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Changes in Patient Safety Culture in Palestinian Public Hospitals

Impact of Quality and Patient Safety Initiatives and Programs

Hamdan, Motasem, PhD*; Saleem, Abed Alra'oof, MSc

doi: 10.1097/PTS.0000000000000522
Original Articles

Objectives To assess the changes in the patient safety culture between 2011 and 2016 after the implementation of patient safety initiative in Palestinian public hospitals.

Methods A cross-sectional quantitative design employed using the Hospital Survey on Patient Safety Culture to collect data. Participants were 1,229 clinical and nonclinical employees from all public hospitals in the West Bank.

Results Significant improvements were observed in patient safety culture with positive responses to 10 (83.3%) composite categories and 36 (86.0%) items of the Hospital Survey on Patient Safety Culture since the baseline survey in 2011 (P < 0.05). The increase in the percent of positive responses to the survey composites ranged from 9.1% (P < 0.001) to “Frequency of events reported” to 3.8% for “Teamwork across hospital units” (P < 0.001). Significant decrease in positive responses to “Staffing” (11.4%) was observed (P < 0.05); no significant change was observed in “Organizational learning—continuous improvement” (P > 0.05). Most participants (70.5%) rated patient safety level in their units/hospital as ‘Excellent/Very good’, with an increase of 6.3% from the baseline (P < 0.001); no significant increase in the number of reported events in the past 12 months was observed (P < 0.05).

Conclusions Compared with the baseline survey results, patients’ safety initiatives and quality improvement programs had positive effect on the safety culture in public Palestinian hospitals.

From the *Faculty of Public Health, Al-Quds University, East Jerusalem, Occupied Palestinian Territory; and

Palestinian Ministry of Health, Ramallah, Occupied Palestinian Territory.

Correspondence: Motasem Hamdan, PhD, Faculty of Public Health, Al-Quds University, East Jerusalem, PO Box 51000, Occupied Palestinian Territory (e-mail:

The authors disclose no conflict of interest.

There are no sources of financial support.

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