Patient Safety Culture Assessment in Five Public Hospitals of Sichuan Province: A Cross-Sectional Study with HSOPSC 2.0

Wenjun Li^1,2Chunyan Peng^1,2Li Gu^1,2Wenjing Fu^1,2*Fangmei Tang^1,2*

• ¹Department of Obstetric Nursing, West China Second University Hospital, Sichuan University, Chengdu, China
• ²Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, China

Background：Patient safety is a core issue in the medical field, influenced by patient safety culture (PSC). Research on PSC in southwestern China remains insufficient. Methods：This study is a cross-sectional survey. A convenience sample of healthcare workers from 5 hospitals in Sichuan Province was surveyed during January to March 2025. The Chinese version of the Hospital Survey on Patient Safety Culture 2.0 was used to assess participants' perceptions of PSC. SPSS 22.0 was used for data analysis, including descriptive statistics, Pearson correlation, t-tests, and ANOVA. Thematic analysis addressed open-ended comments. Results：This study collected 468 valid questionnaires. Among the participants, the majority were female (91.2%) and nurses (80.3%). The overall average positive response rate for PSC was 69.4%. 5 dimensions were identified as strengths, with positive response rates ranging from 75.4% to 83.4%: “Communication about error”, “organizational learning-continuous improvement”, “team work”, “support for patient safety”, and “handoffs and information exchange”. In contrast, 4 dimensions required improvement (positive response rates: 51.5%–71.2%), including “staffing and work pace”, “response to error”, “reporting patient safety events”, and “communication openness”. Notably, the positive response rate for “reporting patient safety events” was 53.1%, which was significantly lower than the 76.0% reported by AHRQ in 2024. Univariate analysis demonstrated statistically significant associations between safety culture scores and several variables, including working hours per week, work unit, adverse event reporting frequency, and self-reported overall patient safety ratings (P<0.05). Qualitative analysis of open-ended comments identified seven primary themes, emphasizing the need for improvements in staffing levels, workload management, and administrative support. Conclusions：Our study reveals that the patient safety culture among healthcare professionals in Sichuan Province is at a moderate level, has not reached the expected standard. Notably, there exist significant gaps in critical domains, such as patient safety events reporting, when compared with developed regions, which underscores the imbalance in medical safety concepts across different regions. Future efforts should focus on establishing non-punitive reporting and learning mechanisms, optimize the allocation of human resources and clinical workflows, and ultimately foster a more robust and advanced PSC.