Contributive factors for the consolidation of patient safety culture in the hospital environment

Andréia Heidmann,Letícia Flores Trindade,Marli Maria Loro,Adriane Cristina Bernat Kolankiewicz,Rosane Teresinha Fontana,Catiele Raquel Schmidt

doi:10.1590/2177-9465-ean-2019-0153

Abstract

ABSTRACT Objective: To understand the contributing factors for the consolidation of the patient safety culture, from a management perspective, in an accredited hospital. Method: A qualitative study developed in a hospital institution of size IV, accredited by the National Accreditation Organization as level II, located in the northwest region of the State of Rio Grande do Sul/Brazil. The inclusion criteria were the following: having been in the leadership position of the institution for over a year and actively participating in the accreditation process. Leaders on vacation or absent due to illness in August 2018 were excluded. The collection was performed using the Focus Group technique in August 2018. Data were explored by thematic analysis. Results: The group reported teamwork, professional appreciation, management support, implementation of protocols, professional satisfaction, and working conditions as factors that contributed to the consolidation of the safety culture. Conclusions and implications for practice: The identified factors allowed for a cultural change in the institution through participatory management in processes and results that encourage workers to assume significant roles in advancing patient safety by assimilating and taking responsibility for change, which plays a crucial role in developing safe care.

Highlights

Patient Safety (PS) is a topic discussed worldwide and is essential for improving the quality of health services
Conclusions and implications for practice: The identified factors allowed for a cultural change in the institution through participatory management in processes and results that encourage workers to assume significant roles in advancing patient safety by assimilating and taking responsibility for change, which plays a crucial role in developing safe care
Important initiatives have been taken since such as the creation of the World Alliance for Patient Safety, called the Patient Safety Program,[2] the elaboration of Global Challenges for PS by the World Health Organization (WHO),[3] the creation of strengthening networks such as the International Nursing and Patient Safety Network (Rede Internacional de Enfermagem e Segurança do Paciente, RIENSP) in 20054 and the Brazilian Network of Nursing and Patient Safety (Rede Brasileira de Enfermagem e Segurança do Paciente, REBRAENSP) created in 2008;5 common among the initiatives is the goal of reducing health care-related adverse events (AEs) and providing safe care

Summary

Introduction

Patient Safety (PS) is a topic discussed worldwide and is essential for improving the quality of health services. In Brazil, the framework of the discussions took place in 2013, with the launch of the National Patient Safety Program (Programa Nacional de Segurança do Paciente, PNSP), published through Ordinance No 529, which has to oversee and monitor AEs in health care as one of the strategies.[6] in the same year, Collegiate Board Resolution (Resolução da Diretoria Colegiada, RDC) No 36 was published, which establishes actions for PS and defines safety culture as a set of values, attitudes and behaviors that determine commitment to health and safety management, replacing the punishment for the opportunity to learn from failures and improve health care[7]. It is understood that a punitive culture does not encourage prevention and has negative consequences such as concealment of errors. It is necessary to evaluate and make a fair culture viable, characterized by greater transparency in health care.[8]

Methods

Results

Conclusion