Patient safety culture in South America: a cross-sectional study.
healthcare quality improvement
patient safety
safety culture
Journal
BMJ open quality
ISSN: 2399-6641
Titre abrégé: BMJ Open Qual
Pays: England
ID NLM: 101710381
Informations de publication
Date de publication:
10 2023
10 2023
Historique:
received:
24
03
2023
accepted:
13
09
2023
medline:
10
10
2023
pubmed:
7
10
2023
entrez:
6
10
2023
Statut:
ppublish
Résumé
Every 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. To assess the PSC in South American hospitals. A 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. A 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. Our 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.
Sections du résumé
BACKGROUND
Every 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.
AIM
To assess the PSC in South American hospitals.
METHODS
A 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.
RESULTS
A 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.
CONCLUSION
Our 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.
Identifiants
pubmed: 37802541
pii: bmjoq-2023-002362
doi: 10.1136/bmjoq-2023-002362
pmc: PMC10565275
pii:
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Informations de copyright
© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.
Déclaration de conflit d'intérêts
Competing interests: None declared.
Références
West J Nurs Res. 2019 Feb;41(2):279-304
pubmed: 29243563
Rev Esc Enferm USP. 2015 Feb;49 Spec No:123-30
pubmed: 26761702
Rev Bras Enferm. 2019 Jun 27;72(3):767-773
pubmed: 31269144
Rev Esc Enferm USP. 2021 Jul 16;55:e03754
pubmed: 34287484
Rev Bras Enferm. 2020;73(5):e20190576
pubmed: 32667406
BMC Health Serv Res. 2021 Oct 6;21(1):1057
pubmed: 34610823
J Nurs Manag. 2022 Jan;30(1):135-143
pubmed: 34498335
Med J Islam Repub Iran. 2015 Aug 23;29:251
pubmed: 26793642
BMC Health Serv Res. 2023 Jan 14;23(1):32
pubmed: 36641474
Int J Environ Res Public Health. 2022 Feb 16;19(4):
pubmed: 35206429
J Public Health Res. 2013 Dec 01;2(3):e32
pubmed: 25170503
Epidemiol Serv Saude. 2017 Jul-Sep;26(3):455-468
pubmed: 28977171
Rev Gaucha Enferm. 2019;40(spe):e20180198
pubmed: 30970102
BMJ Qual Saf. 2013 Jan;22(1):11-8
pubmed: 22849965
BMC Nurs. 2020 Apr 13;19:23
pubmed: 32308560
Sao Paulo Med J. 2019 Jul 22;137(3):216-222
pubmed: 31340252
Healthcare (Basel). 2022 Jul 30;10(8):
pubmed: 36011091
J Nurs Scholarsh. 2010 Jun;42(2):156-65
pubmed: 20618600
Rev Bras Enferm. 2020 Jul 01;73(5):e20190174
pubmed: 32609212
Front Public Health. 2022 Jul 12;10:889870
pubmed: 35903386
Int J Qual Health Care. 2018 Nov 01;30(9):660-677
pubmed: 29788273
Rev Esc Enferm USP. 2016 Sep-Oct;50(5):756-762
pubmed: 27982393
Rev Gaucha Enferm. 2020;41(spe):e20190171
pubmed: 32401859
ScientificWorldJournal. 2018 Jul 19;2018:9156301
pubmed: 30104917
Int J Risk Saf Med. 2023;34(1):5-19
pubmed: 36442211
BMC Health Serv Res. 2021 Oct 28;21(1):1171
pubmed: 34711235
J Nurs Adm. 2014 Oct;44(10 Suppl):S27-37
pubmed: 25279509
Rev Lat Am Enfermagem. 2021 Jun 28;29:e3461
pubmed: 34190951
Rev Lat Am Enfermagem. 2018 Aug 09;26:e3014
pubmed: 30110092
Health Serv Res. 2009 Apr;44(2 Pt 1):399-421
pubmed: 19178583
Int J Environ Res Public Health. 2022 Jan 14;19(2):
pubmed: 35055760
Rev Lat Am Enfermagem. 2019 Aug 19;27:e3167
pubmed: 31432920
BMJ. 2000 Mar 18;320(7237):768-70
pubmed: 10720363
Int J Environ Res Public Health. 2020 Mar 19;17(6):
pubmed: 32204403
Jt Comm J Qual Patient Saf. 2022 Jun-Jul;48(6-7):343-353
pubmed: 35715018
BMJ Open. 2019 Sep 4;9(9):e026896
pubmed: 31488465
J Clin Epidemiol. 2008 Apr;61(4):344-9
pubmed: 18313558
BMJ Open. 2017 Feb 24;7(2):e013487
pubmed: 28237956
Int J Nurs Stud. 2020 Jan;101:103446
pubmed: 31670220
J Radiol Nurs. 2022 Jun;41(2):74-75
pubmed: 35431684
Rev Bras Enferm. 2021 Aug 20;74(6):e20201315
pubmed: 34431940
J Biomed Inform. 2019 Jul;95:103208
pubmed: 31078660
BMC Health Serv Res. 2016 Jun 17;16:199
pubmed: 27316921
Rev Bras Enferm. 2023 Feb 03;76Suppl 1(Suppl 1):e20220280
pubmed: 36753126
BMJ Qual Saf. 2014 Jul;23(7):556-64
pubmed: 24351971
PLoS One. 2019 Jun 24;14(6):e0218756
pubmed: 31233543
BMJ Qual Saf. 2022 Jul;31(7):479-482
pubmed: 34625485
Ann Intern Med. 2013 Mar 5;158(5 Pt 2):369-74
pubmed: 23460092
Cien Saude Colet. 2018 Jan;23(1):161-172
pubmed: 29267821
Gac Sanit. 2017 Sep - Oct;31(5):423-426
pubmed: 28318758
J Immigr Minor Health. 2022 Dec;24(6):1398-1407
pubmed: 35076802
BMJ Lead. 2023 Jun;7(2):91-95
pubmed: 37200171
Int J Environ Res Public Health. 2022 Nov 03;19(21):
pubmed: 36361273
Int J Environ Res Public Health. 2021 Mar 03;18(5):
pubmed: 33802265
Rev Esc Enferm USP. 2018 Nov 01;52:e03379
pubmed: 30403268