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:: Volume 35, Issue 3 (Fall 2025) ::
MEDICAL SCIENCES 2025, 35(3): 367-376 Back to browse issues page
Determining the relationship between systems thinking and patient safety culture in selected hospitals of Kermanshah University of Medical Sciences
Sahel Pashaei1 , Mahboobeh Safavi2 , Khalil Alimohammadzadeh3
1- Department of Health Services Management, School of Public Health, TeMs.C., Islamic Azad University, Tehran, Iran
2- Department of Health Services Management, School of Public Health, TeMs.C., Islamic Azad University, Tehran, Iran & Associate Professor, Department of Health Services Management, TeMs.C., Islamic Azad University, Health Economics Policy Research Center, TeMs.C.,Islamic Azad Univercity, Tehran , Iran , Msafavi@iautmu.ir
3- Professor, Department of Health Services Management,NT.C., Islamics Azad University, Health Economics Policy Research Center, TeMs.C., Islamic Azad Univercity, Tehran, Iran & Associate Member, Academy of Medical Sciences of the Islamic Republic of Iran
Abstract:   (265 Views)
Background: System thinking is defined as "the ability to recognize, understand and synthesize system elements instead of individual components. Patient safety is one of the main components of quality of health services. One of the necessary factors to improve patient safety is the existence of safety culture. Since the development of systemic thinking can be used as a solution to strengthen the safety behaviors of employees, this study was done to determine the relationship between clinical staff's understanding of systemic thinking and patient safety culture in selected hospitals of Kermanshah University of Medical Sciences.
Materials and methods: This study was applied and quantitative in terms of purpose and data type, descriptive and correlational in terms of data conversion into analytical information, and cross-sectional in terms of time. it was conducted among clinical staff (doctors and nurses) of 3 teaching hospitals of Kermanshah City in 2024. Available sampling method was used to select the sample. Systemic thinking and safety culture questionnaires were used to collect data.
Results: In this study, the total score of understanding systems thinking was 99.71%. The percentage of positive scores of patient safety culture was 97.28. Therefore, at the 95% probability level, there was no significant relationship between systems thinking and patient safety culture (p=0.09).
Conclusion: The results of study showed that clinical staff's understanding of systems thinking in selected hospitals was high, patient safety culture was at weak level, and a weak and inconsistent relationship was found between systems thinking and patient safety culture, but it was'nt significant.
 
Keywords: Systemic thinking, Patient safety culture, Relationship
Full-Text [PDF 1043 kb]   (107 Downloads)    
Semi-pilot: Survey/Cross Sectional/Descriptive | Subject: Health Information Management
Received: 2024/09/7 | Accepted: 2024/12/3 | Published: 2025/09/1
References
1. Hossain NUI, Dayarathna VL, Nagahi M, Jaradat R. Systems thinking: a review and bibliometric analysis. Systems 2020;8:23. [DOI:10.3390/systems8030023]
2. Nagahi M, Hossain NUI, Jaradat R, Goerger S, Abutabenjeh S, Kerr CS. Do the practitioners' level of systems-thinking skills differ across sector types? In: Proceedings of the 2020 IEEE Systems Conference; 2020 Apr 20-23; Montreal, QC, Canada. [DOI:10.1109/SysCon47679.2020.9275917]
