• Motasem Hamdan and Abed Alra'oof Saleem.
• Faculty of Public Health, Al-Quds University, Jerusalem, occupied Palestinian territory. mhamdan@med.alquds.edu; mutasemhamdan@yahoo.com
• Int J Qual Health Care. 2013 Apr 1;25(2):167-75.

ObjectiveTo assess the prevalent patient safety culture in Palestinian public hospitals.DesignA cross-sectional design, Arabic translated version of the Hospital Survey on Patient Safety Culture was used.SettingAll the 11 general public hospitals in the West Bank.ParticipantsA total of 1460 clinical and non-clinical hospital staff.Intervention(S)No.Main Outcome MeasuresTwelve patient safety culture composites and 2 outcome variables (patient safety grade and events reported in the past year) were measured.ResultsMost of the participants were nurses and physicians (69.2%) with direct contact with patients (92%), mainly employed in medical/surgical units (55.1%). The patient safety composites with the highest positive scores were teamwork within units (71%), organizational learning and continuous improvement (62%) and supervisor/manager expectations and actions promoting patient safety (56%). The composites with the lowest scores were non-punitive response to error (17%), frequency of events reported (35%), communication openness (36%), hospital management support for patient safety (37%) and staffing (38%). Although 53.2% of the respondents did not report any event in the past year, 63.5% rated patient safety level as 'excellent/very good'. Significant differences in patient safety scores and outcome variables were found between hospitals of different size and in relation to staff positions and work hours.ConclusionsThis study highlights the existence of a punitive and blame culture, under-reporting of events, lack of communication openness and inadequate management support that are key challenges for patient safe hospital care. The baseline survey results are valuable for designing and implementing the patient safety program and for measuring future progress.

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