Factors Influencing Patient Safety Culture in Saudi Arabia: A Systematic Review

Abstract

ABSTRACT
 Context: Patient safety, which is concerned with preventing harm to patients, has already become a vital element of the global healthcare system. The evidence relating to the status of the patient safety culture in Arab countries suggests that it is at a sub-optimal level because of a punitive approach to errors and deficits in communications openness.
 Aim: The given review aimed to identify the relevant evidence related to factors influencing patient safety culture in Saudi Arabia hospitals from patients and health care provider perspectives.
 Methods: A systematic search was conducted in five electronic databases—MEDLINE, CINAHL, Embase, PsycINFO, and the Cochrane Database of Systematic Reviews. Related papers and reference lists of included studies were also hand-searched. One reviewer verified that the research met the inclusion criteria, assessed the research quality, and extracted their relevant features. The Yorkshire Contributory Factors Model (YCFF) was used to categorize factors influencing safety culture in the included documents.
 Results: 14 documents were included, and most research was appraised as being satisfactory to high quality. Strength and weakness factors that are influencing patient safety culture have been identified. In Saudi Arabia, ineffective leadership, a blame culture, workload/inadequate staffing, and poor communication are key factors hindering a positive patient safety culture. Conversely, 'strength' factors influencing a positive patient safety culture included good teamwork within units, realistic manager expectations and supportive actions promoting patient safety, and organizational attitudes to learning/continuous improvement. There is an absence of patient perspectives about patient safety culture in Saudi Arabian studies.
 Conclusion: In the Saudi healthcare system, policymakers should pay attention to factors that may influence a positive patient safety culture, particularly the development of a blame-free culture, improving communications and leadership ability, learning from mistakes, and involving patient perspectives in safety initiatives. Further study must understand the barriers and facilitators in Saudi Arabia Hospitals to implement a positive patient safety culture.