Rethinking Patient Safety Culture: A Systematic Review of Its Multilevel Impact on Adverse Events in Hospital Settings

Abstrak

Background: Patient safety culture (PSC) is an important factor in improving healthcare quality and preventing adverse events in hospitals. However, previous studies have reported inconsistent findings regarding the relationship between patient safety culture and adverse events.

Objective: This study aimed to examine how patient safety culture at the individual, team, organizational, and system levels influences adverse events in hospital settings.
Methods: This study used a systematic review method following the PRISMA 2020 guideline. Literature searches were conducted through PubMed, Scopus, and Google Scholar databases for articles published between 2021 and 2026. Articles were selected using the PICOS framework. A total of seven articles that met the inclusion criteria were analyzed using narrative synthesis.

Results: The findings showed that patient safety culture is influenced by several factors, including communication, teamwork, leadership, incident reporting systems, and staffing adequacy. Hospitals with a strong patient safety culture tend to have lower rates of adverse events. In addition, infection prevention practices, open communication, and non-punitive reporting systems play important roles in improving patient safety. However, previous studies have reported inconsistent findings the association between patient safety culture and adverse events.

Conclusion: Patient safety culture plays an important role in reducing the risk of adverse events in hospitals. Efforts to improve safety culture should be implemented comprehensively through organizational support, effective communication, and safe clinical practices.