JMIR Publications

ABSTRACT

Background:

The high prevalence of adverse events globally in healthcare delivery has led to the establishment of many guidelines to enhance patient safety. However, patient safety is a relatively nascent concept in low-middle-income countries (LMICs) where health systems are already overburdened and under-resourced. This is why it is imperative to study the nuances of patient safety from a local perspective to advocate for judicious use of scarce public health resources.

Objective:

To assess the status of patient safety in a low-resource healthcare system using a multipronged, mixed methods approach of standardized methodologies adapted to the local setting.

Methods:

We propose purposive sampling to include a representative mix of public and private, rural and urban, and tertiary and secondary care hospitals, preferably those ascribed to the same hospital quality standards. Six different approaches will be considered at these hospitals including: 1) Focus group discussions on the status quo of patient safety, 2) Hospital Survey of Patient Safety Culture (HSOPSC), 3) Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS), 4) Estimation of incidence of adverse events identified by patients, 5) Estimation of incidence of adverse events via medical record review, and 6) Assessment against the World Health Organization’s (WHO) Patient Safety Friendly Hospital Framework (PSFHF) via thorough reviews of existing hospital protocols and in-person surveys of the facility.

Results:

The above-mentioned studies collectively are expected to yield quantifiable information on patient safety conditions in a wide range of hospitals within a low-resource health system.

Conclusions:

A multidimensional approach is imperative to holistically assess the patient safety situation, especially in LMICs. Our low-budget, non-resource intensive research methodology can serve as a benchmark to conduct similar studies in other low-resource healthcare settings.