Safety culture and patient safety outcomes in developing countries: A narrative review

Abstract

The effects of medical errors on patients are increasingly becoming a public concern. It is estimated that 10% and 20% of persons receiving healthcare in developed and developing economies, respectively, are harmed, but a majority of these errors are preventable. The purpose of this paper is to summarise the current literature on the level of patient safety culture awareness and practice, predictors of patient safety culture, and the link between patient safety culture and patient outcomes in developing countries. A systematic search for literature from the following data bases, ScienceDirect, PubMed, JSTOR, ProQuest, Taylor & Francis Online, and Emerald Insight was carried out. Consistent with the inclusion criteria and study objectives, 23 published articles were included in this review. We found that patient safety culture awareness and practice in developing countries is low and still evolving. High predictors of patient safety culture include teamwork, communication, work environment and provider job satisfaction. Low predictors include a non-punitive response to errors, handoffs, transitions and transfers, staffing, and blameless reporting systems. We found that improved patient safety culture results in better patient outcomes. However, there is limited evidence on patient safety culture and patient outcomes in African countries, which hinder evidence-based practice aimed at promoting better health outcomes of patients. Stakeholders must ensure enhanced medical data collection and preservation of comprehensive incidence reporting systems and strategies to improve patient safety and health outcomes.