Quality and Accreditation Directorate, Ministry of Health, Kuwait City, Kuwait.
Assistant Undersecretary of Public Health Affairs, Ministry of Health, Kuwait City, Kuwait.
BMC Health Serv Res. 2021 Oct 28;21(1):1172. doi: 10.1186/s12913-021-07199-1.
Assessments of the culture surrounding patient safety can inform healthcare settings on how their structures and processes impact patient outcomes. This study investigated patient safety culture in Primary Health Care Centres in Kuwait, and benchmarked the findings against regional and international results. This study also examined the association between predictors and outcomes of patient safety culture in these settings.
This cross-sectional quantitative study used the Medical Office Survey on Patient Safety Culture. The study was targeted at staff of all the Primary Health Care Centres in Kuwait with at least one year of experience. Data were analysed using SPSS 23 at a significance level of ≤ .05. Univariate (means, standard deviations, frequencies, percentages) and bivariate (chi-squared tests, student t-tests, ANOVA F-tests, Kruskal-Wallis tests, Spearman's correlation) analyses provided an overview of participant socio-demographics and the association between patient safety culture composites and outcomes. We undertook a multivariate regression analysis to predict the determinants of patient safety culture. Results were benchmarked against similar local (Kuwait, 2014), regional (Yemen, 2015) and international (US, 2018) studies.
The responses of 6602 employees from 94 centres were included in the study, with an overall response rate of 78.7%. The survey revealed Teamwork (87.8% positive ratings) and Organisational Learning (78.8%) as perceived areas of strength. Communication about Error (57.7%), Overall Perceptions of Patient Safety and Quality (57.4%), Communication Openness (54.4%), Owner/Managing Partner/Leadership Support for Patient Safety (53.8%) and Work Pressure and Pace (28.4%) were identified as areas requiring improvement. Benchmarking analysis revealed that Kuwait centres are performing at benchmark levels or better on four and six composites when compared to international and regional findings, respectively. Regression modelling highlighted significant predictions regarding patient safety outcomes and composites.
This is the first major study addressing the culture of patient safety in public Primary Health Care Centres regionally. Improving patient safety culture is critical for these centres to improve the quality and safety of the healthcare services they provide. The findings of this study can guide country-level strategies to develop the systems that govern patient safety practices.
评估患者安全文化可以让医疗保健机构了解其结构和流程如何影响患者的治疗结果。本研究调查了科威特初级保健中心的患者安全文化，并将调查结果与区域和国际结果进行了基准比较。本研究还调查了这些环境中患者安全文化的预测因子与结果之间的关联。
本横断面定量研究使用了《医疗办公患者安全文化调查》。该研究的目标人群是在科威特所有初级保健中心工作且至少有一年工作经验的所有员工。使用 SPSS 23 在≤.05 的显著性水平下对数据进行分析。单变量（平均值、标准差、频率、百分比）和双变量（卡方检验、学生 t 检验、方差 F 检验、克鲁斯卡尔-沃利斯检验、斯皮尔曼相关）分析提供了参与者社会人口统计学信息以及患者安全文化综合得分与结果之间的关联概述。我们进行了多元回归分析，以预测患者安全文化的决定因素。结果与类似的本地（科威特，2014 年）、区域（也门，2015 年）和国际（美国，2018 年）研究进行了基准比较。
该研究纳入了 94 个中心的 6602 名员工的回复，总体回复率为 78.7%。调查显示，团队合作（87.8%的积极评价）和组织学习（78.8%）是被认为是优势领域。沟通错误（57.7%）、患者安全和质量整体认知（57.4%）、沟通开放性（54.4%）、所有者/管理合伙人/领导层对患者安全的支持（53.8%）和工作压力与节奏（28.4%）被确定为需要改进的领域。基准分析显示，与国际和区域结果相比，科威特中心在四个和六个综合得分方面的表现达到或优于基准水平。回归模型突出了患者安全结果和综合得分的重要预测因素。
这是首次在区域范围内对公立初级保健中心的患者安全文化进行的重要研究。提高患者安全文化对这些中心提高所提供医疗服务的质量和安全性至关重要。本研究的结果可以指导国家一级制定管理患者安全实践的系统战略。
