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Curr Health Sci J. 2017 Jan-Mar;43(1):31-40. doi: 10.12865/CHSJ.43.01.05. Epub 2017 Sep 27.

Measuring Patient Safety Culture in Romania Using the Hospital Survey on Patient Safety Culture (HSOPSC).

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Department of Hygiene and Prevention, Agenzia di Tutela della Salute, Bergamo, Italy.
Department of Public Health and Healthcare management, University of Medicine and Pharmacy of Craiova, Romania.
Epidemiological Service,Agenzia di Tutela della Salute, Bergamo, Italy.
Department of Public Health and Healthcare management, University of Medicine and Pharmacy of Bucharest, Romania.
Heart Institute "NiculaeStancioiu", Cluj-Napoca, Romania.
Pneumophtisiology Hospital Brasov, Romania.
Filantropia Hospital, Craiova, Romania.
Obstetrics and Gynaecologic Unit, Filantropia Hospital Craiova, Romania.


Purpose To explore patient safety culture among Romanian staff, using the U.S. Hospital Survey on Patient Safety Culture (HSOPSC).


A cross-sectional study was carried out in six hospitals, located in four Romanian regions (Craiova, Cluj-Napoca, Bucharest and Brasov), based on staff census in the Units/hospitals which volunteered to participate in the study (N=1,184). The response rate was 84%. The original questionnaire designed by the American Agency for Healthcare Research and Quality was translated into Romanian (with back translation), pre-tested before application and psychometrically checked. It consists of 42 questions grouped in 12categories, covering multiple aspects of patient safety culture (dimensions). Percentages of positive responses (PPRs) by question and category were analyzed overall and by staff profession.


Most respondents were nurses (69%). The main work areas were surgery (24%) and medicine (22%). The highest PPRs were for Supervisor/Manager Expectations & Actions Promoting Safety (88%), Teamwork Within Units (86%), Handoffs and Transitions (84%), Organizational Learning-Continuous Improvement (81%), Overall Perceptions of Safety (80%), Feedback & Communication About Error (75%). The lowest PPRs were for: Staffing (39%), Frequency of Events Reported (59%) and Non-punitive Response to Errors (61%). Nurses exhibited significantly higher PPRs than doctors.


This small-scale study of staff's attitude towards patient safety in Romanian hospitals suggests that there is room for future improvement, especially within the doctor category. Further research should assess the relationship between patient safety culture and frequency of adverse events.


HSOPSC; Patient safety culture; Romania; hospital; staff

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