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      Status and Factors Affecting Patient Safety Culture at Dilla University Teaching Hospital: A Mixed-Method Cross-Sectional Study

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          Abstract

          Background

          Patient safety culture is now at the forefront of the global health agenda and has been designated as a human right. Assessing safety culture is seen to be a prerequisite for improving safety culture in health-care organizations. However, no research has been conducted to examine the current study setup. Therefore, this study aims at assessing the status and factors influencing patient safety culture at Dilla University Teaching Hospital.

          Methods

          This cross-sectional institutional-based study was conducted from February to March 2022 at Dilla University Hospital. The study used both qualitative and quantitative methods. A total of 272 health professionals were included in the survey. The qualitative data was collected using Key Informant Interviews and In-depth Interviews and 10 health professionals were selected purposively to meet the study objective.

          Results

          The overall composite positive patient safety culture response rate in the current study hospital was 37% (95% CI: 35.3, 38.8). Out of the 12 dimensions, teamwork within hospital units was the highest (75.3%), while frequency of event reporting was the lowest (20.7%) positive percentage response. Only two of the 12 dimensions scored above 50%. Factors affecting patient safety culture majorly at organizational and individual level were poor/low attitude of health professionals, poor documentation practice, and poor cooperation by clients, lack of training and continuous education, lack of standard operating procedure, Staff shortage and high work load.

          Conclusion

          This study revealed that the overall composite positive patient safety culture response rate within the surveyed facility was alarmingly low compared to other hospitals in various countries. The results indicate that there is a need for improvement in areas such as event reporting, documentation, health-care workers’ attitude, and staff training. Hospitals must prioritize patient safety by cultivating a strong safety culture through effective leadership, adequate staffing, and education to enhance overall patient care.

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          Most cited references43

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          Malpractice risk according to physician specialty.

          Data are lacking on the proportion of physicians who face malpractice claims in a year, the size of those claims, and the cumulative career malpractice risk according to specialty. We analyzed malpractice data from 1991 through 2005 for all physicians who were covered by a large professional liability insurer with a nationwide client base (40,916 physicians and 233,738 physician-years of coverage). For 25 specialties, we reported the proportion of physicians who had malpractice claims in a year, the proportion of claims leading to an indemnity payment (compensation paid to a plaintiff), and the size of indemnity payments. We estimated the cumulative risk of ever being sued among physicians in high- and low-risk specialties. Each year during the study period, 7.4% of all physicians had a malpractice claim, with 1.6% having a claim leading to a payment (i.e., 78% of all claims did not result in payments to claimants). The proportion of physicians facing a claim each year ranged from 19.1% in neurosurgery, 18.9% in thoracic-cardiovascular surgery, and 15.3% in general surgery to 5.2% in family medicine, 3.1% in pediatrics, and 2.6% in psychiatry. The mean indemnity payment was $274,887, and the median was $111,749. Mean payments ranged from $117,832 for dermatology to $520,923 for pediatrics. It was estimated that by the age of 65 years, 75% of physicians in low-risk specialties had faced a malpractice claim, as compared with 99% of physicians in high-risk specialties. There is substantial variation in the likelihood of malpractice suits and the size of indemnity payments across specialties. The cumulative risk of facing a malpractice claim is high in all specialties, although most claims do not lead to payments to plaintiffs. (Funded by the RAND Institute for Civil Justice and the National Institute on Aging.).
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            Safety culture assessment: a tool for improving patient safety in healthcare organizations.

            Increasingly, healthcare organizations are becoming aware of the importance of transforming organizational culture in order to improve patient safety. Growing interest in safety culture has been accompanied by the need for assessment tools focused on the cultural aspects of patient safety improvement efforts. This paper discusses the use of safety culture assessment as a tool for improving patient safety. It describes the characteristics of culture assessment tools presently available and discusses their current and potential uses, including brief examples from healthcare organizations that have undertaken such assessments. The paper also highlights critical processes that healthcare organizations need to consider when deciding to use these tools.
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              Variations in patients' adherence to medical recommendations: a quantitative review of 50 years of research.

              The literature on patient adherence to treatment includes hundreds of empirical studies. A comprehensive examination of the findings requires the organization and quantification that is possible with meta-analysis. The goals of this research are retrieval, compilation, and averaging of adherence rates in all published empirical studies from 1948 to 1998; assessment of variation according to sample characteristics, time period of publication, measurement method, disease, and regimen; and examination of the effects on adherence of patient demographic characteristics. We calculated a meta-analysis of 569 studies reporting adherence to medical treatment prescribed by a nonpsychiatrist physician, and 164 studies providing correlations between adherence and patients' age, gender, education, and income/socioeconomic status; group comparison and multiple regression analysis of moderators. The average nonadherence rate is 24.8%. Controlling for intercorrelations among moderator variables, adherence is significantly higher in more recent and smaller studies and in those involving medication regimens and adult samples. The use of physical tests and self-report have respectively significant and borderline negative effects on the level of adherence, and disease severity and use of the medical record have no significant effects. Adherence is highest in HIV disease, arthritis, gastrointestinal disorders, and cancer, and lowest in pulmonary disease, diabetes, and sleep. Demographic effects on adherence are small and moderated by sample, regimen, and measurement variables. This review offers insights into the literature on patient adherence, providing direction for future research. A focus on reliability and validity of adherence measurement and systematic study of substantive and methodologic moderators are recommended for future research on patient adherence.
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                Author and article information

                Journal
                Risk Manag Healthc Policy
                Risk Manag Healthc Policy
                rmhp
                Risk Management and Healthcare Policy
                Dove
                1179-1594
                26 June 2023
                2023
                : 16
                : 1157-1169
                Affiliations
                [1 ]Infection Prevention and Control Department, Dilla University , Dilla, Ethiopia
                [2 ]Department of Environmental Health, Wachemo University , Hosanna, Ethiopia
                Author notes
                Correspondence: Abel Afework, Email agziabel@gmail.com
                Author information
                http://orcid.org/0000-0002-9828-7446
                http://orcid.org/0000-0001-5504-0905
                http://orcid.org/0009-0002-0944-644X
                Article
                419990
                10.2147/RMHP.S419990
                10312320
                37396934
                cde0ff6c-f252-4216-92b9-009174851411
                © 2023 Afework et al.

                This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License ( http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms ( https://www.dovepress.com/terms.php).

                History
                : 04 May 2023
                : 21 June 2023
                Page count
                Figures: 0, Tables: 7, References: 43, Pages: 13
                Categories
                Original Research

                Social policy & Welfare
                patient safety culture,event reporting,patient harm,healthcare quality,incidence reporting

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