Overview of Patient Safety Culture in Bosnia and Herzegovina With Improvement Recommendations for Hospitals.

Abstract

This study investigates the patient safety culture (PSC) in Bosnia and Herzegovina (BiH). We identify factors that contribute to higher patient safety and improved reporting of adverse events, thereby developing recommendations to improve PSC. The study used a correlation design based on cross-sectional surveys in the healthcare sector of BiH (N = 2617). We analyzed the correlation between 9 PSC factors, 4 background characteristics (explanatory variables), and 2 outcome variables (patient safety grade and number of events reported). We also analyzed the variance to determine perceived differences in PSC across the various staff roles in hospitals. The highest rated PSC factors were Hospital handoffs and transitions and Hospital management support for patient safety and the lowest rated factor was Nonpunitive response to error. Each of the 9 factors showed considerable potential to improve from a hospital, department, and outcome perspective. A comparison of the various employee positions shows significant differences in the PSC perceptions of managers versus nurses and doctors as well as nurses versus doctors. We found average scores for most PSC factors, leaving the considerable potential for improvement. Compared with the number of events reported and background characteristics, it is evident that PSC factors contribute significantly to patient safety. These factors are essential for the targeted development of PSC. We propose evidence-based practices as recommendations for improving patients' safety factors.