Building a safety culture in global health: lessons from Guatemala.

Journal Article (Journal Article;Review)

Programmes to modify the safety culture have led to lasting improvements in patient safety and quality of care in high-income settings around the world, although their use in low-income and middle-income countries (LMICs) has been limited. This analysis explores (1) how to measure the safety culture using a health culture survey in an LMIC and (2) how to use survey data to develop targeted safety initiatives using a paediatric nephrology unit in Guatemala as a field test case. We used the Safety, Communication, Operational Reliability, and Engagement survey to assess staff views towards 13 health climate and engagement domains. Domains with low scores included personal burnout, local leadership, teamwork and work-life balance. We held a series of debriefings to implement interventions targeted towards areas of need as defined by the survey. Programmes included the use of morning briefings, expansion of staff break resources and use of teamwork tools. Implementation challenges included the need for education of leadership, limited resources and hierarchical work relationships. This report can serve as an operational guide for providers in LMICs for use of a health culture survey to promote a strong safety culture and to guide their quality improvement and safety programmes.

Full Text

Duke Authors

Cited Authors

  • Rice, HE; Lou-Meda, R; Saxton, AT; Johnston, BE; Ramirez, CC; Mendez, S; Rice, EN; Aidar, B; Taicher, B; Baumgartner, JN; Milne, J; Frankel, AS; Sexton, JB

Published Date

  • 2018

Published In

Volume / Issue

  • 3 / 2

Start / End Page

  • e000630 -

PubMed ID

  • 29607099

Pubmed Central ID

  • PMC5873535

International Standard Serial Number (ISSN)

  • 2059-7908

Digital Object Identifier (DOI)

  • 10.1136/bmjgh-2017-000630


  • eng

Conference Location

  • England