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Article
Publication date: 26 January 2021

Chih-Hsuan Huang, Chun-Ting Lai, Cheng-Feng Wu, Yii-Ching Lee, Chia-Hui Yu, Hsiu-Wen Hsueh and Hsin-Hung Wu

Gender difference exists in the perception of the patient safety culture in healthcare organizations. A case from a medical center in Taiwan is presented to examine how different…

Abstract

Purpose

Gender difference exists in the perception of the patient safety culture in healthcare organizations. A case from a medical center in Taiwan is presented to examine how different genders perceive the patient safety culture in practice from 2014 to 2017.

Design/methodology/approach

A longitudinal study using the data from 2014 to 2017 is conducted quantitatively. Mann–Whitney U test and one-way analysis of variance are employed for analyses.

Findings

The results showed that female nurses had significantly higher emotional exhaustion than male nurses in 2015 and 2016 indicating male nurses had better fatigue recovery than their female counterparts. In addition, male nurses felt a higher degree of fatigue in 2016 and 2017 than those in 2015 statistically. In contrast, female nurses felt more stressful in 2016 and 2017 than those in 2014 statistically. Female nurses had higher emotional exhaustion in 2016 and 2017 than those in 2014 and 2015 statistically.

Practical implications

To sum up, female nurses were more stressful than before, and their recovery was also relatively poor particularly in 2016 and 2017. There is a need to reduce the degree of fatigue for female nurses in this medical center through employee assistance programs, mindfulness-based stress reduction programs, building up female nurses' positive currency and setting up their appreciative inquiry. In contrast to female nurses, male nurses recovered better from fatigue. This might encourage hospital management to deploy male nurses more effectively in this medical center.

Originality/value

The results enable the hospital management to know there is a gender difference in this case hospital. More attention on female nurses is required.

Article
Publication date: 16 March 2022

Hsin-Hung Wu, Yii-Ching Lee, Chih-Hsuan Huang and Li Li

Safety activities have been initiated in healthcare organizations in Taiwan, but little is known about the performance and trends of safety culture on a timely basis. This study…

Abstract

Purpose

Safety activities have been initiated in healthcare organizations in Taiwan, but little is known about the performance and trends of safety culture on a timely basis. This study aims to comprehensively review the articles that have conducted two worldwide patient safety culture instruments (HSPSC and SAQ) in Taiwan to provide the extent of existing knowledge about healthcare professionals' perception related to patient safety.

Design/methodology/approach

The Web of Science, Medline (Pubmed) and Embas were used as the database to search papers related to the patient safety culture in Taiwan from 2008 to June 30, 2019.

Findings

Twenty-four relative articles in total were found and further investigations confirmed that the regular assessment of patient safety culture among hospital staff is essentially important for healthcare organizations to reduce the rates of medical errors and malpractice. Moreover, the elements influencing patient safety culture may vary due to the difference in job positions, age, experience in organization and cultural settings.

Research limitations/implications

The summary of findings enables healthcare administrators and practitioners to understand key components of patient safety culture for continuous improvement in medical quality.

Originality/value

Assessing the safety culture in healthcare organizations is a foundation to achieve excellent medical quality and service. The implications of this study could be useful for hospitals to establish a safer environment for patients.

Article
Publication date: 5 May 2020

Chih-Yi Chi, Chih-Hsuan Huang, Yii-Ching Lee, Cheng-Feng Wu and Hsin-Hung Wu

The purpose of this study is to identify critical demographic variables that would significant influence each dimension of patient safety culture. Understanding nurses' attitudes…

Abstract

Purpose

The purpose of this study is to identify critical demographic variables that would significant influence each dimension of patient safety culture. Understanding nurses' attitudes toward patient safety is important for healthcare organizations to relentlessly improve medical quality and services for patients.

Design/methodology/approach

The internal survey data sets in 2015 and 2016 from nurses' viewpoints are used. Linear regression with forward selection is applied where nine demographic variables are the input variables, while each dimension of the Chinese version of safety attitudes questionnaire (SAQ) is the dependent variable.

Findings

Supervisor/manager is the most essential demographic variable that has significant impacts on six dimensions. Experience in organization is the other critical demographic variable.

Practical implications

Nurses who are in charge of supervisors/managers are more satisfied in six of eight dimensions. Nurses who have much experience in an organization tend to have less satisfaction in three dimensions. Therefore, hospital management should enhance the leader's effectiveness in engaging their subordinates' commitment.

Originality/value

The results enable the hospital management to pay much attention to two major demographic variables, namely supervisor/manager and experience in organization, in order to improve the patient safety culture based on the Chinese version of SAQ in this hospital. Moreover, supervisor/manager is a more critical demographic variable for nurses due to larger absolute values of standardized coefficients by linear regression with forward selection.

Article
Publication date: 24 August 2021

Chih-Hsuan Huang, Ying Wang, Hsin-Hung Wu and Lee Yii-Ching

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…

Abstract

Purpose

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.

