Perceptions of patient safety culture in a teaching hospital in Brazil.

BACKGROUND: Patient safety is a global challenge that has a profound effect on healthcare. To reduce errors and improve outcomes, we must promote a safety culture. It should foster communication and teamwork. Thus, the aim of this study was to assess the safety culture of a teaching hospital in Brazil. METHODS: A descriptive cross-sectional study was conducted with all staff of a teaching hospital in Brazil to respond to the Hospital Survey on Patient Safety Culture. It has 42 questions across 12 dimensions. In Brazil, the HSOPSC is available in its online version as the Hospital Safety Culture E-Questionnaire. We used the non-parametric Friedman test to compare the mean perceptions of professionals from the 12 HSOPSC dimensions and the Box's M test was calculated to analyze the homogeneity of covariance between these data. For correlation analyses, we used Pearson's correlation test. RESULTS: Of the 2,088 eligible professionals, 511 (24.5%) responded to the survey, resulting in 455 valid answers. The average positive response rate on patient safety was 45.5%. Eight dimensions were weak. Statistical analysis reported the prediction of a dependency between the "number of reported adverse events" and "time worked in the hospital". Also, the simple linear regression showed that for every 0.263-point increase in the "perception of patient safety in the work environment" the "general average of patient safety culture" increased by 1 point. This confirmed the relationship between the two variables. CONCLUSIONS: The professionals concluded that the hospital is unsafe. A punitive culture creates fear and reduces the reporting of adverse events. It also leads to a belief that leaders do not support safety. All professionals, mainly the leaders, must work to create a fair, collaborative environment. Future studies should promote practical evidence-based interventions to investigate whether improving patient safety culture positively impacts clinical, economic and humanistic outcomes.