Assessing patient safety culture in 18 Tunisian adult intensive care units and determination of its associated factors: A multi-center study

Tlili, Mohamed Ayoub; Aouicha, Wiem; Rejeb, M Ben; Sahli, Jihène; Dhiab, Mohamed Ben; Chelbi, Souad; Mtiraoui, Ali; Laatiri, Houyem Said; Ajmi, Thouraya; Zedini, Chekib; Mallouli, Manel

doi:10.1016/j.jcrc.2020.01.001

Cited by 13 publications

(21 citation statements)

References 26 publications

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“…Health practices must be systematized, organized, and based on knowledge and experience, but they must also be updated to provide high-quality care [26]. The study by Tlili et al also supports this, demonstrating that professionals that attended patient safety training had a more developed PSC [7].…”

Section: Discussionmentioning

confidence: 94%

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Assessing patient safety culture in 15 intensive care units: a mixed-methods study

Tlili

Aouicha

Sahli

et al. 2022

BMC Health Serv Res

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Background Within hospitals, intensive care units (ICUs) are particularly high-risk areas for medical errors and adverse events that could occur due to the complexity of care and the patients’ fragile medical conditions. Assessing patient safety culture (PSC) is essential to have a broad view on patient safety issues, to orientate future improvement actions and optimize quality of care and patient safety outcomes. This study aimed at assessing PSC in 15 Tunisian ICUs using mixed methods approach. Methods A cross-sectional mixed methods approach using a sequential explanatory design was conducted from December 2019 to January 2020. The first quantitative stage was conducted in 15 ICUs belonging to the two university hospitals in the region of Sousse (Tunisia). All the 344 healthcare professionals (clinical staff) working for more than 1 month in these ICUs were contacted in order to take part in the study. In the second qualitative stage 12 participants were interviewed based on purposive sampling. Results All of the PSC dimensions had a score of less than 50%. The developed dimension was ‘teamwork within units’ (48.8%). The less developed dimensions were ‘frequency of event reporting’ (20.8%), ‘communication openness’ (22.2%) and ‘non-punitive response to error’ (19.7%). Interviews’ thematic analysis revealed four main themes including “Hospital management/system failure”, “Teamwork and communication”, “Error management” and “Working conditions”. Conclusion This research revealed that PSC is still in need of improvement and provided a clearer picture of the patient safety issues that require specific attention. Improving PSC through the use of quality management and error reporting systems may help to improve patient safety outcomes.

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Section: Discussionmentioning

confidence: 94%

“…Moreover, several studies reported that Adverse Events (AEs) and medication errors are more common in ICUs compared to other hospital units which could severely threaten patient safety [3][4][5][6][7][8].…”

Section: Introductionmentioning

confidence: 99%

Assessing patient safety culture in 15 intensive care units: a mixed-methods study

Tlili

Aouicha

Sahli

et al. 2022

BMC Health Serv Res

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“…The response rate that reached 69% demonstrates the considerable involvement of healthcare professionals. This response rate is deemed satisfactory by several authors (Özcan et al , 2020; Tlili et al , 2020).…”

Section: Discussionmentioning

confidence: 64%

“…Initially, PSC is evaluated quantitatively using the HSOPSC. The choice of this instrument is justified by the fact that the HSOPSC is the most frequently cited in the body of scientific literature (Reis et al , 2018; Boughaba et al , 2019; Granel et al , 2020; Tlili et al , 2020).…”

Section: Methodsmentioning

confidence: 99%

“…As for Canada, the annual cost of AEs in acute care is estimated around $397 million (Etchells et al , 2012). Thus, the prevention of AEs became a strategic objective for healthcare organizations (Tlili et al , 2020). However, the existence of a “blame culture” has constituted a major barrier to improving patient safety (Donaghy et al , 2018).…”

Section: Introductionmentioning

confidence: 99%

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Contribution of PCA/K-means methods to the mixed assessment of patient safety culture

Fourar

Djebabra

Benhassine

et al. 2021

IJHG

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PurposeThe assessment of patient safety culture (PSC) is a major priority for healthcare providers. It is often realized using quantitative approaches (questionnaires) separately from qualitative ones (patient safety culture maturity model (PSCMM)). These approaches suffer from certain major limits. Therefore, the aim of the present study is to overcome these limits and to propose a novel approach to PSC assessment.Design/methodology/approachThe proposed approach consists of evaluating PSC in a set of healthcare establishments (HEs) using the HSOPSC questionnaire. After that, principal component analysis (PCA) and K-means algorithm were applied on PSC dimensional scores in order to aggregate them into macro dimensions. The latter were used to overcome the limits of PSC dimensional assessment and to propose a quantitative PSCMM.FindingsPSC dimensions are grouped into three macro dimensions. Their capitalization permits their association with safety actors related to PSC promotion. Consequently, a quantitative PSC maturity matrix was proposed. Problematic PSC dimensions for the studied HEs are “Non-punitive response to error”, “Staffing”, “Communication openness”. Their PSC maturity level was found underdeveloped due to a managerial style that favors a “blame culture”.Originality/valueA combined quali-quantitative assessment framework for PSC was proposed in the present study as recommended by a number of researchers but, to the best of our knowledge, few or no studies were devoted to it. The results can be projected for improvement and accreditation purposes, where different PSC stakeholders can be implicated as suggested by international standards.

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Exploring patient safety culture in emergency departments: A Tunisian perspective

Aouicha

Tlili

Sahli

et al. 2021

International Emergency Nursing

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Assessing patient safety culture in 18 Tunisian adult intensive care units and determination of its associated factors: A multi-center study

Cited by 13 publications

References 26 publications

Assessing patient safety culture in 15 intensive care units: a mixed-methods study

Assessing patient safety culture in 15 intensive care units: a mixed-methods study

Contribution of PCA/K-means methods to the mixed assessment of patient safety culture

Exploring patient safety culture in emergency departments: A Tunisian perspective

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