Measuring the patient safety culture at a tertiary care hospital in Pakistan using the Hospital Survey on Patient Safety Culture (HSOPSC)

Abstract

BackgroundPatient safety is a top priority for many healthcare organisations worldwide. However, most of the initiatives aimed at the measurement and improvement of patient safety culture have been undertaken in developed countries. The purpose of this study was to measure the patient safety culture at a tertiary care hospital in Pakistan using the Hospital Survey on Patient Safety Culture (HSOPSC).MethodsThe HSOPSC was used to measure the patient safety culture across 12 dimensions at Aga Khan University Hospital, Karachi. 2,959 individuals, who had been working at the hospital, were administered the HSOPSC in paper form between June and September 2019.ResultsThe response rate of the survey was 50%. In the past 12 months, 979 respondents (33.1%) had submitted at least one event report. Results showed that the personnel viewed the patient safety culture at their hospital favourably. Overall, respondents scored highest in the following dimensions: ‘feedback and communication on error’ (91%), ‘organisational learning and continuous improvement’ (85%), ‘teamwork within units’ (83%), ‘teamwork across units’ (76%). The dimensions with the lowest positive per cent scores included ‘staffing’ (40%) and ‘non-punitive response to error’ (41%). Only the reliability of the ‘handoffs and transitions’, ‘frequency of events reported’, ‘organisational learning’ and ‘teamwork within units’ was higher than Cronbach’s alpha of 0.7. Upon regression analysis of positive responses, physicians and nurses were found to have responded less favourably than the remaining professional groups for most dimensions.ConclusionThe measurement of safety culture is both feasible and informative in developing countries and could be broadly implemented to inform patient safety efforts. Current data suggest that it compares favourably with benchmarks from hospitals in the USA. Like the USA, high staff workload is a significant safety concern among staff. This study lays the foundation for further context-specific research on patient safety culture in developing countries.

Assessment of Patient Safety Culture Among Nurses Working at Tertiary Care Hospitals in Aljouf Region, Saudi Arabia

“…For a positive patient safety culture, a blame-free, fear-free, and error-reporting environment should be imposed. This finding was in agreement with other studies in India, Saudi Arabia, Pakistan, and Afghanistan [19,[22][23][24][25].…”

“…This workload causes chronic fatigue, increasing the possibility of errors and side effects on patient safety. This was consistent with previous studies that reported low scores in the staffing dimension [22,24,25].…”

“…As the patient is often treated by several specialists in multidisciplinary healthcare facilities, cooperation and open communication should be practiced across all units. This result was the same in a tertiary care hospital in Pakistan [24].…”

Assessment of Patient Safety in a Low-Resource Health Care System: Proposal for a Multimethod Study

“…Studying the incidence and prevalence of AEs within a health system is an effective way to gauge the status of patient safety. Historically, this has been achieved using incident reporting systems and retrospective chart reviews to record error prevalence [ 32 , 33 ], health consumer and provider surveys [ 19 , 23 , 34 ], and by studying medical litigation cases [ 35 ]. There is a considerable amount of literature from high-income countries that highlights the incidence and impact of AEs in health care [ 2 , 27 , 36 ], however, the same is not true for LMICs [ 5 ].…”

“…LMICs can greatly benefit from initiatives like the Global Patient Safety Collaborative and PSFHF and from using tools such as the HSOPSC and HCAHPS, to perform comprehensive risk assessments of their hospitals, deliver patient safety education and training, establish a culture of safety, and expand the capacity for patient safety within their hospitals [ 23 ]. The generalizability of these standardized, validated tools makes them easily adaptable to the local context and can help evaluate patient safety standards across varying health systems.…”