Patient Safety Culture in Rwandan Teaching Hospital Operating Rooms

Abstract

Background: Patient safety is recognized to be an endemic concern and healthcare organization are challenged to improve it. In the aftermath of the IOM publication on magnitude of adverse events in Unites States, the field of patient safety emerged and healthcare organization were recommended to increase patient safety culture (PSC) to improve patient outcomes. Most of the available data are from developed world with very scanty data from developing and middle-income countries and no data available for Rwanda. Aim: To explore PSC in Rwandan teaching hospital operating rooms (OR): healthcare provider perspectives. Methods: A quantitative cross-sectional analytical study was carried out in three teaching hospitals in Kigali. 152 participants selected by stratified random sampling strategy, responded to the Hospital Survey on Patient Safety Culture; a standardized tool that measure 12 safety dimensions. Positive responses were summed and averaged to have level of safety culture of each safety dimension and ultimately the overall PSC. Analysis of variance was performed at significance level of < .05 to check differences among groups and the contribution of each safety dimension. Results: The overall PSC was 51.6% and teamwork within unit was the only area of strength (76.8%) while 6/12 safety dimensions had less than 50% positive perception; non-punitive response to error, staffing, handoffs and transitions, frequency of events reported, communication openness, and overall perception of patient safety; 21.7%, 34.4%, 42.4%, 42.6%, 47% and 49.5% of positive perceptions respectively. Conclusion: The current level of PSC was recognized to be neutral with half of the safety culture dimensions reflecting negative PSC. Therefore, patient safety improvement strategies should be considered to address the areas of weaknesses.