Contributing factors to patient safety: Mixed-methods study of Brazilian patient experiences

Background: We aimed to analyze the contributing factors to patient safety based on the perception and experience of Brazilian patients hospitalized for COVID-19 treatment.Methodology: This is a concurrent nested mixed-method design, with a predominant emphasis on quantitative methods embedded by qualitative components.Patients hospitalized for COVID-19 treatment at four Brazilian university hospitals participated in this study.The Patient Measure of Safety (PMOS) was applied to 293 patients, from among these, 35 patients were interviewed following the Critical Incident Technique (CIT) method.Survey data were analyzed using descriptive and inferential statistics.The J o u r n a l P r e -p r o o f interviews were analyzed using content analysis technic.Results: The most favorable contributing factors to patient safety were communication, teamwork, and organization of care.Positive interactions with the healthcare team, empathy, and respectful attitudes helped patients feel safe.However, factors such as inconsistent information flow, inadequate staffing and delays in care, revealing ongoing safety challenges.These challenges may be associated with active errors, such as patient reports of adverse events.Despite patients' perceptions of safety and trust in healthcare professionals, systemic issues, such as staff shortages, communication failures, and lack of resources, continue to compromise patient safety.Conclusions: These findings underscore the importance of strengthening communication systems, improving working conditions, and actively involving patients in safety strategies.