# Patient Safety Culture of Hospitals in Southern Laos: A Cross-Sectional Study Using the Hospital Survey on Patient Safety Culture

## TL;DR

This study assesses patient safety culture in hospitals in southern Laos, finding strong organizational learning but weak nonpunitive error responses and event reporting.

## Contribution

The study provides the first evidence on patient safety culture in southern Laos using a validated survey tool.

## Key findings

- Organizational learning scored over 75% in both provincial and district hospitals.
- Nonpunitive response to error and frequency of events reported scored less than 20% on average.
- Provincial hospitals scored higher in supervisory support and handoffs than district hospitals.

## Abstract

Background: Patient safety culture is critical for enhancing the quality and safety of healthcare. Studies in low- and middle-income countries have reported challenges in developing patient safety culture, especially in implementing nonpunitive responses to errors and event reporting. However, evidence from Laos remains limited. Objectives: This study aimed to assess patient safety culture in hospitals in southern Laos, using a validated survey tool to identify strengths and areas of improvement. Methods: A cross-sectional study using purposive sampling was conducted in four provincial and twenty-three district hospitals in southern Laos. Healthcare workers on patient safety committees responded to the Hospital Survey on Patient Safety Culture. The positive response rate was analyzed. Bivariate tests (chi-square/Fisher’s exact) were applied to compare positive response rates between hospital types and professions. Results: A total of 253 valid responses (75.5%) were analyzed. “Organizational Learning–Continuous Improvement” scored over 75% in both provincial and district hospitals. In contrast, “Nonpunitive Response to Error” and “Frequency of Events Reported” were scored <20% on average. Provincial hospitals scored significantly higher than district hospitals in supervisory support and handoffs. Conclusions: This study illustrated strengths in organizational learning while identifying nonpunitive responses and event reporting as critical areas of improvement for hospitals in Laos. To improve patient safety, hospitals in Laos must promote a culture in which errors can be reported without fear of blame. Strengthening leadership support and reporting systems is essential. These findings can inform strategies to enhance patient safety in other low-resource healthcare settings.