Assessing Patient Safety Culture in Vietnamese hospitals: An evidence in developing country

Background: Since the IOM’s report: “To Err Is Human: Building a Safer Health System” was published in 1999, patient safety has been paid much attention by the developed countries world-wide. To improve patient safety, patient safety culture in hospitals has been recognized as an essential driven force. Although the statistic data of patient safety are limited in developing countries but the rate of patients who reserving health care services being harmed could be greater. Therefore, facilitating a better understanding of patient safety culture in developing countries is inevitable. The study aims to explore attitudes and perception of health professional and find out Patient Safety Culture level in major hospitals in Vietnam.
Method: A cross-sectional design was used by using Hospital Survey on Patient Safety Culture (HSOPSC) questionnaire originally designed by the United States Agency for Healthcare Research and Quality. The questionnaire measured 12 dimensions of patient safety culture in 67 difference department/unit in 5 difference level hospitals with including one teaching hospital, two difference national specialized hospitals, one regional hospital and one community hospital. The HSOPSC questionnaire contains 42 items which were developed based on the 5-point Likert response scale of agreement (from “Strong disagree” to “Strong agree”) or frequency (“Never” to “Always”). This study used SPSS 20.0 to conduct the statistical analysis of survey data.
Result: A total of 1314 respondents include physician, Nurse, Technician, Midwives from 67 departments/units of 5 hospitals in Vietnam completed the survey. The result showed that positive response on patient safety was low in Vietnam. The overall of positive response for 12 dimensions of HSOPSC was 60.7% that are lower than the finding of AHRQ database 2012 (63.08%). The highest percentage of positive responses were “Team work within Units” (87%). The two dimensions that received the lowest positive responses was “Staffing”(32%) and “frequency of even reporting” (39%) that was lower than the result reported in the US and Taiwan. The positive response of 7 dimensions (Teamwork within units, Supervisor/Management's expectation and action promoting PS, Manager support for Patient safety, Feedback and communication Openness, Communication openness, Handoff and Transition, Nonpunitive Response to Errors, Frequency of Event report)was a significant difference across 5 hospitals (P<0.05).
Conclusion: Patient safety culture assessment is an avenue tools for understanding what healthcare worker think and how they act towards patient safety. This study was the first evaluation about safety culture in Vietnam. The finding of the patient safety culture was lacking and inadequate staffing, the existence of a punitive and blame culture, limited staff’s perception of patient safety that. The result demonstrated that have a significant difference in patient safety culture between difference level hospitals in Vietnam amongst respondent characteristic. Implementing and improving patient safety is a continuous process which need support from government, high attention from administrators and medical staffs. The Vietnam Government will have an overview about weakness and strengthen on patient safety culture, make some discussions and actions for promoting patient safety culture and quality of health care services.