Patient Safety Culture in a Tertiary Hospital: A Cross-Sectional Study.

Patient safety (PS) culture is the set of values and norms common to the individuals of an organization. Assessing the culture is a priority to improve the quality and PS of hospital services. This study was carried out in a tertiary hospital to analyze PS culture among the professionals and to determine the strengths and weaknesses that influence this perception. A cross-sectional descriptive study was carried out. The AHRQ Questionnaire on the Safety of Patients in Hospitals (SOPS) was used. A high perception of PS was found among the participants. In the strengths found, efficient teamwork, mutual help between colleagues and the support of the manager and head of the unit stood out. Among the weaknesses, floating professional templates, a perception of pressure and accelerated pace of work, and loss of relevant information on patient transfer between units and shift changes were observed. Among the areas for improvement detected were favoring feedback to front-line professionals, abandoning punitive measures and developing standardized tools that minimize the loss of information.

Identification and prioritisation of risks in a hospital pharmacy using healthcare failure mode and effect analysis.

OBJECTIVES: The goals of this project included identifying the processes and subprocesses performed in hospital pharmacies, identifying potential adverse events, detecting failure modes and the causes of errors, prioritising the risks identified and designing a map of risks for hospital pharmacies. METHODS: A task force composed of hospital pharmacy staff was committed to update the diagram of processes and design a map of processes performed in hospital pharmacies. Risks were identified by failure mode and effect analysis annd prioritised according to their risk priority index (RPI) and criticality. A risk map of adverse events was designed based on the diagram of processes and/or primary activities where the prioritised failure modes were most frequent. RESULTS: In total, 99 failure modes associated with 80 adverse events and 129 causes were identified in eight hospital pharmacy areas/subprocesses. The three areas with the highest percentages of failure modes were inpatient pharmaceutical care, pharmacy laboratory and pharmaceutical technology, and medication management. The 25 failure modes (first quartile) with the highest RPI scores (RPI≥20) and the 25 failure modes with the highest frequency and criticality scores were classified as priority. CONCLUSIONS: According to their RPI, priority failure modes mostly occurred in the area of inpatient pharmaceutical care (92%). However, according to their criticality, priority failure modes were found to homogeneously occur across all pharmaceutical care areas. As general recommendations pharmacists should assume responsibility and leadership in the implementation of safe medication use practices in healthcare centres.