with high pressure to achieve sales, (4) self-esteem degradation because of evaluator results, and (5) musculoskeletal disorders because of strict adherence to labor processes based on evaluator results.CONCLUSION: Mystery shopping as an evaluation method should be reconsidered not only in terms of health problems but also in terms of organizational efficiency and issues of human rights.
Commerce ; Compliance ; Efficiency, Organizational ; Human Rights ; Korea ; Methods ; Social Control, Formal

BACKGROUND: This study was aimed to examine relationships among workplace bullying, organization culture and nursing performance in clinical nurses.METHODS: A cross-sectional questionnaire survey was conducted from October 16 to 26, 2018 with 168 nurses participating in RN-BSN and graduate programs in a university. Data was analyzed with SPSS 22.0 by t - test, ANOVA, Pearson's correlation coefficient and hierarchical multiple regression.RESULTS: Of nurses, 23.2% were found as victims of workplace bullying. Higher scores for workplace bullying positively correlated with rank-oriented culture (r=.19, p=.015), negatively correlated with relational-oriented culture (r=−.43, p<.001) and innovation-oriented culture (r=−.35, p<.001). After adjusting for other variables, better nursing performance was associated with lower scores for workplace bullying (β=−.18, p=.026) and innovation-oriented culture (β=.24, p=.023). However, there was no moderating effect of organizational culture in the relationship between workplace bullying and nursing performance.CONCLUSION: Efforts to creating innovative organizational culture and reducing workplace bullying can contribute to improving nursing performance.
Bullying ; Nursing ; Organizational Culture

PURPOSE: The purpose of this study was to examine the relationships of authentic leadership and nursing organizational culture to the intention of hospital nurses to stay in their current position. METHODS: The participants of this study were 503 nurses in 8 hospitals. We collected data using questionnaires for assessing authentic leadership, nursing organization culture and intention to stay. For data analysis, t-test, ANOVA, Cronbach's α, Pearson's correlation coefficient, Tukey test, Multiple regression were performed using SAS ver.9.4 (SAS Institute Inc., Cary, NC, USA). RESULTS: Authentic leadership (β=.12, p=.008) and relation-oriented culture (β=.13, p=.009) affected the intention of the hospital nurses to stay. These variables accounted for 29% of the variance in the intention to stay among hospital nurses. CONCLUSION: The finding of this study shows that the authentic leadership and nursing organizational culture especially relation-focused can influence nurses' intention to stay in their current position. For retaining nurses, it is suggested to use an authentic leadership training program for nursing leaders and to make efforts to establish a relation-focused culture in the hospital.
Education ; Intention ; Leadership ; Nursing ; Organizational Culture ; Statistics as Topic

Introduction: The National Unified Health Research Agenda is a major document whose creation by the Philippine National Health Research Systems is mandated by Philippine Law. Multiple frameworks, methods, and approaches for the development of a health research agenda exists. Available literature on research priority setting have mostly focused on its methods, results, or implementation. There are limited studies on the operations management of conducting a national health research priority-setting exercise. Objectives: This paper aims to describe the operational components utilized to develop the NUHRA 2017-2022 and provide lessons learned for future research priority setting endeavors. Methods: This paper identified and categorized the operational components to develop the NUHRA 2017-2022 using the Enabler Criterion of the European Foundation for Quality Management’s (EFQM) Excellence Model. Results: Operationalizing the development of a national health research agenda requires the harmonization of multiple components. Having region-based staff involved in the production of a regional situational analysis improved its context and accuracy. The workload for each cluster team must be considered and anticipated by the management. Stakeholder engagement requires political, diplomatic, advocacy, marketing, management, and technical skills. The process requires building relationships with various institutions. In a largescale project, management processes must be in place to effectively track and monitor its progress. Conclusion Operations and management are usually a neglected area in research and development projects. In a bottoms-up research priority-setting approach, iteration and flexibility is needed which requires a lot of management skills and insight. Duration of the project, planning, resources available, and quality of outputs have a strong interconnected relationship.
Health Priorities ; Organizational Innovation

