Patient safety culture through the perspectives of healthcare workers: a longitudinal study in a private healthcare network in Brazil.

Abstract

Enhancing security and dependability of health systems necessitates resource allocation, a well-defined infrastructure and a steadfast commitment to ensuring its safety and stability over time. The aim of this study was to evaluate the temporal trend of patient safety culture according to the perception of professionals working in a private healthcare network in Brazil over a 7-year period (2015-2022). The Hospital Survey on Patient Safety Culture questionnaire was distributed to 34 hospitals between 2015 and 2022 with 160 607 responders. A linear mixed-effects regression model was applied to fit the trend for the dimension score over time. Out of the 12 measured dimensions in the HSOPSC Survey, 8 showed significant improvement over a 7-year period (p<0.05). The dimensions of communication openness (p=0.22), non-punitive response to errors (p=0.08), staffing (p=0.06) and the frequency of reported events (p=0.22) have not demonstrated improvement over time. Management support for patient safety and organisational learning received positive responses from at least 75% of those surveyed in 2022, earning the distinction as 'strong areas of patient safety'. Comparing 2015 and 2022, the proportion of participants who rated their unit/work area on patient safety as 'fair' or 'good' decreased, while the proportion of participants who considered it 'very good' increased (p<0.001). Findings indicate an improvement in patient safety culture from 2015 to 2022. Key challenges identified in enhancing safety culture included communication openness, staffing, frequency of reported events, and nonpunitive response to errors.