Patient safety culture in primary health care: Medical office survey on patient safety culture in a Brazilian family health strategy setting

Patient safety climate research in primary care dentistry: A systematic scoping review

BACKGROUND

Patient safety climate constitutes an important element for quality improvement. Its current evidence base has been generated in hospital settings in developed countries. Studies in dentistry are limited.

OBJECTIVE

To systematically explore the evidence regarding assessing patient safety climate in dentistry.

METHODS

We developed a search strategy to explore MEDLINE, SCOPUS, and Web of Science databases from January 1st, 2002, to December 31st, 2022, to include observational studies on patient safety culture or patient safety climate assessment. Methodological features and item data concerning the dimensions employed for assessment were extracted and thematically analyzed. Reported scores were also collected.

RESULTS

Nine articles out of 5584 were included in this study. Most studies were generated from high-income economies. Our analysis revealed methodological variations. Non-randomized samples were employed (ranging from 139 to 656 participants), and response rates varied from 28% to 93.7%. Three types of measurement instruments have been adapted to assess patient safety climate. These mainly consisted of replacing words or rewording sentences. Only one study employed an instrument previously validated through psychometric methods. In general, patient safety climate levels were either low or neutral. Only one study reported scores equal to or greater than 75.

DISCUSSION

Despite diverse assessment tools, our two-decade analysis reveals a lag compared with medicine, resulting in methodological variations for assessing patient safety climate. Collaboration is vital to elevate standards, prioritize patient safety across oral healthcare services, and advocate for integrating safety climate into local and national quality and patient safety strategies.

Assessment of patient safety culture in Moroccan primary health care: a multicentric study

BACKGROUND

Promoting patient safety is a critical concern for developing-countries health systems like Morocco. There is an increasing acknowledgment of the need to create a patient-centered culture with the aim to decrease the number of adverse events related to care and improve health-care quality in Morocco.

OBJECTIVE

The purpose of this study is to examine the perceptions of health professionals working in primary care level of care facilities in Morocco about the concept of patient safety culture.

METHODS

We conducted a multicentric cross-sectional study of a quantitative nature in primary healthcare facilities in ten Moroccan cities, measuring ten patient safety culture dimensions, from February 2022 to June 2022. Data was collected using the French version of the HSOPSC questionnaire.

RESULTS

The most developed dimension of the culture of patient safety was found to be Teamwork within Units (69%), followed by Supervisor/Manager's Expectations & Actions Promoting Patient Safety (59%). The least developed dimensions were Staffing (34%) and Nonpunitive Response to Errors (37%).

CONCLUSION

Improving patient safety culture should be a priority for primary healthcare facility administrators and all stakeholders, addressing, in particular, the shortage of human resources. In addition, health personnel should be encouraged to report errors without fear of punitive consequences.

Perception Of Patient Safety Culture At The Primary Care Level: The Case Of The Community Health Centre Ljubljana

Background

Patient safety is a crucial element of quality healthcare, and endeavours to enhance it are vital for attaining universal health coverage and improving patient outcomes. This study aimed to evaluate the perception of patient safety culture among staff at the Community Health Centre Ljubljana (CHCL).

Methods

A cross-sectional study was conducted in December 2022. All CHCL staff (N=1,564) from different professional groups were invited to participate in an anonymous electronic survey using the validated Slovenian version of the "Medical Office Survey on Patient Safety Culture" (MOSPSC). Mean percent positive scores for all items in each composite were calculated.

Results

The final sample included 377 participants (response rate, 24.1%), most of whom were women (91.5%, N=345) with different professional profiles. The mean age of the participants was 44.5 years (SD 11.1) with a mean work experience of 20.1 years (SD 12.1). The percentage of positive overall MOSPSC composite scores was 59.6%. A strong patient safety culture perception was identified in the following dimensions: Information exchange with other settings (93.5%), Organisational learning (90.2%), List of patient safety and quality issues (88.1%), Patient care tracking/follow-up (76.2 %) and Teamwork (75.0%). Weak patient safety culture was identified in the dimensions of Work pressure and pace (10.7%), Leadership support for patient safety (27.1%), Communication openness (40.9%), Office processes and standardisation (48.2%) and Overall ratings on quality and patient safety (49.4%).

