Assessing Patient Safety Culture in a Secondary Care Hospital in Saudi Arabia Using the Hospital Survey on Patient Safety Culture Tool - A Cross-Sectional Study

Q: What was the main purpose of the study?

To assess patient safety culture (PSC) in a secondary care public hospital in Riyadh using the HSOPSC tool, identifying strengths, weaknesses, and predictors of a robust safety culture.

Q: How was patient safety culture measured?

A cross-sectional electronic survey used the bilingual HSOPSC Version 1.0, followed by descriptive statistics, Cronbach’s alpha, Spearman correlation, multiple linear regression, and Kruskal-Wallis tests across professional roles.

Q: Which factors were the strongest predictors of overall PSC?

Non-punitive response to error, event reporting frequency, and communication openness were identified as the strongest predictors of overall PSC (p < 0.001).

Q: What were the key weakest areas found in the results?

Staffing (43%) and communication openness (57%) scored lowest, while unit teamwork and event reporting frequency scored highest (both 85%).

Sep 30, 2026

Uploaded by Sophia Brooks

A positive patient safety culture (PSC) reduces preventable harm and strengthens healthcare outcomes, yet many low- and middle-income settings lack structured PSC measurement. This cross-sectional study evaluated PSC in a 200-bed secondary public hospital in Riyadh, Saudi Arabia, using the Hospital Survey on Patient Safety Culture (HSOPSC) tool. Surveyed 1,084 eligible staff (57% response), it identified strongest areas in unit teamwork and event reporting frequency and weaker domains in staffing and communication openness. Regression indicated non-punitive error responses, reporting frequency, and communication openness as key predictors.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages11

Reading Time28 min

AccessFree to download

Background

Local problem

Methods

Results

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Introduction

Problem description

Available knowledge

Review began 11/18/2025 Review ended 11/27/2025 Published 12/08/2025 © Copyright 2025 Irfan et al. This is an open access article distributed under the terms of the Creative Commons Attribution License CC-BY 4.0. , which permits unrestricted use , distribution , and reproduction in any medium , provided the original author and source are credited. DOI: 10.7759/cureus.98682 Open Access Original Article Assessing Patient Safety Culture in a Secondary Care Hospital in Saudi Arabia Using the Hospital Survey on Patient Safety Culture Tool: A CrossSectional Study Mohammad Irfan 1, Najla Al Motairi 2, Muna Bhutta 3, Abidah Parveen 4, Mohamed El Attar 5 1. Emergency Medicine, Mid Yorkshire Teaching NHS Trust, Wakefield, GBR 2. Quality Management and Patient Safety, Al Iman General Hospital, Riyadh, SAU 3. Obstetrics and Gynaecology, Al Iman General Hospital, Riyadh, SAU 4. Department of Pharmaceutical Sciences, Abbottabad University Of Science and Technology, Havelian, PAK 5. General Surgery, Al Iman General Hospital, Riyadh, SAU Corresponding author: Mohammad Irfan, [irfan.doctor@hotmail.com](irfan.doctor@hotmail.com) Abstract Background: A positive patient safety culture (PSC) is integral to reducing preventable harm and improving healthcare outcomes. In many low-and middle-income countries, there is a lack of structured measurement of PSC, hindering the identification of systemic weaknesses. This study assessed PSC in a secondary care public hospital in Riyadh, Saudi Arabia, using the Hospital Survey on Patient Safety Culture (HSOPSC) tool, with the aim of identifying strengths, weaknesses, and predictors of a robust safety culture. Local Problem: PSC remains under-assessed in Saudi secondary care hospitals, with inadequate systems for event reporting and weak staffing policies. Methods: A cross-sectional study using the bilingual (Arabic/English) HSOPSC Version 1.0 was conducted ina 200-bed secondary hospital. All eligible staff were surveyed electronically. Statistical analysis included descriptive statistics, Cronbach’s alpha for internal consistency, Spearman correlation, and multiple linear regression to identify predictors of overall safety culture. Kruskal-Wallis tests compared scores across professional roles. Intervention: Survey dissemination was supported by departmental champions and aimed to build a baseline for future safety initiatives. Results: Of 1,084 eligible staff, 613 completed the survey (57% response) . Teamwork within units (85%) and frequency of events reported (85%) scored highest; staffing (43%) and communication openness (57%) were weakest. Regression identified non-punitive response to error, event reporting frequency, and communication openness as the strongest predictors of overall PSC (p < 0 .001) . Nurses reported significantly lower scores than physicians (p < 0 .001) . Conclusions: The study highlights strong internal collaboration but emphasises the need for improved staffing and transparency. These results form the basis for targeted quality improvement aligned with national healthcare goals. Categories: Health Policy, Epidemiology/Public Health, Quality Improvement Keywords: communication openness, hsopsc, patient safety culture survey, saudi arabia, staffing Introduction Problem description Patient safety remains one of the most critical global priorities in healthcare. The World Health Organisation (WHO) estimates that approximately one in ten hospitalised patients worldwide experiences some form of harm related to unsafe healthcare practices, and nearly half of these adverse events are considered preventable [1] . In low-and middle-income countries, unsafe medical care is estimated to contribute to approximately 2.6 million deaths annually, primarily due to systemic deficiencies, communication breakdowns, and the underreporting of incidents [2] . These findings highlight the substantial human, ethical, and economic burden associated with preven

FAQs

What was the main purpose of the study?

To assess patient safety culture (PSC) in a secondary care public hospital in Riyadh using the HSOPSC tool, identifying strengths, weaknesses, and predictors of a robust safety culture.

How was patient safety culture measured?

A cross-sectional electronic survey used the bilingual HSOPSC Version 1.0, followed by descriptive statistics, Cronbach’s alpha, Spearman correlation, multiple linear regression, and Kruskal-Wallis tests across professional roles.

Which factors were the strongest predictors of overall PSC?

Non-punitive response to error, event reporting frequency, and communication openness were identified as the strongest predictors of overall PSC (p < 0.001).

What were the key weakest areas found in the results?

Staffing (43%) and communication openness (57%) scored lowest, while unit teamwork and event reporting frequency scored highest (both 85%).

Sep 30, 2026

Uploaded by Sophia Brooks