The aim of the study. To evaluate the safety culture in domestic health care using a mixed approach, that is, using a questionnaire survey, document analysis, as well as an analysis of the state of safety of patients and medical personnel.

Materials and methods. The evaluation of safety culture in Ukrainian healthcare has been carried out based on the methodology of the IAEA (International Atomic Energy Agency), specifically employing a triangulation approach involving questionnaire surveys, document analysis, as well as an analysis of patient and medical personnel safety conditions. Our analysis and assessment of the regulatory framework for safety provision in the hospital environment from 1994 to 2020, as well as the safety status of patients from 2003 to 2020 and medical personnel from 2002 to 2018, formed the basis of the material used in this study. Additionally, the evaluation of safety culture was conducted through a questionnaire survey involving 199 healthcare professionals from various healthcare facilities.

Research results. The study revealed that safety culture in domestic healthcare facilities is at an early stage of formation and requires systematic improvement. Developing a more comprehensive methodology for assessing safety culture in the medical field is an important and promising direction for future research. The results of our study confirmed the effectiveness of employing a triangulation approach to assess the level of safety culture excellence in healthcare facilities.

Conclusions. Strengthening the identified weaknesses in safety culture within the domestic medical industry can become the goal and foundation of a future strategy to create a safe hospital environment based on improving and enhancing safety culture.

healthcare, safety culture, patient safety, healthcare institutions

1. Arslan V, Kurt RE, Turan O, De Wolff L. Safety culture assessment and implementation framework to enhance maritime safety. Transportation Research Procedia. 2016;14:3895-904. https://doi.org/10.1016/j.trpro.2016.05.477

2. Leadership and management for safety: general safety requirements part 2. Vienna: International Atomic Energy Agency; 2016. 47 p. IAEAL 16-01048.

3. Halligan M, Zecevic A. Safety culture in healthcare: a review of concepts, dimensions, measures and progress. BMJ Quality & Safety. 2011 Feb 8;20(4):338-43. https://doi.org/10.1136/bmjqs.2010.040964

4. International Atomic Energy Agency: IAEA safety culture perception questionnaire for license holders:working document; 2017. 26 p.

5. Hudson P. Implementing a safety culture in a major multi-national. Safety Science. 2007 Jul;45(6):697-722. https://doi.org/10.1016/j.ssci.2007.04.005

6. Kultura bezopasnosti na yadernikh ustanovkakh [Safety culture in nuclear installations]. Vienna: IAEA; 2002. 98 p. TECDOC-1329. Russian

7. OSART independent safety culture assessment (ISCA) guidelines. Vienna: International Atomic Energy Agency; 2016. 50 p. IAEA Services Series No. 32.

8. Pro skhvalennia Kontseptsii reformuvannia systemy upravlinnia okhoronoiu pratsi v Ukraini ta zatverdzhennia planu zakhodiv shchodo yii realizatsii[On the approval of the Concept of reforming the labour protection management system in Ukraine and the approval of the plan of measures for its implementation], Rozporiadzhennia Kabinetu Ministriv Ukrainy [Order of the Cabinet of Ministers of Ukraine] No. 989-r, 2018 Dec 1. Ukrainian https://zakon.rada.gov.ua/laws/show/989-2018-р#Text

9. Granel-Gimйnez N, Palmieri PA, Watson-Badia CE, Gуmez-Ibбсez R, Leyva-Moral JM, Bernabeu-Tamayo MD. Patient safety culture in european hospitals: a comparative mixed methods study. International Journal of Environmental Research and Public Health. 2022 Jan 14;19(2):939. https://doi.org/10.3390/ijerph19020939

10. Skaletskyi YuM, Yavorovskyi OP, Hychka SH, Ryhan MM, Didkovskyi VL, Brukhno RP. [Trends in inpatient and postoperative mortality as indicators of patient safety in Ukraine]. Ukrainskyi medicnyi chasopys [Ukrainian Medical Journal]. 2020 Jul 3. Ukrainian https://doi.org/10.32471/umj.1680-3051.137.182411

11. [Trends in in-hospital and postoperative mortality as indicators of patient safety at the level of individual healthcare facilities (message 2)]. Ukrainskyi medicnyi chasopys [Ukrainian Medical Journal]. 2020 Dec 29;140. Ukrainian https://doi.org/10.32471/umj.1680-3051.140.196368

12. Naumenko AN, Skaletsky YN, Regan MM, Didkovsky VL. [The scope of inpatient mortality due to safety incidents in domestic hospitals]. Svit medicyny ta biolohii [World of Medicine and Biology]. 2020;16(73):074. Ukrainian https://doi.org/10.26724/2079-8334-2020-3-73-74-77

13. Yavorovsky OP, Rygan MM, Ivanko AV, Skaletsky YM, Brukhno RP, Mikhailenko PM, Zinchenko TA, Badiuk MI. [The system of ensuring the safety of personnel and patients in hospitals: a strategy for improvement]. Ukrainskyi zhurnal viiskovoi medicyny [Ukrainian Journal of Military Medicine]. 2021 Jun 30;2(2):23-33. Ukrainian. https://doi.org/10.46847/ujmm.2021.2(2)-023

14. Yavorovsky AP, Rygan MM, Naumenko AN, Skaletsky YN, Gichka SG, Ivanko AV, Brukhno RP, Gorval AK. [Patient safety culture in health care facilities in Ukraine (message 1)]. Medicni Perspektivi (Medical Perspectives). 2021 Sep 30;26(3):179-87. Ukrainian. https://doi.org/10.26641/2307-0404.2021.3.242257.

15. Yavorovsky AP, Rygan MM, Naumenko AN, Skaletsky YN, Gichka SG, Ivanko AV, Varyvonchyk DV, Shkurba AV et al. [A comparative analysis on safety culture in domestic and foreign health care facilities and enterprises of other activities (message 2)]. Medicni perspektivi (Medical Perspectives). 2021 Dec 20;26(4):153-60. Ukrainian. https://doi.org/10.26641/2307-0404.2021.4.248210.