Causal relationships of patient safety culture based on the chinese version of safety attitudes questionnaire

This study uses the decision-making trial and evaluation laboratory method to identify critical dimensions of the Chinese version of the safety attitudes questionnaire to improve the patient safety culture in Taiwan from experts’ viewpoints. Stress recognition, perceptions of management, emotional exhaustion, and work-life balance are causal dimensions, whereas teamwork climate, safety climate, job satisfaction, and working conditions are receiving dimensions. Improving effect-based dimensions might have little impact on effects. In contrast, improving a causal dimension would not only improve the dimension itself but would also result in better performance of other dimension(s) that it directly affects. This work identifies emotional exhaustion as the most critical dimension of the questionnaire, followed by perceptions of management. These two dimensions are main causal dimensions that have significant effects on the other dimensions. Therefore, hospital management needs to address emotional exhaustion and perceptions of management to improve patient safety culture.