Design/methodology/approach

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.

Findings

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.

Originality/value

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.

Details

The TQM Journal, vol. 34 no. 5
Type: Research Article
ISSN: 1754-2731

Keywords

Article
Publication date: 7 November 2023

Chih-Hsuan Huang, Yii-Ching Lee and Hsin-Hung Wu

Medical staff's emotional exhaustion increases cynical attitudes and behaviors about work and patients and leads medical staff to become detached from work. This may decrease…

Abstract

Purpose

Medical staff's emotional exhaustion increases cynical attitudes and behaviors about work and patients and leads medical staff to become detached from work. This may decrease patients' trust and satisfaction and even endanger patients' lives. There is a need to examine the critical factors affecting the medical staff's emotional exhaustion by investigating its relationship with the patient-safety dimensions based on the safety attitudes questionnaire (SAQ).

Design/methodology/approach

A case study is conducted from the viewpoints of physicians and nurses to examine the relationship between emotional exhaustion and six dimensions of the SAQ from 2016 to 2020 from a regional teaching hospital in Taiwan. Linear regression with forward selection is employed. Six dimensions of the SAQ are the independent variables, whereas emotional exhaustion is the dependent variable for each year.

Findings

Stress recognition is the most important variable to influence emotional exhaustion negatively, while job satisfaction is the second important variable to affect emotional exhaustion positively from 2016 to 2020. On the contrary, working conditions do not influence emotional exhaustion in this hospital from medical staff's viewpoints.

Originality/value

This study uses longitudinal data to find that both stress recognition and job satisfaction consistently influence emotional exhaustion negatively and positively, respectively, in this five-year period. The third dimension to impact emotional exhaustion varies from time to time. Thus, the findings from a cross-sectional study might be limited. The authors' findings show that reducing stress recognition and enhancing job satisfaction can lead to the improvement of emotional exhaustion from medical staff's viewpoints, which should be monitored by hospital management.

Details

Journal of Health Organization and Management, vol. 38 no. 1
Type: Research Article
ISSN: 1477-7266

Keywords

Article
Publication date: 29 December 2022

Yung-Tai Tang, Hsin-Hung Wu, Yii-Ching Lee and Chih-Hsuan Huang

The rapid changes that the healthcare services industry is undergoing pose a challenge to obtaining accurate measurements of the delivery of medical services to patients. Current…

Abstract

Purpose

The rapid changes that the healthcare services industry is undergoing pose a challenge to obtaining accurate measurements of the delivery of medical services to patients. Current Chinese measures of patient safety culture may not adequately capture how medical staff perceives the promotion of patient safety. This study aims to construct a valid and applicable patient safety culture instrument by re-estimating the Chinese version of the Safety Attitudes Questionnaire (SAQ) with medical staff in Taiwan.

Design/methodology/approach

Exploratory factor analysis (EFA) was conducted on data collected from a sample of 448 medical workers at a regional teaching hospital in Taiwan, and data from 804 participants at a medical center were subjected to confirmatory factor analysis (CFA). The distribution of the questions among the dimensions was different from that in the Chinese version of the SAQ.

Findings

The authors' results confirm that 3 correlated first-order factors, including 11 items, can be used to measure collaboration and safety, stress recognition and emotional exhaustion (EE). The authors' data suggest that the cooperation mechanism, patient safety promotion, stress management and emotional management are drivers of patient safety and should be prioritized when seeking to evaluate the perceptions of hospital staff toward patient safety culture in hospitals in Taiwan.

Originality/value

To improve the quality and safety of patient care, the measurement scale should be revisited and modified as the industry changes over time and to take account of cultural variation. The authors restructured the current Chinese version of the SAQ developed by the Joint Commission of Taiwan (JCT) to offer more precise measures that increase the sensitivity of the measurement of the level of care in items of patient safety and that serve as a diagnostic instrument to review patient safety management.

Details

Journal of Health Organization and Management, vol. 37 no. 1
Type: Research Article
ISSN: 1477-7266

Keywords

Article
Publication date: 3 August 2022

Li Li, Hsin-Hung Wu, Chih-Hsuan Huang, Yuanyang Zou and Xiao Ya Li

Understanding the antecedents of patient safety culture among medical staff is essential if hospital managers are to promote explicit patient safety policies and strategies. The…

Abstract

Purpose

Understanding the antecedents of patient safety culture among medical staff is essential if hospital managers are to promote explicit patient safety policies and strategies. The factors that influence patient safety culture have received little attention. The authors aim to investigate the antecedents of patient safety culture (safety climate) in relation to medical staff to develop a comprehensive approach to improve patient safety and the quality of medical care in China.

