Improving Patient Safety Culture in Conflict-Affected Zones: A Cross-Sectional Survey of North Kivu Surgical Personnel in the Democratic Republic of the Congo.

Abstract

Background: Patient safety culture significantly impacts outcomes in surgery, where preventable errors can occur. This study assessed patient safety culture and its determinants in operating rooms across North Kivu, a conflict-affected province in the eastern Democratic Republic of the Congo (DRC).

Methods: A descriptive multicenter cross-sectional study was conducted from July to September 2024 in five urban and six rural hospitals. The French version of the Hospital Survey on Patient Safety Culture (HSOPSC) questionnaire was administered to 328 operating room healthcare professionals.

Results: The response rate was 78% (256 completed surveys). Urban hospitals accounted for 55.5% of respondents, who were 73.4% male and 62.5% under the age of 40. The overall composite score for patient safety culture was 63.2%. Teamwork (81.1%) and management support for patient safety (77.7%) received the highest positive responses, whereas error reporting (39.9%) and patient safety event reporting (50%) scored lower. Half (49.6%) of the respondents rated patient safety as excellent or very good. There were no significant differences in overall mean composite scores between urban and rural hospitals (p = 0.677) and between medical and paramedical staff (p = 0.694).

Conclusions: The patient safety culture rating in North Kivu falls below international standards, highlighting an urgent need for improvement, particularly in error response and event reporting. Developing a tailored patient safety bundle for the region is essential to enhance overall health outcomes.