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

Abstract

Background. Patient safety research is scarce in developing countries. Estimates of patient harm due to the processes of healthcare 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. Objectives. To investigate the patient safety culture within high-risk units of a tertiary hospital in South Africa Methods. Quantitative, descriptive, cross-sectional methodology using a survey questionnaire which measured 10 safety dimensions and one outcome measure among clinical and nursing staff. Results. Two hundred participants completed the survey questionnaire. Areas of strength identified by the participants included organisational learning (91.09%), staff attitudes (88.83%) and perceptions on patient safety (76.65%). Dimensions which have the 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 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 regards to reporting adverse events. It is recommended that targeted efforts to improve patient safety are urgently implemented, and followed-up with future research.