Views and experiences of decision‐makers on organisational safety culture and medication errors

Abstract

Background In 2017, the World Health Organization published ‘Medication Without Harm, WHO Global Patient Safety Challenge’, to reduce patient harm caused by unsafe medication use practices. While the five objectives emphasize the need to create a framework for action, engaging key stakeholders and others, most published research has focused on the perspectives of health professionals. The aim was to explore the views and experiences of decision‐makers in Qatar on organizational safety culture, medication errors and error reporting. Method Qualitative, semi‐structured interviews were conducted with healthcare decision‐makers (policy makers, professional leaders and managers, lead educators and trainers) in Qatar. Participants were recruited via purposive and snowball sampling, continued to the point of data saturation. The interview schedule focused on: error causation and error prevention; engendering a safety culture; and initiatives to encourage error reporting. Interviews were digitally recorded, transcribed, and independently analysed by two researchers using the Framework Approach. Results From the 21 interviews conducted, key themes were the need to: promote trust within the organization through articulating a fair blame culture; eliminate management, professional and cultural hierarchies; focus on team building, open communication and feedback; promote professional development; and scale‐up successful initiatives. There was recognition that the current medication error reporting processes and systems were suboptimal, with suggested enhancements in themes of promoting a fair blame culture and open communication. Conclusion These positive and negative aspects of organizational culture can inform the development of theory‐based interventions to promote patient safety. Central to these will be the further development and sustainment of a ‘fair’ blame culture in Qatar and beyond.