Comparative Studies on Patient Safety Culture to Strengthen Health Systems Among Southeast Asian Countries

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diringkas oleh Dini Handayani, anggota KNKP

Kang, Sunjoo; Ho, Trang T. T. T.; Lee, Nam-Ju
January, 12th 2021.
Switzerland: Frontiers in Public Health. ISBN: 2296-2565

Without a doubt, patient safety is a very important part of the healthcare system around the world. The publication of “To Err is Human” by IOM was the starting point of safety culture promotion in this modern era. It has shaped the study of patient safety to the next level with various kind of models and frameworks to evaluate the barriers of patient safety among health professionals. However, most of the studies comes from developed countries which taken the patient safety more seriously compared to low- and middle-income countries. One study from Kang, Ho, and Lee (2021) bring an interesting perspective of safety culture from developing country in Southeast Asia. They synthesized the information from several Southeast Asia countries including Indonesia, Thailand, Malaysia, Vietnam, Singapore, and Philippines.

After reviewing 21 articles, they found that several factors become a positive dimension of patient safety culture in these countries including supervisor/manager expectation and action, organizational learning and continuous improvement, teamwork within units, teamwork climate, and working condition. While the negative dimension consisted of handoffs and transitions, non-punitive responses to an error, patient safety reporting, and staffing. Also, as we have expected and other studies found, the overall prevalence of patient safety culture ranged from low to moderate. They also found 2 main factors that affecting patient safety culture: systematic and human factor.

While the study only focused on positive and negative dimension, another study in the same region have revealed several issues that hindered the patient safety culture. Those were the high risk of infection in healthcare facilities, medication error, the quality and provision of maternal and perinatal care, and the quality of healthcare provision overall (Harrison, Cohen, & Walton, 2015). The 2 main factors that found by the authors also confirm by other researchers. The systemic factors including organization and management, work environment, care delivery, handoff of information, responsibility, and accountability (Lee, Phan, Dorman, Weaver, & Pronovost, 2016). While human factors depend on the health professional characteristic including age, position, total years of experiences, etc. (Kang et al., 2021).

Despite the important of both factors, human factors seem to get more attention in patient safety culture compared to systemic factors. Singer and Vogus (2013) stated that systemic intervention is essential in reducing errors. Previous critical review also in line with this statement which argue that to solve the patient safety problems we need to move from concentration of error (human factors) to more comprehensive examination of the connection between system levels (systemic factors) (Waterson, 2009).

Nevertheless, to achieve the ultimate goal of maintaining patient safety culture, improvement in the system level must take into account the human factors. This has to be done to ensure the system approach is in line with the human approach who will run the system. More study from developing countries should be done to understand the underlying factors and what can be done to maintain the patient safety culture. Also, lesson learn from developed countries can give a valuable input in designing the system with consideration of local value and preference.