The impact of empowerment, collaboration, and teamwork on patient safety culture in the perioperative setting

The purpose of this study was to model through path analysis techniques the relationships between structural empowerment, collaboration with physicians and other colleagues, and teamwork on patient safety culture. King's Conceptual System and Theory of Goal Attainment formed the framework for this study. In this study, 246 perioperative nurses responded to a survey that combined three instruments: Conditions of Work Effectiveness Questionnaire-II (a measure of structural empowerment), Collaboration and Satisfaction About Care Decisions (a measure used to assess both physician and other colleague collaboration), and Hospital Survey on Patient Safety Culture (measuring teamwork and patient safety culture). A review of literature supported the proposed theoretical model demonstrating the path of direct and indirect effects of structural empowerment, collaboration with physicians, collaboration with other colleagues, and teamwork on patient safety culture. Data was collected and analyzed using SPSS and LISREL. Path analysis was used for the main statistical analysis because of its ability to demonstrate direct and indirect effects simultaneously. The results of this study supported the theoretical assertion that there was a positive relationship between structural empowerment and patient safety, and the direction of influence flowed from structural empowerment to patient safety culture. The examination of both direct and indirect effects of structural empowerment, collaboration with physicians, collaboration with other colleagues, and teamwork on patient safety culture revealed that collaboration with physicians and other colleagues moderated the relationships between structural empowerment and teamwork, and then through teamwork to patient safety culture. This demonstrates the importance of collaboration and teamwork to enhance the impact of structural empowerment on patient safety culture. The study results showed the importance of implementing empowering structures and employing strategies to improve collaboration and teamwork for nurses.