Abstract
Background. Few studies have sought to measure health professional perceptions of quality and safety across an entire system of public hospitals. Therefore, three questions that gauge different aspects of quality and safety were included in a national New Zealand survey of clinical governance.
Methods. Three previously used questions were adapted. A total of 41 040 registered health professionals employed in District Health Boards were invited to participate in an online survey. Analyses were performed using the R statistical environment. Proportional odds mixed models were used to quantify associations between demographic variables and responses on five-point scales. Relationships between other questions in the survey and the three quality and safety questions were quantified with the Pearson correlation coefficient.
Results. A 25% response rate delivered 10 303 surveys. Fifty-seven percent of respondents (95% CI: 56-58%) agreed that health professionals in their District Health Board worked together as a team; 70% respondents (95% CI: 69-70%) agreed that health professionals involved patients and families in efforts to improve patient care; and 69% (95% CI: 68-70%) agreed that it was easy to speak up in their clinical area if they perceived a problem with patient care. Correlations showed links between perceptions of stronger clinical leadership and performances on the three questions, as well as with other survey items. The proportional mixed model also revealed response differences by respondent characteristics.
Conclusions. The findings suggest positive commitment to quality and safety among New Zealand health professionals and their employers, albeit with variations by district, profession, gender and age, but also scope for improvement. The study also contributes to the literature indicating that clinical leadership is an important contributor to quality improvement.