Patient safety culture at the unit level of a tertiary hospital in South Africa: a survey study

Submitted: 16 May 2022
Accepted: 3 July 2022
Published: 28 April 2023
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  • Veena Abraham Department of Pharmaceutical Sciences, School of Pharmacy, Sefako Makgatho Health Sciences University, Medunsa, South Africa.
  • Johanna Meyer Department of Public Health Pharmacy and Management, School of Pharmacy, Sefako Makgatho Health Sciences University, Medunsa, South Africa.
  • Brian Godman Department of Public Health Pharmacy and Management, School of Pharmacy, Sefako Makgatho Health Sciences University, Medunsa, South Africa; Strathclyde Institute of Pharmacy and Biomedical Sciences, Strathclyde University, Glasgow, United Kingdom; Center of Medical and Bio-Allied Health Sciences Research, Ajman University, United Arab Emirates.
  • Elvera Helberg Department of Public Health Pharmacy and Management, School of Pharmacy, Sefako Makgatho Health Sciences University, Medunsa, South Africa.

Background. Patient safety research is scarce in developing countries. Estimates of patient harm due to healthcare processes in resource-poor settings are thought to be greater than those in developed countries. Ideally, errors in healthcare should be seen as opportunities to improve the future quality of care.
Objective. This study aimed to investigate patient safety culture within high-risk units of a tertiary hospital in South Africa.
Methods. A quantitative, descriptive, cross-sectional methodology, using a survey questionnaire that measured 10 safety dimensions and one outcome measure among clinical and nursing staff, was employed.
Results. Two hundred participants completed the survey questionnaire. Areas of strength identified by the participants included organizational learning (91.09%), staff attitudes (88.83%), and perceptions of patient safety (76.65%). Dimensions that have potential for improvement included awareness and training (74.04%), litigation (73.53%), feedback and communication about errors (70.77%), non-punitive response to error reporting (51.01%), size and tertiary level of the hospital (53.76%), and infrastructure and resources (58.07%). The only dimension identified as weak was teamwork and staffing (43.72%). In terms of the patient safety grade, respondents graded their own units highly but graded the hospital as a whole as having a poor patient safety grade.
Conclusion. There are still significant gaps in the quality of care provided at this tertiary hospital. The current patient safety culture is perceived as punitive in nature with regard to reporting adverse events. It is advised that targeted patient safety improvements be made, followed by further investigation.

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