Academic journal article Iranian Journal of Public Health

Patient Safety Culture Based on Medical Staff Attitudes in Khorasan Razavi Hospitals, Northeastern Iran

Academic journal article Iranian Journal of Public Health

Patient Safety Culture Based on Medical Staff Attitudes in Khorasan Razavi Hospitals, Northeastern Iran

Article excerpt


Background: Since establishing a safety culture in an organization is considered as the first step in patient safety improvement, there is always a need for updated field evaluation to better plan future decisions.

Methods: We performed a cross-sectional, analytic-descriptive study in 25 hospitals related to Mashhad University of Medical Sciences (MUMS) during a 3-month period from April to June 2012. A questionnaire, designed by previous patient safety culture studies with confirmed validity and reliability, was used and distributed among a sample of 922 staff, chosen randomly from the mentioned hospitals. Data were analyzed by SPSS software version 16.

Results: "Organizational learning - continuous improvement" and "teamwork within unit" had the highest percentage of positive results as 79.85 ± 12.03% and 71.92 ± 17.08%, respectively; whereas "non-punitive response" to errors (21.57 ± 6.42) and "staffing" ( 26.36 ± 16.84) came out as the least important factors. There were no meaningful statistical relation between general features of die understudy hospitals including die number of beds, educational level or proficiency status widi die general safety culture score.

Conclusion: Most of the safety culture aspects were reported as low to moderate in terms of importance. If something needs to be modified interventionally in this respect, "the approach to confront errors" would be a wise choice. This could be achieved by establishing an atmosphere of open communication and continuous learning dirough elimination of die fear for reporting errors and installing a more acceptable approach in hospitals.

Keywords: Safety culture, Adverse events, Patient safety, Hospital


Patient safety is one of the key elements in healthcare systems, which has turned into an im- portant priority for most of such organizations all around the world through the recent decades (1-4). Patient safety means preventing unwanted events or accidents that might happen during the time period of providing healthcare services for pa- tients (5). These mostly preventable events - hap- pening repeatedly - put a considerable financial burden on healthcare units, needless to mention the drawbacks of each death they bring (6-8). The American Institute of Medicine (IOM) report "to err is human" made healthcare and therapeutic service providing organizations improve patient safety (9) and in order to do so, the British Na- tional Patient Safety Agency introduced "safety culture establishment" as the first step in its 7-step model (10). Being a subdivision of the general cul- ture of an organization, safety culture arises from attitudes, viewpoints, value perceptions and be- havioral patterns of people within work units which determine the style and the proficiency of health care management and organizational safety (11, 12). It was firstly announced in the Chernobyl disaster report in 1986 (13) and many high risk industries such as aviation or nuclear corporations started investigations on the definition and evalua- tion of safety culture as a pathway to decrease the risk of unwanted events and accidents (14). Healthcare is considered to be a high risk industry based on the morbidity and mortality it is involved in; therefore healthcare providing organizations should establish a safety culture among their staff in consistent with the efforts they make to im- prove patient safety (15, 16). Indeed communica- tions based on a bilateral trust, common percep- tions of safety importance and faith in the effi- ciency of preventive methods are counted as the major characteristics for safety culture beholder organizations (17, 18).

In order to change a safety culture within an or- ganization, it should first be understood properly and this could not be achieved unless an appropri- ate safety culture evaluation is performed which helps the organization to better perceive its strength or weakness points. Besides, it makes an ideal opportunity for hospitals to detect their dif- ferent aspects and it would be a reliable scale for comparisons with other hospitals or performing research studies. …

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