Exploring human factors that affect patient safety in dentistry: a qualitative study of hospital-based practice

This qualitative study explores how hospital-based dental professionals in Pakistan perceive and navigate human factors that influence patient safety, with particular attention to the structural and cultural contexts of low- and middle-income countries (LMICs) like Pakistan.

A qualitative exploratory design grounded in the SEIPS (Systems Engineering Initiative for Patient Safety) framework was employed. Purposive sampling was used to recruit participants with clinical experience in hospital-based dentistry. Interviews were audio-recorded, transcribed, and thematically analysed using Braun and Clarke's framework, with deductive mapping to SEIPS domains. Member checking and coder triangulation supported analytical rigour.

Following interviews with 29 participants, three interrelated domains emerged: (1) Individual-level preconditions for safe practice, such as fatigue, emotional stress, and cultural sensitivity; (2) Team and process-level factors, including hierarchical barriers, communication gaps, and reliance on experienced support staff; and (3) Organisational and systemic conditions, including inadequate infrastructure, time pressure, and punitive supervisory cultures. These factors interact dynamically to affect clinical decision-making and procedural safety.

Human factors shape patient safety in dental hospitals, particularly within LMIC contexts where structural limitations and cultural norms amplify existing risks. Addressing these challenges requires context-sensitive safety protocols, enhanced communication frameworks, ergonomic reforms, and supportive supervision. Findings underline the importance of integrating human factors education into dental curricula and governance to promote a culture of safety.