Effect of prosocial voice and structural empowerment on patient safety culture moderated by self-monitor and mediated by psychological empowerment at Saudi public hospitals

The culture of patient safety has attracted more intention of researchers and healthcare
decision makers to create safe environment for the patient. Therefore, through literature
review there are theoretical gaps that have to be examined. Consequently, to contribute to
the literature, the objectives of this research are to assess patient safety culture (PSC),
structural empowerment (SE), to examine the relationship between structural empowerment (SE) and patient safety culture (PSC), to examine the relationship between prosocial voice (PSV) and patient safety culture (PSC), to examine the interaction between prosocial voice (PSV) and patient safety culture (PSC) moderated by self-monitoring (SM), and to examine the interaction between structural empowerment (SE) and patient safety culture (PSC) mediated by psychological empowerment (PE), in the Saudi Public Hospitals. Towards this end, this study has developed the proposed model based on the Structural Process Outcome (SPO) Theory. To examine the proposed model,
the quantitative survey questionnaire research approach was followed where 3810 questionnaires were distributed, out of which 2117 were returned and only 1793 were usable ones. By using hierarchical regression and correlation analysis through SPSS, those data were analyzed. The results show that there was moderate level of patient safety culture and structural empowerment among public hospitals in Saudi Arabia. So, there are areas for improving dimensions of patient safety culture and structural empowerment. Additionally, there was significant relation between structural empowerment and patient safety culture. On the other hand, there was no significant relation between prosocial voice and patient safety culture at public hospital in Saudi Arabia. Furthermore, there is no significant moderating effect of self-monitoring and there is no mediating effect of psychological empowerment. Besides providing suggestions for future research, this study provides several recommendations for leaders of public hospital in Saudi Arabia.