Design/methodology/approach

The Chinese version of the Safety Attitudes Questionnaire (CSAQ) was used to examine the attitudes toward patient safety among physicians and nurses. This medical staff was asked to submit the intra-organizational online survey via email. A total of 1780 questionnaires were issued. The final useable questionnaires were 256, yielding a response rate of 14.38%. One-way analysis of variance (ANOVA) was employed to test if different sex, supervisor/manager, age, working experience, and education result in different perceptions. Confirmatory factor analysis (CFA) was used to verify the structure of the data. Then linear regression with forward selection was performed to obtain the essential dimension(s) that affect the safety culture (safety climate).

Findings

The CFA results showed that 26 CSAQ items measured 6 safety-related dimensions. The linear regression results indicated that working conditions, teamwork climate, and job satisfaction had significant positive effects on safety culture (safety climate).

Practical implications

Hospital managers should put increased effort into essential elements of patient-oriented safety culture, such as working conditions, teamwork climate, and job satisfaction to develop appropriate avenues to improve the quality of delivered medical services as well as the safety of patients.

Originality/value

This study focused on the contribution that the antecedents of patient safety culture (safety climate) make with reference to the perspective of medical staff in a tertiary hospital in China.

Details

The TQM Journal, vol. 35 no. 6
Type: Research Article
ISSN: 1754-2731

Keywords

Article
Publication date: 2 February 2022

Yung Tai Tang, Hao-Wei Yang, Ming-Min Lo and Hsin-Hung Wu

The purpose of this study is to focus on a database from a supermarket for market segmentation.

Abstract

Purpose

The purpose of this study is to focus on a database from a supermarket for market segmentation.

Design/methodology/approach

Rather than using the questionnaire to collect the customers' purchase behaviors, this study uses a database from a supermarket as an example to illustrate how market segmentation can be performed by adding useful variables particularly from behavioral variables and through Chi-square test and analysis of variance.

Findings

The illustration of the database from a branch supermarket shows that two demographic variables (gender and age group) and two behavioral variables (date of transactions and time of purchase) are critical variables for market segmentation when total money spent and purchased merchandize items are taken into consideration.

Practical implications

This case study can be a reference for supermarket practitioners to follow in order to increase profit and to provide better services for their customers.

Originality/value

No studies have been found to combine demographic variables, behavioral variables, merchandize items and total amount for market segmentation simultaneously. Different combinations of demographic variables, behavioral variables and merchandize items can be further used to perform market segmentation more effectively. This framework used in this case study can be further applied in similar industries including retail industries for market segmentation as well as to fulfill customer needs in practice.

Article
Publication date: 16 October 2017

Xiaoxiang Zhang, Jo-Ting Wei and Hsin-Hung Wu

The purpose of this paper is to examine how family firms affect analyst forecast dispersion, accuracy and optimism and how earnings smoothness as the moderating factor, affects…

Abstract

Purpose

The purpose of this paper is to examine how family firms affect analyst forecast dispersion, accuracy and optimism and how earnings smoothness as the moderating factor, affects these relationships in an emerging market context.

Design/methodology/approach

This paper uses the population sample of firms listed on the Taiwan Stock Exchange from 2009 to 2010 as the research sample, which includes 963 firm-year observations.

Findings

The findings show that analysts following family firms are more likely to have more dispersed, less accurate and more optimism biased forecasts than those following nonfamily firms. Earning smoothness is mainly used by nonfamily firms as a signaling strategy to improve analyst forecast quality. In contrast, earnings smoothness is mainly used by families as a garbling strategy, stimulating forecast optimism. Only earnings smoothness in family firms with a high level of family ownership concentration is likely to be signaling-oriented to improve analyst forecast accuracy and mitigate analyst optimism biases.

Originality/value

Emerging markets are not only featured by prevailing principal-principal conflicts but also have multiple levels of agency conflicts among large shareholders, minority shareholders and professionally hired managers. This research reveals the multiple governance roles of family owners in affecting analyst forecast quality, including their entrenchment role in extracting private benefits of control through opaque environments and market discipline distortion role in aligning interests between managers and families without prioritizing meeting or beating analyst forecasts, both at the cost of minority shareholders. This research further disentangles the intertwined signaling oriented and garbiling oriented incentives associated with earnings smoothness under family governance.

Details

Management Decision, vol. 55 no. 9
Type: Research Article
ISSN: 0025-1747

Keywords

Article
Publication date: 21 August 2001

Hsin‐Hung Wu

This study uses MATLAB as a programming tool and applies the bootstrap method to process capability analysis. The advantage of using MATLAB in bootstrap method is to make the…

Abstract

This study uses MATLAB as a programming tool and applies the bootstrap method to process capability analysis. The advantage of using MATLAB in bootstrap method is to make the bootstrap method much easier to implement and apply particularly in process capability analysis. An example is provided to further illustrate the easy use of MATLAB in bootstrap method.

Details

Asian Journal on Quality, vol. 2 no. 2
Type: Research Article
ISSN: 1598-2688

Keywords

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