1. Introduction

Health care is vulnerable to error, and so all health care environments and professionals are involved in complex care processes. Since the IOM report [1], almost all countries and health care organizations are attending to Patient Safety issues. In more recent years, the European Council launched a recommendation [2] that shows the importance of establishing patient safety culture in all health care settings. We can read in this recommendation that a poor patient safety represents both a severe public health problem and a high economic burden on limited health resources. A large proportion of adverse events, both in the hospital sector and in primary care, are preventable with systemic factors appearing to account for a majority of them.

(patient centered, effective, timely, efficient, and equitable) and to provide an overall rating on

Patient Safety Culture in Portuguese Primary Care: Validation of the Portuguese Version of the Medical Office…

http://dx.doi.org/10.5772/intechopen.80035

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Composites Items

1. Teamwork C1; C2; C5; C13 2. Patient Care Tracking/Follow Up D3; D5; D6; D9 3. Organizational Learning F1; F5; F7 4. Overall Perceptions of Patient Safety and Quality F2; F3; F4R; F6R 5. Staff Training C4; C7; C10R 6. Owner/Managing Partner/Leadership Support for Patient Safety E1R; E2R; E3; E4R 7. Communication about Error D7R; D8R; D11; D12 8. Communication Openness D1; D2; D4R; D10R 9. Office Processes and Standardization C8R; C9; C12R; C15 10. Work Pressure and Pace C3R; C6R; C11; C14R

According to the MOSPSC author's [8], patient safety culture composites and its definitions are: 1. Teamwork—the extent to which the office has a culture of teamwork, mutual respect, and

2. Patient Care Tracking/Follow Up—the extent to which the office reminds patients about appointments, documents how well patients follow treatment plans, follows up with patients who need monitoring, and follows up when reports from an outside provider

3. Organizational Learning—the extent to which the office has a learning culture that facilitates making changes in office processes to improve the quality of patient care and evalu-

4. Overall Perceptions of Patient Safety and Quality—the extent to which the quality of patient care is more important than getting more work done, office processes are good at

5. Staff Training—the extent to the office gives providers and staff effective on-the-job training, trains them on new processes, and does not assign tasks they have not been trained to

6. Owner/Managing Partner/Leadership Support for Patient Safety—the extent to which office leadership actively supports quality and patient safety, places a high priority on improving patient care processes, does not overlook mistakes, and makes decisions based

7. Communication about Error—the extent to which providers and staff are willing to report mistakes they observe and do not feel like their mistakes are held against them, and

preventing mistakes, and mistakes do not happen more than they should.

close working relationships among staff and providers.

patient safety (Table 1).

are not received.

Table 1. MOSPSC composites and items.

perform.

ates changes for effectiveness.

on what is best for patients.

Before implementing patient safety programs, health care staff must understand their safety culture [3]. Quantitative instruments designed to assess safety culture have been developed, and a few review articles have been published, which allows a more comprehensive way of implementing models of safety culture [4]. Measuring health care safety culture enables us to identify improvements, safety behaviors, and outcomes for both patients and staff. These instruments should also serve as decision making tools, especially for managers.

Much has been done in hospital environment, and more recently, primary care has also been in the sights. A few review articles were published allowing researchers and primary care staff to take robust decisions on tools to assess patient safety culture [5–7].

With the publication of the National Patient Safety Plan (2015–2020), the Portuguese Directory of Health along with the Portuguese Hospital Association carried out patient safety culture assessment either in hospitals or in primary care. It was published as a national standard, and every 2 years, patient safety culture is assessed either in primary care or in hospitals nationwide.

The purpose of this study was to translate, adapt, validate, and analyze the reliability and validity of the Portuguese version of the Medical Office Survey on Patient Safety Culture.
