Patient Safety Culture in Emergency Departments of Yemeni Public Hospitals: A Survey Study

Abstract

Introduction: Quality and safety is an important challenge in healthcare systems all over the world particularly in developing parts.
 Objective: This survey aimed to assess patient safety culture (PSC) in emergency departments (EDs) in Yemen and identify its associated factors.
 Methods: A questionnaire containing the Hospital Survey on Patient Safety Culture (HSOPSC) was distributed to ED physicians, nurses, and clinical, and non-clinical staff at three public teaching general hospitals. The percentages of positive responses on the 12 patient safety dimensions and the summation of PSC and two outcomes (overall patient safety grade and adverse events reported in the past year) were assessed. Factors associated with PSC aggregate score were analyzed.
 Results: finally, out of 400 questionnaires, 250 (64%) were analyzed. In total, 207 (82.3%) participants were nurses and physicians; 140 (56.0%) were male; 134 (53.6%) were less than 30 years old; and 134 (53.6%) had a university degree. Participants provided the highest ratings for the “teamwork within units” PSC composite (67%). The lowest rating was for “non-punitive response to error” (21.3%). A total of 120 (48.1%) participants did not report any events in the past year and 99 (39.7%) gave their hospital an “excellent/very good” overall patient safety grade. There were significant differences between the hospitals’ EDs in the rating of “handoffs and transitions” (p=0.016), “teamwork within units” (p=0.018), and “frequency of adverse events reported” (p=0.016). Staff working in intensive care units (8.4%, n=21) had lower patient safety aggregate scores.
 Conclusions: PSC ratings appear to be low in Yemen. This study emphasizes the need to create and maintain a PSC in EDs through the implementation of quality improvement strategies and environment of transparency, open communications, and continuous learning.

Comparison of Perceptions About Patient Safety Culture Between Physicians and Nurses in Public Hospitals in Vietnam

“…To get the average scores of each dimension, the items were linearly converted to a scale from 0 to 100 points. 21 The average positive response rate refers to the combined percentage of respondents who answered “Strongly agree” or “Agree”, or “Always” or “Most of the time”, which was calculated for every participant based on the HSOPSC instructions.…”

“… 13 , 15–21 Nonpunitive response to errors often had the lowest scores and teamwork across units often had the highest scores. 9 , 18 , 21 Other research has also indicated that sharing and trust in safety culture are communicated in a health institution with a positive safety culture assessment, which serves to support work performance. 6 , 22…”

“…[12][13][14] Literature has revealed that the most frequent positive safety culture aspects reported in hospitals in different countries including Ethiopia, Saudi Arabia, Switzerland, the US, China, Brazil, Yemen and Vietnam were "organizational learning and continuous improvement", "teamwork within units", "feedback and communication about errors"; "communication openness", while the most frequent negative dimensions were "non-punitive responses to an error", "staffing"; "handoffs and transitions"; "overall perceptions of safety", and "frequency of event reporting". 13,[15][16][17][18][19][20][21] Nonpunitive response to errors often had the lowest scores and teamwork across units often had the highest scores. 9,18,21 Other research has also indicated that sharing and trust in safety culture are communicated in a health institution with a positive safety culture assessment, which serves to support work performance.…”

“…13,[15][16][17][18][19][20][21] Nonpunitive response to errors often had the lowest scores and teamwork across units often had the highest scores. 9,18,21 Other research has also indicated that sharing and trust in safety culture are communicated in a health institution with a positive safety culture assessment, which serves to support work performance. 6,22 Physicians and nurses are considered core staff with professional skills, dedicating themselves to health service delivery in hospitals.…”

Strategies and interventions for improving safety culture in Australian Emergency Departments: A modified Delphi study

“…1 Patient safety and safety culture are critical aspect for quality healthcare delivery and components of modern healthcare in general [2][3][4] and Emergency Department (ED) in particular. 5 However, the high-paced, unpredictable nature of the ED environment may impact adversely on it. As a consequence, many patients are negatively influenced by adverse incidents.…”