Patient safety at a public hospital in southern India: A hospital administration perspective using a mixed methods approach

Background: Patient safety cannot be considered in isolation when organizational factors, both active and latent, influence patient outcomes. Methods: We did a cross-sectional mixed methods study using a convergent parallel design at a tertiary care public sector hospital in Hyderabad, Telangana (i) to qualitatively investigate the nature and determinants of patient safety incidents occurring in the hospital; (ii) to quantify the perception of hospital staff regarding factors affecting patient safety from an organizational perspective; and (iii) to triangulate the results to highlight areas in need of improvement. Results: The most common factors affecting patient safety were situational factors, working conditions and latent organizational factors including communication systems. Despite the relatively poor knowledge of paramedical staff regarding patient safety incidents, they perceived innovation and flexibility, outward focus, reflexivity, quality, pressure to produce, performance feedback and effort to be significantly higher compared to the heads of departments and clinical faculty. The strength of the dimensions: integration, involvement, training, welfare, supervisory support in the hospital was weak as perceived by all categories of staff. Conclusion: There is a need to build team work, improve trust and communication between various departments, invest more in training, and provide supervisory support along with structural and process improvements in issues such as drug procurement and developing patient-friendly physical environment.