Qualidade e Segurança do Paciente, Hospital Israelita Albert Einstein, São Paulo, Brazil
Qualidade e Segurança do Paciente, Hospital Israelita Albert Einstein, São Paulo, Brazil.
BMJ Open Qual. 2023 Oct;12(4). doi: 10.1136/bmjoq-2023-002362.
Every year, millions of patients suffer injuries or die due to unsafe and poor-quality healthcare. A culture of safety care is crucial to prevent risks, errors and harm that may result from medical assistance. Measurement of patient safety culture (PSC) identifies strengths and weaknesses, serving as a guide to improvement interventions; nevertheless, there is a lack of studies related to PSC in Latin America.
To assess the PSC in South American hospitals.
A multicentre international cross-sectional study was performed between July and September 2021 by the Latin American Alliance of Health Institutions, composed of four hospitals from Argentina, Brazil, Chile and Colombia. The Hospital Survey on Patient Safety Culture (HSOPSC V.1.0) was used. Participation was voluntary. Subgroup analyses were performed to assess the difference between leadership positions and professional categories.
A total of 5695 records were analysed: a 30.1% response rate (range 25%-55%). The highest percentage of positive responses was observed in items related to patient safety as the top priority (89.2%). Contrarily, the lowest percentage was observed in items regarding their mistakes/failures being recorded (23.8%). The strongest dimensions (average score ≥75%) were organisational learning, teamwork within units and management support for patient safety (82%, 79% and 78%, respectively). The dimensions 'requiring improvement' (average score <50%) were staffing and non-punitive responses to error (41% and 37%, respectively). All mean scores were higher in health workers with a leadership position except for the hospital handoff/transitions item. Significant differences were found by professional categories, mainly between physicians, nurses, and other professionals.
Our findings lead to a better overview of PSC in Latin America, serving as a baseline and benchmarking to facilitate the recognition of weaknesses and to guide quality improvement strategies regionally and globally. Despite South American PSC not being well-exploited, local institutions revealed a strengthened culture of safety care.
每年,数以百万计的患者因不安全和劣质的医疗保健而受伤或死亡。安全护理文化对于预防可能因医疗援助而导致的风险、错误和伤害至关重要。测量患者安全文化(PSC)可以识别优势和劣势,为改进干预措施提供指导;然而,拉丁美洲缺乏相关的 PSC 研究。
评估南美洲医院的 PSC。
2021 年 7 月至 9 月,由四个来自阿根廷、巴西、智利和哥伦比亚的医疗机构组成的拉丁美洲医疗机构联盟进行了一项多中心国际横断面研究。使用了患者安全文化医院调查(HSOPSC V.1.0)。参与是自愿的。进行了亚组分析,以评估领导职位和专业类别的差异。
共分析了 5695 份记录:回应率为 30.1%(范围为 25%-55%)。观察到与患者安全作为首要任务相关的项目的正面回应比例最高(89.2%)。相反,观察到与记录其错误/失败相关的项目的比例最低(23.8%)。最强的维度(平均得分≥75%)是组织学习、单位内的团队合作和管理层对患者安全的支持(分别为 82%、79%和 78%)。需要改进的维度(平均得分<50%)是人员配备和对错误的非惩罚性反应(分别为 41%和 37%)。除了医院交接/过渡项目外,所有平均得分都在具有领导地位的卫生工作者中更高。在专业类别之间发现了显著差异,主要在医生、护士和其他专业人员之间。
我们的发现使人们对拉丁美洲的 PSC 有了更好的了解,为区域和全球范围内的弱势识别和质量改进策略提供了基准和参考。尽管南美洲的 PSC 尚未得到充分利用,但当地机构显示出了更强的安全护理文化。