Assessment of hospital capacities in patient safety in the Philippines

Tags: Poster
Acuin J1
1De La Salle University, Philippines

Background: Despite growing public concerns and more stringent government regulation, Philippine public hospital programs to ensure patient safety are perceived to be hampered by severe infrastructural limitations. Little attention, however, is paid to human resource and programmatic constraints in aligning hospital cultures with organizational goals.

Objectives: To assess human resources, programs and patient safety climates in government hospitals.

Methods: Four 200- to 400-bed public hospitals (one children’s hospital (A), one transplant center (B), one general hospital in an island province (C) and another in Manila (D)) that had begun patient safety programs were included. Human resource and programmatic markers, based on Department of Health hospital accreditation standards implemented since 2010, were determined from key informant interviews and policy document reviews using the Institute for Healthcare Improvement (IHI) framework for achieving patient safety and high reliability. The 19-item IHI Safety Climate Survey was administered to managers and staff in high-risk patient care areas. Summary estimates were calculated for each hospital.

Results: Except for hospital C, the hospitals generally had designated officers and working committees. Hospital C had the lowest nurse to patient bed ratio (1:38). Programmatic markers were generally absent in all four hospitals. Thus, even when working committees are present, the scopes of responsibilities in ensuring patient safety appear limited and underdeveloped. Except for hospital A, the hospitals had no patient disclosure processes. About 60% of the 131 respondents (range, 50%-82%) viewed the safety climate as positive. Overall and patient safety means were highest in hospital B. The lowest scored items involved management action on staff’s safety suggestions and management’s willingness to compromise safety concerns for productivity.

Conclusion: The number of hospital staff engaged in patient safety appears to be adequate. However, they have limited formal programmatic roles and have fair regard for their hospitals' safety climates.