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

Abstract

Study objectives To assess the patient safety culture in Primary Health Care (PHC) setting after the transition to the Family Health Strategy (FHS) model in a Brazilian metropolitan area and compare the results between the categories of health care professionals. Methods A cross-sectional study including 246 workers from primary health care services in Federal District, Brazil. Data collection took place from October to December 2019 through the Medical Office Survey on Patient Safety Culture (MOSPSC) application. Patient safety culture was considered positive when the score was above 60%. For comparisons between the categories of health care professionals’, the ANOVA and Kruskal-Wallis test were used for composite percent positive scores, and Pearson’s chi-square or Fishers exact test for frequency and percentage of positive responses. Results The overall MOSPSC composite percent positive score was 49.9%. Among the 12 dimensions, only three showed a positive patient safety culture: Teamwork (73.1%), Organizational learning (62.9%), and Patient care tracking/follow-up (60.1%). The percentage of positive responses on overall quality assessment (78.1%) and overall patient safety assessment (78.0%) showed a positive evaluation. There was no significant difference in the composite percent positive score of overall MOSPSC (p = 0.135) and the percentage of positive responses on overall patient safety assessment (p = 0.156) between the categories of health care professionals. Overall quality assessment showed a significant difference between job roles (p < 0.001), in which nursing /health care technicians showed a significantly lower score than other job roles. Conclusion The patient safety culture assessment showed a weakness in the patient safety in the PHC services. The MOSPSC and nine of its dimensions presented a negative safety culture assessment, regardless of the high scores in the overall patient safety and quality assessments.

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

“…This could be attributed to the presence of management support for patient safety, the development of good communication between nurses and between nurses and their managers, as well as feedback about errors, nurses working as a team within hospital units, and continuous learning and improvement through attendance at training programs at both hospitals under study. This conclusion was consistent with and confirmed by Araújo et al (2022) [ 14 ], and Olsen & Leonardsen (2021) [ 21 ], who explained that the overall emphasis in quality and safety initiatives appears to be stressing features that change more at the unit level than at the hospital level. Furthermore, nurse leaders’ patient safety actions are related to how nurses evaluate their organizations and unit’s ability to provide safe patient care.…”

“…Healthcare companies’ safety culture serves as a guide for healthcare personnel to know how to behave in the workplace and what behaviors are appropriate for overcoming patient safety issues that affect patient outcomes [ 14 ]. Building a patient safety culture requires healthcare organizations to define their current safety culture, use teamwork and communication on a daily basis and in operations, understand what the leadership role is, investigate how to maintain the safety culture once established, recognize that there will be barriers along the way, and look at best practice organizations that focus on patient safety for a guide to success and profitability [ 15 ].…”

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

“…Their analysis of the U.S. Agency for Healthcare Research and Quality (AHRQ) medical office data found that people working in management roles reported higher evaluations of patient safety than all other job types. Consistent with this finding, Araújo and colleagues 3 suggested that those with nursing and health care technical roles within medical offices of primary health care services reported lower patient safety ratings compared with those with other job roles. Managers within hospital systems help organize how different job roles work together to conduct the mission of the unit.…”

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

“…Considering the majority of health care is delivered at the primary level, primary care is a critical area for patient safety research [ 20 ]. Recognizing the necessity of quantifying patient safety culture in primary care to improve patient safety, various studies have attempted to measure professionals PSC perception in this environment [ 21 ].…”