3. Colbert CY, Ogden PE, Ownby AR, Bowe C. Systems-based practice in graduate medical education: systems
4. Dolansky MA, Moore SM, Palmieri PA, Singh MK. Development and validation of the systems thinking scale. J Gen Intern Med 2020;35:2314-20. [DOI:10.1007/s11606-020-05830-1]
5. Englander R, Cameron T, Ballard AJ, Dodge J, Bull J, Aschenbrener CA. Toward a common taxonomy of competency domains for the health professions and competencies for physicians. Acad Med 2013;88:1088-94. [DOI:10.1097/ACM.0b013e31829a3b2b]
6. Fan CJ, Pawlik TM, Daniels T, Vernon N, Banks K, Westby P, et al. Association of safety culture with surgical site infection outcomes. J Am Coll Surg 2016;222:122-8. [DOI:10.1016/j.jamcollsurg.2015.11.008]
7. Jha AK, Larizgoitia I, Audera-Lopez C, Prasopa-Plaizier N, Waters H, Bates DW. The global burden of unsafe medical care: analytic modelling of observational studies. BMJ Qual Saf 2013;bmjqs-2012-001748. [DOI:10.1136/bmjqs-2012-001748]
8. Wang Y, Eldridge N, Metersky ML, Verzier NR, Meehan TP, Pandolfi MM, et al. National trends in patient safety for four common conditions, 2005-2011. N Engl J Med 2014;370:341-51. [DOI:10.1056/NEJMsa1300991]
9. Soop M, Fryksmark U, Köster M, Haglund B. The incidence of adverse events in Swedish hospitals: a retrospective medical record review study. Int J Qual Health Care 2009;21:285-91. [DOI:10.1093/intqhc/mzp025]
10. Abadi MBH, Akbari H, Akbari H, Gholami-Fesharaki M, Ghasemi M. The Association of Nursing Workloads, Organizational, and Individual Factors with Adverse Patient Outcome. Iranian Red Crescent Medical Journal 2016;19:1-9. [In Persian] [DOI:10.5812/ircmj.43444]
11. Zegers M, De Bruijne M, Wagner C, Hoonhout L, Waaijman R, Smits M, et al. Adverse events and potentially preventable deaths in Dutch hospitals: results of a retrospective patient record review study. Qual Saf Health Care 2009;18:297-302. [DOI:10.1136/qshc.2007.025924]
12. Han JH, Roh YS. Teamwork, psychological safety, and patient safety competency among emergency nurses. Int Emerg Nurs 2020;51:100892. [DOI:10.1016/j.ienj.2020.100892]
13. James JT. A new, evidence-based estimate of patient harms associated with hospital care. J Patient Saf 2013;9:122-8. [DOI:10.1097/PTS.0b013e3182948a69]
14. Jin J, Yi YJ. Patient safety competency and the new nursing care delivery model. J Nurs Manag 2019;27:1167-75. [DOI:10.1111/jonm.12788]
15. Armitage G. The risks of double checking. Nurs Manag (Harrow) 2009;16:30. [DOI:10.7748/nm2009.05.16.2.30.c7012]
16. Hwang JI, Park HA. Nurses' systems thinking competency, medical error reporting, and the occurrence of adverse events: A cross-sectional study. Contemp Nurse 2017;53:622-32. [DOI:10.1080/10376178.2017.1409081]
17. Jang H, Lee NJ. Patient safety competency and educational needs of nursing educators in South Korea. PLoS One 2017;12:e0183536. [DOI:10.1371/journal.pone.0183536]
18. Kakemam E, Ghafari M, Rouzbahani M, Zahedi H, Roh YS. The association of professionalism and systems thinking on patient safety competency: A structural equation model. J Nurs Manag 2022;30:817-26. [DOI:10.1111/jonm.13536]
19. Dolansky MA, Moore SM, Palmieri PA, Singh MK. Development and validation of the systems thinking scale. Journal of General Internal Medicine. 2020;35:2314-20. [DOI:10.1007/s11606-020-05830-1]
20. Moore S, Dolansky M, Singh M, Palmieri P, Alemi F. The systems thinking scale. Cleveland: Case Western Reserve University; 2010.
