Patient safety culture in South America: a cross-sectional study

Abstract

BackgroundEvery year, millions of patients suffer injuries or die due to unsafe and poor-quality healthcare. A culture of safety care is crucial to prevent risks, errors and harm that may result from medical assistance. Measurement of patient safety culture (PSC) identifies strengths and weaknesses, serving as a guide to improvement interventions; nevertheless, there is a lack of studies related to PSC in Latin America.AimTo assess the PSC in South American hospitals.MethodsA multicentre international cross-sectional study was performed between July and September 2021 by the Latin American Alliance of Health Institutions, composed of four hospitals from Argentina, Brazil, Chile and Colombia. The Hospital Survey on Patient Safety Culture (HSOPSC V.1.0) was used. Participation was voluntary. Subgroup analyses were performed to assess the difference between leadership positions and professional categories.ResultsA total of 5695 records were analysed: a 30.1% response rate (range 25%–55%). The highest percentage of positive responses was observed in items related to patient safety as the top priority (89.2%). Contrarily, the lowest percentage was observed in items regarding their mistakes/failures being recorded (23.8%). The strongest dimensions (average score ≥75%) were organisational learning, teamwork within units and management support for patient safety (82%, 79% and 78%, respectively). The dimensions ‘requiring improvement’ (average score <50%) were staffing and non-punitive responses to error (41% and 37%, respectively). All mean scores were higher in health workers with a leadership position except for the hospital handoff/transitions item. Significant differences were found by professional categories, mainly between physicians, nurses, and other professionals.ConclusionOur findings lead to a better overview of PSC in Latin America, serving as a baseline and benchmarking to facilitate the recognition of weaknesses and to guide quality improvement strategies regionally and globally. Despite South American PSC not being well-exploited, local institutions revealed a strengthened culture of safety care.

Patient Safety Culture from a Nursing Perspective in a Chilean Hospital

“…No other study in Latin America uses version 2.0 of the HSOPS adapted to its country’s population. This converges with what was expressed in a study published in 2023 by Pedroso and collaborators [ 25 ], which highlights the importance of advancing the implementation of permanent measurements of this area in public health. Most of the discussions in Latin America are carried out by studies that applied version 1.0 of the HSOPS instrument, which was later refined to a reduced number of items and categories in version 2.0.…”

“…With the above, we see the need to reinforce how teams deal with possible errors. These results coincide with a multicenter study in South America [ 25 ], emphasizing teamwork as an item valued positively with the highest scores.…”

“…Thus, the staff valued communication positively. However, questions linked to an authority presented lower values, which reaffirms the “fear” of authority seen in countries in Latin America, which is often caused by job insecurity and the fear of losing one’s job [ 25 ].…”