The purpose of this study was to introduce the concept of academic medicine to the medical societies of Korea and to identify any potential obstacles in the establishment of academic medicine in Korea. The core concepts of academic medicine include medical education, research, and patient care. Academic medicine can be practiced in the unique area of healthcare involving medical schools and teaching hospitals by faculty physicians in the academic medicine field. Through academic medicine, the next generation of healthcare professionals is trained, new discoveries can be made, and patients can find new hope for a cure. The flourishing of academic medicine has resulted in substantial advancements in medicine over the past few centuries, but at the turn of the 21st century, there was concern that academic medicine was on the decline. To address this concern, the International Campaign to Revitalize Academic Medicine was established and announced five scenarios to 2025 to debate the future of academic medicine. Although the system resembles that of Western medical societies, Korean medical societies were not familiar with academic medicine, and poor conditions caused by the distorted healthcare system in Korea have actually interfered with the nurturing of academic medicine. One of the main problems may include less interest in medical education and research relative to clinical practice by medical societies and the government. Collaborative efforts from both medical societies and the government are needed to establish academic medicine successfully in Korea for a better future.
Delivery of Health Care ; Education, Medical ; Hope ; Hospitals, Teaching ; Humans ; Korea ; Organizational Policy ; Patient Care ; Schools, Medical ; Societies, Medical

PURPOSE: The purpose of this study was to determine nurses' perceptions of the disclosure of patient safety incidents (DPSI), which is known to be effective in reducing medical litigation and improving the credibility of medical professionals. METHODS: Three focus group discussions were conducted with 20 nurses using semistructured guidelines. Transcribed content including a record of the progress of the focus group discussions and researchers' notes were analyzed using directed content analysis. RESULTS: Most participants thought that DPSI is necessary because of its effectiveness and for ethical justification. However, participants held varied opinions regarding the primary responsibility of DPSI. Participants agreed on the necessity of explaining the incident and expressing sympathy, apologizing, and promising appropriate compensation that are chief components of DPSI. However, they were concerned that it implies a definitive medical error. A closed organizational culture, fear of deteriorating relationships with patients, and concerns about additional work burdens were suggested as barriers to DPSI. However, the establishment of DPSI guidelines and improving the hospital organization culture were raised as facilitators of DPSI. CONCLUSION: Most nurse participants acknowledged the need for DPSI. To promote DPSI, it is necessary to develop guidelines for DPSI and provide the appropriate training. Improving the hospital organization culture is also critical to facilitate DPSI.
Compensation and Redress ; Disclosure ; Focus Groups ; Humans ; Jurisprudence ; Korea ; Medical Errors ; Organizational Culture ; Patient Rights ; Patient Safety

Neonatal thrombocytopenia, defined as platelet counts of less than 150,000/µL, is a frequent hematologic abnormality in neonatal period. Differential diagnosis of neonatal thrombocytopenia may be challenging to pediatric hematologists and neonatologists because neonatal thrombocytopenia is associated with diverse maternal or neonatal clinical conditions. An accurate diagnosis for neonatal thrombocytopenia will lead to appropriate evaluation and management. Platelet transfusion is the primary management of neonatal thrombocytopenia. Most thrombocytopenic newborns received platelet concentrates to prevent major hemorrhage or treat ongoing bleeding according to institutional policy. However, scientific evidences for benefit and consistent guideline for platelet transfusion in neonates are lacking, further investigation to establish the standard recommendation for platelet transfusion is needed. This article reviewed the diagnostic approach and current guideline for platelet transfusion management for neonatal thrombocytopenia.
Blood Platelets ; Diagnosis ; Diagnosis, Differential ; Hemorrhage ; Humans ; Infant ; Infant, Newborn ; Organizational Policy ; Platelet Count ; Platelet Transfusion ; Thrombocytopenia ; Thrombocytopenia, Neonatal Alloimmune