La cultura della sicurezza negli ospedali italiani: uno studio mixed methods rivolto ai professionisti di area chirurgica

Domenica Gazineo; Elvio Di Rado; Lea Godino

doi:10.54103/dn/31004

Authors

Domenica Gazineo Governo Clinico e Qualità https://orcid.org/0000-0003-1866-3358
Elvio Di Rado Operating Room - Cardiac Surgery Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
Lea Godino Medical Genetics Unit, IRCCS AOUBO https://orcid.org/0000-0002-3763-9372

DOI:

https://doi.org/10.54103/dn/31004

Keywords:

Safety culture, Operating room, Healthcare professionals, Mixed methods

Abstract

INTRODUCTION: Safety culture is crucial in surgical settings, which are characterized by high technical complexity and strong interdependence among healthcare professionals. In Italy, studies adopting a mixed-methods approach to explore professionals’ perceptions and the organizational actions aimed at promoting safety remain limited.

METHODS: A convergent parallel mixed-methods design was adopted. The quantitative phase consisted of the online administration of the validated Italian version of the Safety Attitudes Questionnaire (SAQ), while the qualitative phase involved focus groups analyzed using an inductive thematic approach. The two components were integrated through a comparative matrix.

RESULTS: The highest SAQ scores were observed for the Safety Climate and Other Conditions dimensions, whereas less positive perceptions emerged for Perception of Hospital Management and Working Conditions. Significant differences were associated with professional role, gender, and years of experience in the operating room. The qualitative analysis identified five main themes: safety as a relational climate; the role of experience and training; communication and organizational challenges; the operating room as an identity-forming space of safety; and improvement strategies, including continuous training, simulation activities, non-punitive audits, and greater professional involvement in decision-making processes. The mixed-methods integration revealed strong convergence between quantitative and qualitative findings, while also highlighting organizational needs not captured by the questionnaire alone.

CONCLUSIONS: Safety culture in Italian surgical settings appears overall positive but shows critical issues related to managerial and organizational dimensions. Strengthening structured training, interprofessional communication, and the involvement of healthcare professionals in decision-making processes represents a strategic lever to promote safety-oriented behaviors.

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