Patient Safety Culture in a Saudi Health Cluster: A Cross-sectional Survey

The Saudi Patient Safety Center cross-sectional survey, based on the Agency for Healthcare Research and Quality Hospital Survey on Patient Safety Culture 2.0, was conducted from September 3 to October 28, 2023 to summarize the patient safety culture profile in Eastern Health Cluster hospitals and to identify benchmark, hospital-size, and staff-category patterns relevant for improvement. Ten composites were computed as percent-positive scores and descriptively compared with Saudi and US benchmarks. Of the 13,507 eligible staff, 10,853 responded (80%), and 83% reported having direct contact with patients. The mean percent-positive score for all was 63.29%. Teamwork (74.49%) and organizational learning-continuous improvement (71.76%) had the highest scores. The lowest scores were for Staffing and Work Pace (43.93%), Response to Error (51.09%), and Hospital Management Support for Patient Safety (57.73%). All composites had scores below Saudi benchmarks and smaller hospitals (≤200 beds) had higher scores than larger hospitals (>200 beds). Reporting Patient Safety Events had a score of 66.95%, with 53% of respondents reporting no patient safety events in the past 12 months, suggesting that voluntary reporting may not reflect the true picture of patient safety. The key areas for improvement are staffing, work pace, nonpunitive approach to error, and leadership support. Nurse-to-patient staffing and acuity review should be combined with just culture practices, closed-loop feedback, and active event detection via trigger tools and chart review.