Mapping strategies for strengthening safety culture: Scope review

Abstract

Background Despite decades of recognition, 1 in 10 patients suffer harm in hospitals in highincome countries. Strengthening the safety culture is essential, with strategies to integrate it into healthcare processes. This scoping review aims to map patient safety culture strengthening strategies described in the literature. Method: This scoping review follows the Joanna Briggs Institute methodology. It adhered to all scoping review checklist items (PRISMA-ScR) with searches in the databases: LILACS, MedLine, IBECS, and PubMed, and on the official websites of national and international patient safety organizations. Eligibility criteria included studies that addressed the guiding question, published without language restrictions, in the last ten years, derived from fully, freely, and openly published research in journals available in the selected databases, consistent with the proposed objective, and with the descriptors listed in the search. The research took place during the year 2023. Results: The included studies were 58, comprising 52 articles and 6 documents from health organizations. The most described strategies were communication (69.0%), followed by teamwork (58.6%), and active leadership (56.9%). Various strategies were identified and grouped into seven categories based on similarity, highlighting the need for a comprehensive organizational approach to improve patient care. Conclusion: The identified strategies promote the development of a culture in which an organization can achieve patient safety, involving practices and attitudes that reduce risks and errors in healthcare. However, it is limited to identifying strategies and does not assess their effectiveness in improving the patient safety culture. Therefore, we recommend implementing, in clinical practice, the strategies listed in the literature. Systematic review registration: Open Science Framework (https://osf.io/edtc6/).