ORGANIZATIONAL JUSTICE, COMFORT WITH SAFETY REPORTING, AND PERCEPTIONS OF HOSPITAL SAFETY: AN ANALYSIS USING STRUCTURAL EQUATION APPROACH

Abstract

<p>Patient safety in healthcare has become a national objective. Hospital safety concerns are not isolated to patient safety, occupational safety is also important. One initiative adopted by healthcare is improving patient safety climate – shifting from one of a "no harm, no foul" approach to a culture of learning that encourages the reporting of errors, even those in which patient harm does not occur. Lacking from the literature, however, is an understanding of how to encourage reporting and how safety perceptions are formed among hospital employees. In addition, although safety-related reporting and safety perceptions are deemed important, the majority of research has been conducted in nursing populations. In order to create a safer hospital, it is crucial to investigate safety-related reporting and safety perceptions among all hospital employees.</p> <p>The purpose of this cross-sectional study is to test and refine a model that explains the influence of perceived procedural justice, interpersonal justice, informational justice, and distributive justice on comfort with safety-related reporting and, ultimately, hospital safety perceptions among hospital employees.</p> <p>The proposed model was tested on a sample of 652 hospital employees from a regional children’s hospital with a 76% return rate. Consistent with the hypothesized model, perceptions of higher interpersonal justice predicted higher comfort with safety reporting, which in turn predicted perceptions of hospital safety. In addition, comfort with safety reporting, interpersonal justice, and informational justice contributed directly to the prediction of hospital safety perceptions.</p> <p>This study illustrates why different dimensions of organizational justice, specifically interpersonal justice and informational justice, should be considered above and beyond safety-specific climate when individuals are intent on improving hospital safety. Thus, hospital managers and administrators should enhance interpersonal justice along with comfort with safety-related reporting and informational justice to create a safer hospital. Study limitations and recommendations for new research methods and areas are discussed.</p>