Conclusions

CHCL leadership should address weaknesses, redesign processes, and implement strategies to reduce patient safety incidents. Establishing a just culture that encourages employees to report errors fosters transparency and facilitates learning from errors.

Patient Safety Perception Within Hospitals: An Examination of Job Type, Handoffs and Information Exchange, and Hospital Management Support

OBJECTIVES

The study has 3 aims: (1) to assess to what extent a person's job role relates to their evaluation of patient safety in the hospital setting; 2) to identify the relationship from hospital management aspects, including level of organizational learning-continuous improvement, level of management support, and level of leader support to patient safety perception in the hospital setting; and 3) to examine the relationship between the rating of the ease of information exchange and clinical handoffs and perceived patient safety in the hospital setting.

METHODS

This study used a publicly available, deidentified cross-sectional data set from the 2021 Agency for Healthcare Research and Quality's Survey on Patient Safety Culture Hospital Survey 2.0. Welch's analysis of variance and multiple linear regression were used to examine each factor's impact on patient safety rating.

RESULTS

Supervisors had a higher ( P < 0.001) patient safety perception than people in other job types, whereas nurses had a lower ( P < 0.001) patient safety perception than other job types. Level of organizational learning-continuous improvement ( P < 0.001), level of hospital management ( P < 0.001), level of leader support ( P < 0.001), and ease of handoffs and information exchange ( P < 0.001) were positively related to perceived patient safety.

CONCLUSIONS

This study highlights the importance of identifying the unique issues affecting nurses and supervisors, different from other job types, that may explain their lower patient safety ratings. Findings from this study suggest that it is critical for organizations to focus on initiatives and policies that promote leadership, management, ease in information exchange and handoffs, and continuous learning.

Professional burnout and patient safety culture in Primary Health Care

OBJECTIVES

to analyze the association between the risk of occupational exhaustion (burnout) and safety culture in Primary Health Care.

METHODS

ross-sectional study conducted in 18 Primary Health Care Units in the Northeast of Brazil. Three questionnaires were used: sociodemographic, Maslach Burnout Inventory, and the Medical Office Survey on Patient Safety Culture. The study was approved by the Research Ethics Committee.

RESULTS

seventy-eight healthcare workers participated, of which 64.1% presented a reduced risk of burnout; and 11.5%, a high risk (p=0.000). The following were identified as weakened dimensions of safety culture: Work pressure and pace; Owner, managing partners, leadership support; Overall ratings on quality; and Overall rating on patient safety.

CONCLUSIONS

an association was found between low risk of developing burnout syndrome and positive evaluation of safety culture.

Factors Affecting Patient Safety Culture from Nurses’ Perspectives for Sustainable Nursing Practice

Individual and group beliefs, attitudes, perceptions, competences, and behavioral patterns all contribute to the safety culture of a healthcare company. The study’s goal is to assess nurses’ perceptions of elements that influence patient safety culture in order to promote long-term nursing practice. A descriptive cross-sectional study design was done among a sample of 146 nurses who were recruited from one hospital in Egypt. They completed a self-administered, printed questionnaire. The questionnaire assessed participants’ socio-demographic data and their perception regarding patient safety culture for sustainable nursing practices. The findings revealed that nursing staff had a high perception regarding patient safety culture a with mean score (159.94 ± 7.864). Also, the highest percentage (74.66%) of had no safety events reported yearly. Creating a unit-specific patient safety culture suited to the competences of the unit’s RNs in patient safety practice would be crucial to increasing and sustaining high levels of patient safety attitudes, skills, and knowledge among the unit’s RNs, influencing patient safety. When implementing interventions to promote patient safety and reporting culture in hospitals, policymakers, hospital administrators, and nurse executives should take the current findings into account. A multidimensional network intervention addressing many elements of patient safety culture and integrating different organizational levels should be implemented to enhance patient safety and a no-blame culture.