21. Lawshe CH. A quantitative approach to content validity. Pers Psychol 1975;28:563-75. [DOI:10.1111/j.1744-6570.1975.tb01393.x]
22. Kakemam E, Albelbeisi AH, Davoodabadi S, Azarmi M, Zolghadr F, Mamene M. The impact of nurses' perceptions of systems thinking on occurrence and reporting of adverse events: A cross‐sectional study. %J Journal of nursing management 2022;30:482-90. [DOI:10.1111/jonm.13524]
23. Polit DF, Beck CT, Owen SV. Is the CVI an acceptable indicator of content validity? Appraisal and recommendations. Res Nurs Health 2007;30:459-67. [DOI:10.1002/nur.20199]
24. Hyrkäs K, Appelqvist-Schmidlechner K, Oksa L. Validating an instrument for clinical supervision using an expert panel. Int J Nurs Stud 2003;40:619-25. [DOI:10.1016/S0020-7489(03)00036-1]
25. Cronbach LJ. Coefficient alpha and the internal structure of tests. psychometrika 1951;16:297-334. [DOI:10.1007/BF02310555]
26. Cronbach LJ, Shavelson RJ. My current thoughts on coefficient alpha and successor procedures. Educational and Psychological Measurement 2004;64:391-418. [DOI:10.1177/0013164404266386]
27. Sorra JS, Dyer N. Multilevel psychometric properties of the AHRQ hospital survey on patient safety culture. BMC Health Serv Res 2010;10:1-13. [DOI:10.1186/1472-6963-10-199]
28. Moghri J, Ghanbarnezhad A, Moghri M, Rahimi Forooshani A, Akbari Sari A, Arab M. Validation of Farsi version of hospital survey on patient Safety culture questionnaire, using confirmatory factor analysis method. Journal of Hospital. 2012;11:19-30. [In Persian]
29. Sorra JS, Dyer N. Multilevel psychometric properties of the AHRQ hospital survey on patient safety culture. BMC Health Services Res 2010;10:1-13. [DOI:10.1186/1472-6963-10-199]
30. Le Pogam M-A, Januel J-M, Colin PC. Modalités d'utilisation et de diffusion des PSI (Indicateurs de sécurité des soins hospitaliers) dans les pays de l'OCDE. Clarte-Version du 2011;15:2011.
31. McNab D, McKay J, Shorrock S, Luty S, Bowie P. Development and application of 'systems thinking'principles for quality improvement. BMJ open Qual 2020;9:e000714. [DOI:10.1136/bmjoq-2019-000714]
32. Lee SE, Morse BL, Kim NW. Patient safety educational interventions: A systematic review with recommendations for nurse educators. Nurs Open 2022;9:1967-79. [DOI:10.1002/nop2.955]
33. Dolansky MA, Moore SM. Quality and Safety Education for Nurses (QSEN): The Key is Systems Thinking. Online J Issues Nurs 2013;18:1. [DOI:10.3912/OJIN.Vol18No03Man01]
34. Farokhzadian J, Dehghan Nayeri N, Borhani F. The long way ahead to achieve an effective patient safety culture: challenges perceived by nurses. BMC Health Serv Res 2018;18:1-13. [DOI:10.1186/s12913-018-3467-1]
35. Edwards MT. An organizational learning framework for patient safety. Am J Med Qual 2017;32:148-55. [DOI:10.1177/1062860616632295]
36. Alswat K, Abdalla RAM, Titi MA, Bakash M, Mehmood F, Zubairi B, et al. Improving patient safety culture in Saudi Arabia (2012-2015): trending, improvement and benchmarking. BMC Health Serv Res 2017;17:1-14. [DOI:10.1186/s12913-017-2461-3]
37. Tetuan T, Ohm R, Kinzie L, McMaster S, Moffitt B, Mosier M. Does systems thinking improve the perception of safety culture and patient safety? Journal of Nursing Regulation 2017;8:31-39. [DOI:10.1016/S2155-8256(17)30096-0]
38. Moazez M, Miri S, Foroughameri G, Farokhzadian J. Nurses' perceptions of systems thinking and safe nursing care: A cross‐sectional study. Journal of Nursing Management 2020;28:822-30. [DOI:10.1111/jonm.13000]
39. Dolatabadi FD, Ziaeirad M. The relationship between critical thinking and patient safety culture in the nurses. Journal of Nursing Education. 2021;10:1-12. [In Persian]
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Pashaei S, Safavi M, Alimohammadzadeh K. Determining the relationship between systems thinking and patient safety culture in selected hospitals of Kermanshah University of Medical Sciences. MEDICAL SCIENCES 2025; 35 (3) :367-376
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Volume 35, Issue 3 (Fall 2025) Back to browse issues page
فصلنامه علوم پزشکی دانشگاه آزاد اسلامی واحد پزشکی تهران Medical Science Journal of Islamic Azad Univesity - Tehran Medical Branch
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