Abstract

Conducting patient safety culture assessments can provide hospitals with information on how structures and processes within their system can impact patient outcomes. This study used the Hospital Survey on Patient Safety Culture (HSOPSC) to conduct an assessment of patient safety culture in public hospitals in Kuwait and benchmark against regional and international studies that utilized the same tool. This objective of this study is to examine the association between the predictors and outcomes of patient safety culture. This cross sectional study adopted a customized version of HSOPSC developed by the Agency for Healthcare Research and Quality. The survey targeted selected public hospital staff with at least one year of experience. Data was analyzed using SPSS 24 at a significance level of 0.05. Univariate analysis was utilized to obtain an overview of respondent demographics. The association between patient safety grade and the number of events reported and the remaining patient safety culture composites was analyzed using ANOVA f-test. Four regression models were constructed, two adopted Generalized Estimating Equations and the others were linear models. Results were benchmarked against similar initiatives in Lebanon, Saudi Arabia and USA. A total of 12,092 employees from 16 public hospitals in Kuwait completed the survey. The overall response rate was 60.5% (20,003 distributed surveys). Areas of strength were Teamwork within Units, Organizational Learning—Continuous Improvement, Management Support for Patient Safety, Supervisor/Manager Expectations & Actions Promoting Patient Safety, and Feedback and Communication about Error. Regression findings highlighted significant association between patient safety outcomes and composites. Benchmarking analysis revealed that Kuwaiti hospitals are performing at or better than benchmark on several composites compared to regional and international findings. This is the first major study addressing patient safety culture in public hospitals in Kuwait. Despite having some areas for improvement, public hospitals in Kuwait were found to have multiple areas of strength. Improving patient safety culture is critical if hospitals want to improve quality and safety of medical services. Study findings can guide and inform country level strategies to further improve the systems governing patient safety practices.

Highlights

  • Conducting patient safety culture assessments can provide hospitals with information on how structures and processes within their system can impact patient outcomes

  • Ali et al BMC Health Services Research (2018) 18:158 organizations have require patient safety culture assessments within their standards so that hospitals can assess and evaluate issues such as teamwork, managerial actions, support from upper administration and leadership to support patient safety, staffing challenges, reporting of incidents, and other related issues [4]. This allows healthcare organizations to develop a clearer view of the areas where they need to focus their attention as part of their efforts to strengthen patient safety culture [5]

  • The most commonly used patient safety culture survey is the Hospital Survey on Patient Safety Culture (HSOPSC) which assesses patient safety culture based on 12 dimensions: Teamwork within Units, Supervisor/ manager Expectations and Actions Promoting Patient Safety, Organizational Learning and Continuous Improvement, Management Support for Patient Safety, Overall Perceptions of Patient Safety, Feedback and Communication about Error, Communication Openness, Frequency of Events Reported, Teamwork across Units, Handoffs and Transitions, Staffing and Non punitive Response to Error [7]

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Summary

Introduction

Conducting patient safety culture assessments can provide hospitals with information on how structures and processes within their system can impact patient outcomes. Ali et al BMC Health Services Research (2018) 18:158 organizations have require patient safety culture assessments within their standards so that hospitals can assess and evaluate issues such as teamwork, managerial actions, support from upper administration and leadership to support patient safety, staffing challenges, reporting of incidents, and other related issues [4]. This allows healthcare organizations to develop a clearer view of the areas where they need to focus their attention as part of their efforts to strengthen patient safety culture [5]. The HSOPSC survey, which was developed by the Agency for Healthcare Research and Quality (AHRQ), has immense international reverberation as it has been validated and used in different continents and contexts [8]

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