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Assessment of patient safety culture during COVID-19: a cross-sectional study in a tertiary a-level hospital in China

Chih-Hsuan Huang (Hubei University of Economics, Wuhan, China)
Ying Wang (Hubei University of Economics, Wuhan, China)
Hsin-Hung Wu (Department of Business Administration, National Changhua University of Education, Changhua, Taiwan) (Faculty of Education, State University of Malang, Malang, Indonesia)
Lee Yii-Ching (Hung Kuang University, Shalu, Taiwan)

The TQM Journal

ISSN: 1754-2731

Article publication date: 24 August 2021




The aims of this study are to (1) evaluate physicians and nurses' perspectives on patient safety culture amid the COVID-19 pandemic and (2) integrate the emotional exhaustion of physicians and nurses into an evaluation of patient safety culture to provide insights into appropriate implications for medical care.


Patient safety culture was assessed with the Chinese version of the Safety Attitudes Questionnaire. Confirmatory factor analysis was conducted to validate the structure of the data (i.e. reliability and validity), and Pearson's correlation analysis was performed to identify relationships between safety-related dimensions.


Safety climate was strongly associated with working conditions and teamwork climate. In addition, working conditions was highly correlated with perceptions of management and job satisfaction, respectively. It is worth noting that the stress and emotional exhaustion of the physicians and nurses during this epidemic were high and needed attention.

Practical implications

For healthcare managers and practitioners, team-building activities, power of public opinions, IoT-focused service, and Employee Assistance Programs are important implications for inspiring the patient safety-oriented culture during the period of the COVID-19 pandemic.


This paper considers the role of emotional state into patient safety instrument, a much less understood but equally important dimension in the field of patient safety.



Huang, C.-H., Wang, Y., Wu, H.-H. and Yii-Ching, L. (2021), "Assessment of patient safety culture during COVID-19: a cross-sectional study in a tertiary a-level hospital in China", The TQM Journal, Vol. ahead-of-print No. ahead-of-print.



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