Assessment of patient safety culture and associated factors among healthcare professionals in public hospitals of Bahir Dar City, Northwest Ethiopia: A mixed-methods study

Abstract

Background: Patient safety is an essential component of healthcare quality. Despite enormous advances in medical knowledge, many adverse events continue to endanger patient safety. Although mixed-method studies are necessary to gain a deeper understanding of safety culture, few studies provide practical evidence of patient safety culture and associated factors in Ethiopia. This study aimed to assess patient safety culture and associated factors among healthcare professionals in public hospitals in Bahir Dar City, Northwest Ethiopia.

Methods: A cross-sectional study design was employed, in triangulation with qualitative methodologies, from March 10 to April 10, 2022. A stratified sampling technique was used to select 420 study participants from three public hospitals. A standardized tool measuring 12 patient safety culture composites was used for data collection. Purposive sampling was employed in the qualitative study. Bi-variable and multivariable linear regression analyses were performed using SPSS version 23, with significance set at a 95% confidence interval and a p-value of <0.05. Content analysis was utilized in the qualitative study.

Results: The overall patient safety culture score was 47.6% (95% CI: 42.7, 52.5). Age (β = 1.196, 95% CI: (0.968, 1.322), patient safety training (β = 0.168, 95% CI: 0.040, 0.297), working in pediatric wards (β = 0.236, 95% CI: 0.099, 0.370), and resource availability (β = 0.346, 95% CI: 0.220, 0.473) were significantly associated with patient safety culture. The in-depth interviews identified infrastructure, communication barriers, lack of management support, poor governance, healthcare professionals' knowledge, skills, and attitudes, and patient involvement during treatment as factors affecting patient safety.

Conclusions: This study concludes that the patient safety culture in the studied hospitals is suboptimal, falling below the acceptable threshold. Enhancing resource availability, providing continuous patient safety training, improving communication systems, and fostering a supportive management environment are essential steps towards building a safer healthcare system.

Fig 1. Hospital’s overall patient safety grade among healthcare professionals in Bahir Dar City public hospitals, Northwest Ethiopia, 2022 (N = 393).