Alsaleh Fatemah M, Albraikan Shaikha, Alzoubi Hadeel, Abahussain Eman A, Elamir Hossam
College of Pharmacy, Kuwait University, P.O. Box 24923, Safat 13110, Kuwait City, Kuwait.
Ministry of Health, Kuwait City, Kuwait.
BMC Health Serv Res. 2025 Apr 22;25(1):579. doi: 10.1186/s12913-025-12668-y.
Several international health bodies advocate measuring patient safety culture within an organisation as an effective strategy for sustainably improving safety. This study aims to assess and compare patient safety culture across public and private hospitals in Kuwait.
A cross-sectional study was conducted utilising the Hospital Survey of Patient Safety Culture. The questionnaire was distributed among clinical staff in public general and private hospitals. Data analysis using Microsoft Excel and SPSS 23 (α level = 0.05) provided an overview of participant characteristics and patient safety culture scores. A model for predicting the determinants of patient safety culture score was constructed from a regression analysis.
A total of 890 questionnaires were distributed equally between the public and private sectors. The overall response rate was 94.9%. Assessment of the positive percentage of patient safety culture showed that nationally, five composites were areas of strength: "Teamwork within Units" (87.2%), "Organizational Learning-Continuous Improvement" (87.5%), "Management Support for Patient Safety" (77.8%), "Feedback & Communication about Error" (75.8%) and "Teamwork across Units" (75.0%). Private hospitals showed these same areas of strength, whereas public hospitals had fewer. Private hospitals scored statistically significant higher positive percentages than public hospitals in most of the composites. Benchmarking against a 2015 study in Kuwait indicates that the positive percentages of six composites increased at the national level, whereas four remained the same. "Staffing" and "Non-punitive response to errors" were strikingly low.
In this first national study to assess patient safety culture in public and private hospitals in Kuwait, many areas of safety culture had improved. However, some areas require special attention, although causality cannot be inferred, which is a limitation of the study's design. A comparison between the two sectors revealed differences in the patient safety culture, which might be relevant to the guidelines governing them. Policymakers should set unified guidelines governing staffing in both sectors and devise intervention strategies to develop a culture that establishes learning from adverse events and supports patient safety, incorporating a just culture and whistle-blower protection. In academia, Kuwait University should incorporate patient safety and quality-of-care topics into its curricula.
几个国际卫生机构主张，衡量一个组织内的患者安全文化是可持续改善安全状况的有效策略。本研究旨在评估和比较科威特公立医院和私立医院的患者安全文化。
采用《患者安全文化医院调查》进行横断面研究。问卷在公立综合医院和私立医院的临床工作人员中分发。使用Microsoft Excel和SPSS 23进行数据分析（α水平=0.05），提供了参与者特征和患者安全文化得分的概述。通过回归分析构建了一个预测患者安全文化得分决定因素的模型。
共向公共部门和私营部门平均分发了890份问卷。总体回复率为94.9%。对患者安全文化积极百分比的评估表明，在全国范围内，有五个综合指标是优势领域：“科室内部团队合作”（87.2%）、“组织学习 - 持续改进”（87.5%）、“管理层对患者安全的支持”（77.8%）、“关于错误的反馈与沟通”（75.8%）和“跨科室团队合作”（75.0%）。私立医院也有这些相同的优势领域，而公立医院的优势领域较少。在大多数综合指标中，私立医院的积极百分比在统计学上显著高于公立医院。与科威特2015年的一项研究进行对比表明，在国家层面，六个综合指标的积极百分比有所增加，而四个保持不变。“人员配备”和“对错误的非惩罚性反应”极低。
在这项评估科威特公立医院和私立医院患者安全文化的首次全国性研究中，安全文化的许多领域都有改善。然而，尽管无法推断因果关系（这是本研究设计的一个局限性），但一些领域仍需特别关注。两个部门之间的比较揭示了患者安全文化方面的差异，这可能与管理它们的指导方针相关。政策制定者应制定统一的两个部门人员配备指导方针，并制定干预策略，以培养一种从不良事件中学习并支持患者安全的文化，包括公正文化和举报人保护。在学术界，科威特大学应将患者安全和医疗质量主题纳入其课程。
