A survey on patient safety culture in primary healthcare services in Turkey

Objective. To evaluate the patient safety culture in primary healthcare units. Design. A cross-sectional study, utilizing the Turkish version of the Hospital Survey on Patient Safety Culture developed by the Agency for Healthcare Research and Quality and a demographic questionnaire. Setting. Twelve primary healthcare centers in the center of the city of Konya, Turkey. Participants. One hundred and eighty healthcare staff, including general practitioners (GPs), nurses, midwives and health officers. Intervention None. Main Outcome Measure(s). The patient safety culture score including subscores on 12 dimensions and 42 items; patient safety grade and number of events reported. Results. Fifty-four (30%) of the participants were GPs, 48 (27%) were nurses, 51 (28%) were midwives and 27 (15%) were health officers. The mean overall score for positive perception of patient safety culture in primary healthcare units was 46 ± 20 (43-49 CI). No differences were found by staff members' profession. Among the dimensions of patient safety, those with the highest percentage of positive ratings were teamwork within units (76%) and overall perceptions of safety (59%), whereas those with the lowest percentage of positive ratings were the frequency of event reporting (12%) and non-punitive response to error (18%). Reporting of errors was infrequent with 87% of GPs, 92% of nurses and 91% of other health staff indicating that they did not report or provide feedback about errors. Conclusions. Improving patient safety culture should be a priority among health center administrators. Healthcare staff should be encouraged to report errors without fear of punitive action. © The Author 2009. Published by Oxford University Press in association with the International Society for Quality in Health Care; all rights reserved.