Accident and Emergency Care Made High Reliable: Perception of Staff on Factors Affecting Application of High-Reliability Organization Principles in Accident Emergency Units

Abstract

There is a growing concern regarding patient safety and high reliability which made more intense with this ongoing pandemic.Aim of this study is to assess the organizational factors affecting the practice of High-Reliability Organization (HRO) Principles as perceived by staff in selected Accident and Emergency Units. Methodology: A hospital based cross-sectional study in three Accident and Emergency care setting, among healthcare staff, conducted using a self-administered questionnaire.Results: Out of the five factors affecting HRO practices as perceived by staff, “Organizational Safety Culture” (Mean-4.27., SD-0.49) has the highest mean value followed by Leadership (Mean: 3.96, SD: 0.44) and Teamwork (Mean: 3.95, SD: 0.5). “Work Environment” (Mean: 3.94, SD: 0.46) has the lowest score. All independent and dependent variables have a significant positive correlation with HRO principles (Correlation is significant at the 0.01 level-1-tailed). Multivariate analysis was carried out to assess the proportion variability of the dependent variable. The linear regression model explains 22% of the variability of the HRO practices (dependent variable) by factors affecting HRO practices (independent variables) if all the factors operate together.The distribution of Coefficients, Standardized B value is 0.29 (significant at the 0.01 level), showing if “Organizational Safety Culture” operates together with the other four independent variables 29% of the variability of the HRO practices (dependent variable) can be explained by Organizational Safety Culture.Conclusion: Organizational safety culture shows significant (< 0.01) effect on determining HRO practices.