Improving patient safety culture in hospitals: A scoping review

Patient safety culture is the product of individual and group behaviors that determine the commitment, style, and proficiency of a healthy and safe healthcare organization. To improve a hospital's patient safety culture, it is necessary to understand the strategies that exist and those that best impact health outcomes.

Analyze strategies that modify patient safety culture in the hospital environment.

A scoping review was conducted of experimental or quasi-experimental studies published until March 2025 on different strategies that determine patient safety culture. The terms used were related to "Patient Safety," "Safety Management," "Organizational Culture," "Experimental or Quasi-experimental studies," and "Hospitals" and for the search, the databases Cochrane, Embase, PubMed, Scopus, and Web of Science. Subsequently, two researchers independently analyzed the titles, abstracts, and full texts, and a third evaluator resolved divergences in the selection of studies.

Fifty one studies were included in this systematic review. 17 studies were named before and after, 16 quasi-experimental studies, 11 randomized controlled trial and seven as interrupted time-series studies. Regarding strategies to improve safety culture, educational strategies were used in 31 (60.8 %) studies, cooperative work strategies were identified in nine (17.6 %), and organizational change strategies were applied in 11 (21.6 %). Five studies correlated the strategies applied in patient safety culture with the clinical outcomes in patient health, and only one study measured the economic impact.

It can be concluded that the strategies that brought the most relevant results to the patient safety culture in hospitals were those with greater cooperation from health professionals with a focus on teamwork, those with a duration and follow-up of over one year, those focused on optimizing the relationship between professionals and the institution's leaders, and those that optimized clinical and economic outcomes.