Safety Culture Data.2024

Background: The aim of this study is to analyze the temporal trend of patient safety culture within a network of private hospitals in Brazil, while also evaluating the relationship between safety culture and the hospital accreditation process. Method: A retrospective study was carried out through the application of the Hospital Survey on Patient Safety Culture (HSOPSC) questionnaire and distributed to 68 hospitals from 2014 to 2022 with a total of 259,268 responders. The analyzed hospitals were classified as accredited (AH) or non-accredited (NAH). Findings: Eleven dimensions of HSOPSC significantly improved over an 8-year period, except for the frequency of reported events, which remained unchanged over time. Two dimensions had less than 50% of positivity “communication openness” (47.13% [38.19 - 58.73]) and “nonpunitive response to errors” (41.24% [34.13 - 51.98]). AH demonstrated an increase in the safety culture across 11 dimensions, except for the frequency of reported events, which remained unchanged. In NAH, the frequency of reported events decreased over time and the remaining dimensions showed no significant change. Interpretation: These results suggest that patient safety culture improved in this network of private hospitals from 2013 to 2022. Accreditation has been a tool that has fostered a culture of safety over time. Non-accredited hospitals tended to decrease the number of reported adverse events, which suggests underreporting and missed opportunities for healthcare system improvement through adverse event analysis.背景：本研究旨在分析巴西私立医院网络内患者安全文化的时间趋势，并评估安全文化与医院认证流程之间的关联。方法：本研究为回顾性研究，采用患者安全文化医院调查问卷（Hospital Survey on Patient Safety Culture, HSOPSC）开展调研，于2014年至2022年间向68家医院发放问卷，累计回收有效答卷259268份。纳入分析的医院分为认证医院（Accredited Hospital, AH）与非认证医院（Non-Accredited Hospital, NAH）两类。结果：在8年的观测周期内，HSOPSC的11个维度得分均呈显著上升趋势，仅不良事件上报频率维度无明显变化。其中，“沟通开放性”（47.13% [38.19 - 58.73]）与“对错误的非惩罚性回应”（41.24% [34.13 - 51.98]）两个维度的阳性率不足50%。认证医院的11个安全文化维度得分均有所提升，仅不良事件上报频率维度无明显变化；而非认证医院的不良事件上报频率随时间呈下降趋势，其余维度均未出现显著变化。解读：上述结果表明，2013年至2022年间，该私立医院网络的患者安全文化水平得到了提升。医院认证作为长效机制，可助力安全文化的培育。非认证医院的不良事件上报数量呈下降趋势，这一现象提示存在上报不足的问题，进而错失了通过不良事件分析推动医疗体系改进的契机。