Patient Safety Knowledge and Compliance Among Physicians in Public Hospitals in Lebanon

Abstract

Introduction: Patient safety (PS) remains a paramount concern within the global healthcare landscape. Among healthcare practitioners, physicians, by virtue of their central role in healthcare, have a major direct and indirect influence on PS. Their knowledge and practices shape the safety culture and the prevention of adverse events. This research aims at evaluating PS knowledge, attitudes, and practices, and their determinants among physicians in all 28 Lebanese public hospitals.

Methods: Data were obtained for analysis from a previous exhaustive survey in 2020-2021.

Results: The survey included 111 physicians, of whom 67% were men and 33% women. The average age of the group was 34 years. Most work locations (62.2%) were in rural areas. About 65% reported the absence of PS training in their medical curriculum. Six dimensions of PS knowledge were summed up in one overall score, with a mean of 60 on a scale of 0-100 (SD= 19.9). The mean actual “compliance” of participants with PS goals, was 58.8 (SD = 10.7) on a range from 0-100. On multivariate linear regression, higher compliance with PS goals was associated with the hospital’s urban location, alternating work schedule, presence of a PS office, PS knowledge score, and lower frequency of reporting events.

Discussion and conclusions: Compliance was highest in urban hospitals, often linked to a university, although some notable exceptions imply that urban location and university affiliation alone do not guarantee robust PS practices. Physicians’ engagement, institutionalized prioritization of patient safeguards, and enforced protocols on the other hand appear to be vital determinants of successful implementation. Active monitoring and oversight mechanisms specifically targeting physicians may yield an important improvement, especially since physicians are often looked upon as leaders in establishing and upholding PS standards within a hospital setting. The implementation of PS structures and protocols can be enhanced through a reformed accreditation process integrating more dimensions of PS than is the current practice. Inter-hospital collaboration within the same geographical area to create CME modules for training in PS has been reported to be a good tool for improvement in PS outcomes in Lebanon.