Policy Analysis of the Patient Safety Culture Program in Iran Using the Policy Analysis Triangle Framework

Background: Healthcare is one of the most complex human activities that is inherently associated with a high potential to create risk. To this end, the present study aimed to perform a policy analysis of the patient safety culture program in Iran and present some recommendations for necessary reforms. Methods: The present study was conducted using a policy analysis approach and a retrospective design following Walt and Gilson’s (1994) policy analysis triangle framework. Various methods were used to analyze the patient safety culture program, including reviewing the literature and related documents. Furthermore, to validate the research findings, a qualitative study was conducted using guided content analysis, and semi-structured interviews were conducted with nine subject-matter experts. Results: The policy analysis of the patient safety culture program found that most of the actors who played a role in establishing and implementing the program did not perform well in promoting patient safety culture in Iranian hospitals, and the infrastructures necessary for its implementation are not available in many hospitals in Iran. Thus, factors that require prompt intervention, including non-punitive response to errors, management support, staff shortages, and interdisciplinary teamwork, need to be considered as action priorities. Conclusion: Patient safety in hospitals should be classified as a strategic priority based on the existing infrastructure and organizational culture of Iranian hospitals and be implemented in the form of detailed plans of action. Thus, adapting the required training in the undergraduate nursing program and considering the interests of all stakeholders can contribute to the full establishment of this program across hospitals.