Perceptions of Patient Safety Culture in United States Hospitals: A Systematic Review and Meta-Analysis

Abstract

Despite having the highest healthcare spending, the United States of America is seeing marginal overall impacts on patient outcomes within the developed world. Studying PSC, as assessed by the Hospital Survey on Patient Safety Culture (HSOPSC), can provide insights into the status of patient safety culture: an indicator of overall patient safety and attitudes around medical errors. The purpose of this study is to examine patient safety culture in United States hospitals across professional categories via a systemic review and meta-analysis of published literature. Embase, PubMed, Web of Science, Scopus, and AHRQ’s Bibliography were consulted for identifying studies. A total of 31 articles met the eligibility criteria for inclusion, which garnered 608,443 survey participants in a national population of hospital healthcare professionals. The HSOPSC composite average across all the studies was 61.3% positive responsiveness, indicating a need for improvement in patient safety. “Teamwork within units” had the highest positive PSC perception while “nonpunitive response to error” and “handoffs and transitions” scored the lowest. Furthermore, healthcare trainees and physicians seemed to have overall worse perceptions of patient safety culture compared to other professional subgroups, indicating the potential impacts of inexperience and a culpability culture on patient safety and medical error in hospitals. Hospitals should consider interventions—such as teamwork training and error-reporting systems—to address the weak dimensions of patient safety culture, thus improving patient safety measures and reducing the incidence of medical errors.

Keywords

• Patient safety
• Patient safety culture
• Hospital survey on patient safety culture