Patient safety culture assessment in Iran using the "Hospital survey on patient safety culture" tool: A systematic review and meta-analysis

Background: Paying attention to patient safety is a crucial aspect of the healthcare provision delivery. Integrating and coordinating the different parts of the health system can ensure a safe, high-quality and efficient care. Patient safety culture (PSC) is a broad, complex and multi-dimensional conceptual framework. In recent years, several studies have been conducted to evaluate PSC using the "Hospital Survey on Patient Safety Culture" (HSOPSC) tool. The aim of this study was to examine the level of PSC in Iranian hospitals. Methods: ISI/Web of Sciences (WoS), PubMed/MEDLINE, Embase, CINAHL, PsychINFO and Scopus as well as Iranian databases including Maglran and SID were searched from January 2000 to July 2018. The Newcastle-Ottawa Scale checklist was used to assess the quality of the studies. The mean score of the participants' responses for each dimension of the questionnaire was calculated using the DerSimonian-Laird's random model with a 95% confidence interval. Results: In the current systematic review and meta-analysis, 27 studies conducted between 2012 and 2017 were included. The participants were 9264. Low scores (in the range 37.79-65.43) were found, especially when compared to other countries such as Lebanon, Turkey and the USA. Conclusion: Our results showed that in Iran the level of PSC is low and requires special attention from healthcare managers and providers. PSC should be a very important priority in Iran's health sector. Health decision- and policy-makers should pay particular attention to offering training programs to promote and develop PSC.