Assessment of patient safety culture in a rural tertiary health care hospital of Central India

R. C. Goyal, Sonali Choudhari


Background: A safety culture assessment provides an organization with a basic understanding of the safety related perceptions and attitudes of its managers and staff. While patient safety has been a major area of research in industrialized nations for over a decade, data on the root causes of unsafe care in low-income settings is sparse. The objective of the study was to assess the patient safety culture in a rural tertiary health care hospital situated in Central India.

Methods: A survey conducted during year 2015, in a rural tertiary health care teaching hospital, Maharashtra (India). The study participants were the 156 hospital staff working in various clinical work areas. The agency for healthcare research and quality hospital survey on patient safety culture, a validated instrument is used as an assessment tool.

Results: Total 144 participants included in the study, 75 (52%) were females and rest were males 48%. Out of these 111 (77), maximum number of staff (57.05%) was belonging to different intensive care units.  57% of participants had worked in the hospital for 1 to 5 years.  For the unit level safety culture dimension, the maximum composite score of positive responses was obtained for “Organizational learning- continuous improvement” (67%) followed by “Hospital management support for patient safety” (65%).  On the other hand only 48% survey participants gave an affirmative opinion with respect to “Feedback and communication about error”. For the hospital wide dimensions response rate was obtained as 62% for the “Teamwork across Hospital Units” while for the dimension “Hospital Handoffs & Transitions”, the score came out as 55%.

Conclusions: The perception of patient safety and standards of patient safety were fairly good in the present rural tertiary health care hospital, but there is an ample of prospect in improvement with regard to event reporting, feedback and non punitive error.


Assessment, Patient safety culture, Hospital survey

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Sorra JS, Nieva VF. Hospital Survey on Patient Safety Culture. (Prepared by Westat, under Contract No. 290-96-0004). AHRQ Publication No. 04-0041. Rockville, MD: Agency for Healthcare Res Quality. 2004.

Health and Safety Commission (HSC). Organizing for safety: Third report of the human factors study group of ACSNI. Sudbury: HSE Books; 1993.

Agency for Healthcare Research and Quality (2007, April). Patient safety culture surveys. Rockville, MD: Author. Available at: http:/

qual/ hospculture. Accessed on 3 March 2018.

Nieva VF, Sorra J. Safety culture assessment: a tool for improving patient safety in healthcare organizations. Qual Saf Health Care. 2003;12:217-23.

Jha AK, Prasopa-Plaizier N, Larizgoitia I, Bates DW. Research Priority Setting Working Group of the WHO World Alliance for Patient Safety. Patient safety research: An overview of the global evidence. Qual Saf Health Care. 2010;19:42-7.

Horton R, Das P. Indian health: The path from crisis to progress. Lancet. 2011;377:181-3.

Sorra JS, Nieva VF. Hospital Survey on Patient Safety Culture. Rockville, MD: Agency for Healthcare Research and Quality; 2004. Report No.: AHRQ publication 04-0041.

Etchegaray JM, Thomas EJ. Comparing two safety culture surveys: safety attitudes questionnaire and hospital survey on patient safety. BMJ Qual Saf. 2012;21:490-8.

Williams RG, Silverman R, Schwind C, Fortune JB, Sutyak J, Horvath KD, et al. Surgeon information transfer and communication: factors affecting quality and efficiency of inpatient care. Ann Surg. 2007;245(2):159-69.

Kohn LT, Corrigan JM, Donaldson MS. To err is human: building a safer health system. Washington, DC: National Academy Press; 1999.

Youngberg BJ. Event reporting: the value of a nonpunitive approach. Clin Obstet Gynecol. 2008;51:647–55.

Watcher RM, Provonost PJ. Balancing ‘‘no blame’’ with accountability in patient safety. N Engl J Med. 2009;361:1401-6.