Assessment of Patient Safety Culture in Primary Healthcare Services in Alexandria, Egypt

Abstract

Background: Patient safety is a critical component of healthcare quality. This study aimed at assessing the perceptions of primary healthcare staff members about patient safety culture and explores the areas of deficiency and opportunities for improvement concerning this issue.

Methods: This descriptive cross sectional study surveyed 328 staff members in 28 primary healthcare facilities in Alexandria using an anonymous direct structured interview format of a modified “Hospital Survey on Patient Safety Culture” adopted questionnaire. The total number of respondents was 250 participants (response rate = 76.2%). The main outcome measures include patient safety culture score including sub scores on 12 dimensions and 42 items; patient safety grade, number of events reported and factors contributing to the adverse events.

Results: The overall median% score for perception of patient safety culture at the facility level was 68.6%. After controlling of the confounders; being female respondent, being physicians or nurses or midwives, having long experience in PHC service and receiving education and training about safety issues were positively associated with positive response on patient safety culture scale. The domains with the highest positive score and are thus considered areas of strength were teamwork within units (80.0%), management support for patient safety (80.0%), supervisor expectations and actions promoting patient safety (75.0%) and handoffs and transitions (75.0%). Dimensions scoring the lowest and as such can be considered areas requiring improvement were overall perceptions of patient safety, frequency of events reported and staffing (60% give positive response for each). More than two-fifths (43.6%) did not report any events in the 12 months preceding the survey. The difference between professions regarding the most common procedure that causes adverse event is statistically significant. Patients' related factors such as ignorance and socio cultural acceptance were reported to be the most common factors contributing to the adverse events (92.4% of the studied participants reported that).

Conclusions: Improving patient safety culture should be a priority among health center administrators. Healthcare staff should be encouraged to report errors