Although the amount of workforce with migration background in German healthcare institutions is rising, there is only little known about the influence of heterogeneity on patient safety and what kind of competencies employees in heterogeneous teams need to adequately handle the cultural diversity of their co-workers to ensure a safe working environment.

The study “The Influence of Diversity/Heterogeneity on Patient Safety” is part of the main project “Gestaltungskompetenz as an Innovator for Highly Reliable Organisations in the Healthcare System”. Aim of the study is to identify competencies that enable the workforce to deal with heterogeneity between employees and thereafter use the knowledge to develop an interactive learning environment to train the workforce. Thereby, next to reactive, especially proactive approaches for patient safety will be used. Consequently, the research question of this study is:

“Which competencies do employees of heterogeneous teams (in the sense of cultural sensitivity) need to create a safety culture in hospitals and how can these competencies be facilitated?”

To identify problem areas and a potential demand for competencies of workforce in healthcare institutions, a CIRS data analysis was conducted. The analysis revealed that especially communication demonstrated a challenge for cultural diversity between employees. Further, communication problems led to a change in the working structure and execution and thereby threatened the safety of patients. Additionally, conflicts on a personal level emerged due to misunderstandings.

Focus groups with students

Three focus groups with in total eleven students from nursing and health science from the University Osnabrueck were conducted from January to February 2019. In the following a deductive-inductive category formation was largely carried out based on the qualitative content analysis of Mayring, which resulted in ten categories. The focus groups identified the category “communication” as a central competence regarding the adequate dealing of cultural diversity in heterogenous teams. Further, categories such as “openness”, “interest”, 2acceptance”, “prejudice”, 2empathy” and the “appreciaction towards different cultures” were inductively built and identified as potentially contributing factors for patient’s safety.

Employee survey

For the survey in total 20 interviews with 27 employees working at the cooperative clinic were conducted. Participants of the interviews came from medical, nursing and administrative areas as well as from the managerial level. An analysis of the interviews identified, that statements of the employees were almost congruent with those of the students. Next to religious rites and the understanding of the role of men and women in one’s society, especially the communication was seen as significant for the influence on aspects of patient safety. In the following, the results of the analysis of the focus groups as well as of the interviews with employees were used to develop the interactive learning management system online.

Since the 25^th of November 2019 the GIO-project is testing the online course “Cultural diversity and communication among employees” as an interactive learning management system online using the platform Moodle. The five participants first work individually on the theoretical content and start in January together with the handling of a case using the teaching method “Problem Based Learning”.