They found that when hospital staff used the Gershon tool there was considerable increase in the patient safety culture. They concluded that the health care decision makers when using Gershon safety tools, which appear to have sufficient reliability and validity, can effectively analyze the perception of the employees about patient safety in their organization and can use the tool as an indicator of the employee satisfaction with current procedures adopted for patient safety (as cited in Turnberg and Daniell, 2008). Another PSC quantitative model was developed by Leonard and Frankel (2010), who stated that the main goal of all health care systems is to bring safe and reliable healthcare services to the registered patients. The organizations are required to implement the systemic models that effectively tackle the both culture and processes of care in order to eliminate the performance gap in quality, care and safety. The model explained in a recent study conducted by Leonard and Frankel (2010) is a comprehensive and generalized design to improving the care which can be applied in any clinical field. Moreover, it provides a guideline to the workers to evaluate the weaknesses and strengths of their care system, which can help them to plan and organize their work. This evaluation is very important for the sustenance of success in patient safety culture structures. The quality and safety care delivered can be improved by applying the tools and concepts highlighted in their study (Leonard and Frankel.2010).

Leonard and Frankel (2010) in their study observed that different ways of thinking and learning are a necessity for the successful delivery of safe and reliable healthcare. They also acknowledge the fact that patient safety culture is engulfed in different challenges. Healthcare economists acknowledge these challenges as the "perfect storm." The perfect storm is the phenomenon that states aging workforce and the demands of ageing generates the requirement of complex care, which has caused an increase in the finances; these finances have over the years become more and more difficult to sustain due to limited government funding and private investments. These are the universal issues, found almost in every country. To be successful in this complex environment, healthcare organizations need to implement a systematic approach in order to improve the quality safety and operational efficiency (Leonard and Frankel, 2010).

Furthering, Leonard and Frankel's findings Carayon (2010) stated that in order to improve patient safety, the organizations and experts have advocated the use of Human Factors and Ergonomics methods, tools, concepts and theories. However, the experts propose that it is important to understand the HFE innovation's transmission, propagation, implementation and sustainability. This is important in order to spread and facilitate the knowledge and skills in the healthcare and patient safety amongst the practitioners i.e. doctors, nurses and other hospital staff members. In the spread of HFE innovation in the healthcare organizations, there are various factors identified by using Greenhalgh model of innovation that can become either barriers or facilitators. Limited knowledge about these benefits, limited system thinking, and complexity of HFE innovations are classified as the barriers. Moreover, HFE involvement has been reported to have a positive impact on the task performance for local champions, who in return facilitate its adoption, execution and sustainability. The results of the study assert the need for alternatives and improvements in the healthcare structure (Carayon, 2010).

Milligan (2006) has supported this argument and emphasized that one has to make some alterations in the healthcare educations in order to make significant moves towards the patient safety culture. Furthermore, in the process of caring and treatment of the patient, there are a number of errors that Milligan has identified, which have made the improvement in patient safety top international priority. Milligan's approach to highlighting the importance of patient safety culture included a brief descriptive agenda on the patient safety measures and analysis of human factor theory along with its utilization in the critical industries such as aviation. The relevance of human factor theory to the health care education was also identified when the frequent errors in drug administration occurred in the data collection process (Milligan, 2006).

In his Meta-analysis, Dalton (2008) extracted the literature from the ERR human publications by the Institute of Medicine (IOM) on the awareness of the injuries that patients suffer in the hospitals within the United States of America. Dalton (2008) asserted that execution of cultural safety in every health care facility should be included as a top priority in order to improve the patient safety structures and procedures that currently exist. This in turn will also reduce the incidences of medical errors. Another important approach highlighted by Dalton (2008)...

