The Perceptions of the Nurse Managers on the Patient Safety Culture and Safety Culture Maturity Level of Selected Internationally Accredited Hospitals in Metro Manila: A Comparative Study

Mignodel M. Morales, DNM, RN
Trinity University of Asia
This study determined the perception of nurse managers-respondents on safety culture and safety culture maturity levels in selected internationally-accredited hospitals in Metro Manila with the end view of proposing a framework for a
progressive hospital organization. Mixed method research design was utilized to 261 nurse manager-respondents that were conveniently selected. Data were obtained using an open-access, validated standardized questionnaire for Patient Safety Culture adopted from Agency of health Research and Quality (AHRQ) and a researcher made questionnaire based on the Safety Culture Model of Fleming.

While there is a shift in the workforce currently happening in different generations in the nursing profession, this research also considered the profile characteristics of nurse-manager respondents in order to have comprehensive understanding of safety practices that can be tied into safety culture maturity of hospital institution.

Findings of the study showed that majority of the respondents from selected internationally accredited hospitals are middle aged, mostly females, with Bachelors degree in Nursing, and with under 10 years in service. Internationally-accredited
hospitals equally reflected very good to excellent safety practices in organizational learning - quality improvements, teamwork across units, and good handoff transition,  However, these hospitals vary in performance in terms of management support for patient safety feedback and communication about error, communication openness,
staffing, and non- punitive response to error. Safety culture maturity level in selected internationally-accredited hospitals vary in terms of continually improving.

However, the stages of emerging, managing, involving, and cooperating are manifested in both hospitals.

Significant difference was evident on the assessment of staff nurse respondents on their safety practices in terms of age, educational attainment, and length of service. Moreover, significant difference was noted on the assessment of
staff nurse respondents of their hospital’s safety culture maturity level in terms of age, sex, educational attainment, and length of service.

Research findings assert that selected internationally-accredited hospital organizations have yet to improve on other domains of patient safety culture particularly on organizational learning-quality improvement; feedback and
communication about errors; teamwork across units; staffing; and non-punitive response to errors. Furthermore, the selected internationally-accredited hospital organizations vary in terms of emerging level in which safety is not seen as a
primary business risk.

Utilization of the proposed framework for progressive hospital organization is essential in enhancing patient safety and sustaining quality service. Hospital administrators play a critical role in patient safety. They are essential in building a
culture of safety and resilience into workflows and patient care processes enabling healthcare organizations to progress toward high reliability. Aligning patient safety and safety culture maturity, when coupled with effective leadership, can provide a long-term approach for quality care.


nurses; safety practices; safety culture maturity; patient safety; internationally accredited hospitals