A Narrative Synthesis of Qualitative Studies Conducted to Assess Patient Safety Culture in Hospital Settings

Abstract

This review aimed to identify methodological aspects of qualitative studies conducted to assess patient safety culture (PSC) in hospital settings. Searches of Google Scholar (Google LLC, Menlo Park, California, USA), MEDLINE® (National Library of Medicine, Bethesda, Maryland, USA), EMBASE (Elsevier, Amsterdam, Netherlands), PsycINFO (American Psychological Association, Washington, District of Columbia, USA) and Web of Science (Clarivate Analytics, Philadelphia, Pennsylvania, USA) databases were used to identify qualitative articles published between 2000 and 2017 that focused on PSC. A total of 22 studies were included in this review and analysis of methodological approaches showed that most researchers adopted purposive sampling, individual interviews, inductive content and thematic analysis. PSC was affected by factors related to staffing, communication, nonhuman resources, organisation and patient-related factors. Most studies lacked theoretical frameworks. However, many commonalities were found across studies. Therefore, it is recommended that future studies adopt a mixed methods approach to gain a better understanding of PSC.Keywords: Patient Safety; Culture; Needs Assessment; Qualitative Research.

Exploring Patient Safety Culture in a Kuwaiti Secondary Care Setting

“…Interview questions were drawn from the PSC literature in the field and informed by an earlier survey conducted in the same department. 4,10 Openended questions about factors affecting PSC in the department were used to guide the discussions, with follow-up questions from the researcher to obtain a deeper understanding of the participants' views. Participants were also asked to speculate on strategies to improve PSC.…”

“…For example, a narrative synthesis of 22 qualitative and mixed methods PSC studies revealed that none had been conducted in Arab contexts. 4 Since this review, only one qualitative study in the Arab/GCC context was published. 5 This recent study explored doctors' and nurses' PSC perspectives in two public hospitals in Kuwait.…”

“…7 Patient perspectives were seldomly considered in PSC studies. 4 However, patients are at the centre of the service delivery process and are an ideal source of information on PSC. 8 Patients also see PSC from a different perspective than healthcare professionals.…”

Assessing patient safety culture in 15 intensive care units: a mixed-methods study

“…PSC assessment is a critical first step towards optimizing PSC in healthcare settings [ 12 , 13 ]. It enables for the identification of key strengths and weaknesses, as well as the adoption of initiatives that promote safe care with the goal of improving patient outcomes, minimizing avoidable healthcare-related damages, and prioritizing patient safety [ 7 ].…”

“…The vast majority of PSC studies have used quantitative methods, which are advantageous since they are cost-effective, time-efficient, and enable direct comparisons between results of different contexts [ 13 ]. Despite the relevance and importance of these research, questionnaires do not provide a complete image and an understanding of why specific responses are given [ 2 , 13 ].…”