Another effective and durable relief approach from dire and fatal medical malpractice crises can include the design and implementation of a medical culture focused on performance and delivery of quality. This can then serve as the basis for the continued betterment in the safety of the patients. For execution of these cultures, health policy makers need to design policies and principles that encourage and motivate the hospital staff and executives to implement the safety structures within their institutions (Dalton, Samaropoulos, Dalton, 2008)
While most researchers have been busy developing and testing PSC models and metrics, few have paid attention to the viewpoints of healthcare consumers, i.e. patients and how they are the driving force behind the paradigm shift taking place in healthcare education. For instance, Attree and his colleagues (2007) found that patients based in UK, have been prioritizing patient safety as one of the major keys of motivation towards choosing a healthcare plane and hospital. Furthermore, the researchers assert that the education structures are playing a critical role in the development of the knowledge, expertise and attitude that promote the concept of patient safety culture in healthcare institutions. They conclude that facts are inadequate on the subject of patient safety in healthcare professional curricula and organizational development of safety practices. (Attree, Cooke and Wakefield, 2007).

When considering other studies focusing on the patient safety structures adopted within the United States, research indicates that the U.S. hospitals are getting more responsible in matters related to the reduction of medical errors and patient safety. Furthermore, according to the published report of the Institute of Medicine, the patient's safety has become the main motive behind the numerous changes in the healthcare organizational structures currently being adopted within U.S. hospitals (Institute of Medicine, 2000, 2001).

As mentioned above problems in health care due to medical errors, and ways to recuperate from the health care delivery has been the main objective of quite a few researches in the past (Stelfox, Palmisani, Scurlock, Orav and Bates, 2006). Once such research includes the one conducted by Stocka and colleagues (2007) where in the 1st report they asserted that the ratio of approx 98,000 deaths per annum, in the hospitals of U.S., had been a steadily increasing number with every passing year. Moreover, researchers suggested that the amount of deaths could have been prevented by 58% if the patient safety culture was better implemented. However, these reports admit that the efforts for patient safety system improvement would have to be resolute involvement from patients to policy makers. Besides that new patient safety standards had also been put forward by Joint Commission on Accreditation of Healthcare Organization that had a condition for all unexpected medical results to be anticipated and notified as potential results before healthcare plans are executed for any and all patients (Stocka, McFaddena and Gowen III, 2007).

Bibliography

Attree, M., Hannah Cooke, H. And Wakefield, a. (2008). Patient safety in an English pre-registration nursing curriculum. Nurse Education in Practice 8, 239 -- 248.

Bonner, a.F. (2008). Certified Nursing Assistants' Perceptions of Nursing Home Patient Safety Culture: Is There a Relationship to Clinical or Workforce Outcomes?: A Dissertation. Graduate School of Nursing, University of Massachusetts Worcester. GSN Dissertations.

Carayon, P. (2010). Human factors in patient safety as an innovation. Applied Ergonomics 41, 657 -- 665.

Carroll J.S. And Quijada, M.A. (2004). Redirecting traditional professional values to support safety: changing organisational culture in health care. Qual Saf Health Care, 13: ii16-ii21.

Castle, J.E. (2003). Maximizing Research Opportunities: Secondary Data Analysis. Journal of Neuroscience Nursing, 35(5), 287-290. Taken from: Bonner, Certified Nursing Assistants' Perceptions of Nursing Home Patient Safety Culture: Is There a Relationship to Clinical or Workforce Outcomes?: A Dissertation. Graduate School of Nursing, University of Massachusetts Worcester. GSN Dissertations.

Castle, N.G., & Sonon, K.E. (2006). A culture of patient safety in nursing homes. Quality and Safety in Health Care, 15(6), 405-408. Taken from: Bonner, Certified Nursing Assistants' Perceptions of Nursing Home Patient Safety Culture: Is There a Relationship to Clinical or Workforce Outcomes?: A Dissertation. Graduate School of Nursing, University of Massachusetts Worcester. GSN Dissertations.

Dalton, G.D., Samaropoulos, X.F. And Dalton, a.C. (2008). Improvements in the safety of patient care can help end the medical malpractice crisis in the…