Patient safety knowledge and compliance among physicians in public hospitals in Lebanon

Authors

  • Mohamed M. Khamis Department of Medicine, Mercy Hospital St. Louis, Missouri, USA https://orcid.org/0000-0002-3419-2173
  • Hayat Akoum Faculty of Public Health, Lebanese University, Beirut, Lebanon
  • Salim M. Adib Epidemiology and Population Health Department, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon

DOI:

https://doi.org/10.18203/2394-6040.ijcmph20252080

Keywords:

Patient safety culture, Hospital accreditation, Medical error prevention, International patient safety goals, Patient safety, Healthcare Compliance

Abstract

Background: Patient safety (PS) remains a global healthcare concern. Physicians, through their central role, significantly influence PS culture and adverse event prevention. This research evaluates PS knowledge, attitudes, practices, and their determinants among physicians in Lebanese public hospitals.

Methods: This study is a secondary data analysis from a survey conducted with healthcare workers in Lebanese public hospitals in 2020-2021. Data were analyzed using descriptive statistics and multivariate linear regression to identify factors associated with PS compliance.

Results: The study included 111 physicians (67% men, 33% women; average age 34 years), with 62.2% working in rural areas. Six dimensions of PS knowledge yielded a mean score of 60/100 (SD=19.9). Mean compliance with PS goals was 58.8/100 (SD=10.7). Multivariate linear regression showed higher compliance associated with urban hospital location, alternating work schedules, presence of a PS office, higher PS knowledge scores, and lower frequency of reporting events.  

Conclusions: Compliance was highest in urban hospitals with university affiliations, though exceptions indicated these factors alone don't guarantee robust PS practices. Physician engagement, institutionalized prioritization of safeguards, and enforced protocols were key determinants of successful implementation. Active monitoring mechanisms targeting physicians may yield significant improvements, as physicians often establish PS standards within hospitals. PS structures and protocols can be enhanced through reformed accreditation processes integrating more PS dimensions. Inter-hospital collaboration creating continued medical education modules for PS training has shown positive outcomes in Lebanon.

Metrics

Metrics Loading ...

References

WHO. Patient Safety. WHO. Accessed 11 September 2023, 2023. Available at: https://www.who.int/newsroom/factsheets/detailpatientsafety#:~:text=Key%20facts,from%20unsafe%20care%20(1). Accessed on 3 March 2025.

Institute of Medicine (US) Committee on Quality of Health Care in America. To Err is Human: Building a Safer Health System. In: Kohn LT, Corrigan JM, Donaldson MS, eds. Washington, DC: National Academies Press (US); 2000.

Leape L, Berwick D, Clancy C, Conway J, Gluck P, Guest J, et al. Transforming healthcare: a safety imperative. Qual Saf Health Care. 2009;18(6):424-8. DOI: https://doi.org/10.1136/qshc.2009.036954

Joint Commission I, Joint Commission on Accreditation of Healthcare O. Joint Commission International accreditation standards for hospitals: including standards for Academic Medical Center Hospitals. Seventh edition ed. Joint Commission Resources Oak Brook, Illinois; 2020. Available at: https://www.clinicalkey.com/dura/browse/bookChapter/3-s2.0-B9781635851489X50013. Accessed on 3 March 2025.

Sorra J. Hospital survey on patient safety culture. AHRQ publication: 2004.

Sorra J YN, Famolaro T, et al. Quality AfHRa, ed. AHRQ Hospital Survey on Patient Safety Culture Version 2.0: User’s Guide. Agency for Healthcare Research and Quality; 2021. Available at: https://www.ahrq.gov/sites/default/files/wysiwyg/sops/surveys/hospital/hospitalsurvey2-users-guide.pdf Accessed on 3 March 2025.

Elmontsri M, Almashrafi A, Banarsee R, Majeed A. Status of patient safety culture in Arab countries: a systematic review. BMJ Open. 2017;7(2):e013487. DOI: https://doi.org/10.1136/bmjopen-2016-013487

El-Jardali F, Jaafar M, Dimassi H, Jamal D, Hamdan R. The current state of patient safety culture in Lebanese hospitals: a study at baseline. Int J Qual Health Care. 2010;22(5):386-95. DOI: https://doi.org/10.1093/intqhc/mzq047

Al Akoum HASMA, Akoum HA, El Abed AA, Salameh PR. Patient Safety Knowledge and Compliance Among Nurses In Public Hospitals In Lebanon. IOSR J Nurs Health Sci (IOSR-JNHS). 2022;11(3):11.

Ministry of Public Health L. Accreditation Standards for Hospitals in Lebanon. Ministry of Public Health, Lebanon. Accessed December, 2022. Available at: https://www.moph.gov.lb/en/Pages/ 3/20553/-revised-hospital-accreditation-standards-in-lebanon-december-2022. Accessed on 3 March 2025.

JCI. Joint Commission International Accreditation Standards for Hospitals (7 ed.). Available at: https://www.jointcommissioninternational.org/-/media/jci/jci-documents/accreditation/hospital-and-amc/jci-errata-standards-only_7th-ed-hospital.pdf. Accessed on 14 March 2025.

El-Jardali F, Jamal D, Dimassi H, Ammar W, Tchaghchaghian V. The impact of hospital accreditation on quality of care: perception of Lebanese nurses. Int J Quality Health Care. 2008;20(5):363-71. DOI: https://doi.org/10.1093/intqhc/mzn023

El-Jardali F, Fadlallah R. A review of national policies and strategies to improve quality of health care and patient safety: a case study from Lebanon and Jordan. BMC Health Serv Res. 2017;17(1):568. DOI: https://doi.org/10.1186/s12913-017-2528-1

(MOPH) TLMoPH. Revised Hospital Accreditation Standards in Lebanon- December 2022. Available at: https://www.moph.gov.lb/en/Pages/3/20553/-revised-hospital-accreditation-standards-in-lebanon-december-2022. Accessed on 3 March 2025.

El-Jardali F, Jaafar M, Jamal D, Rabbaa S. Integrating patient safety standards into the accreditation program: a qualitative study to assess the readiness of Lebanese hospitals to implement into routine practice. J Patient Saf. 2012;8(3):97-103. DOI: https://doi.org/10.1097/PTS.0b013e318258ca70

El-Jardali F, Dimassi H, Jamal D, Jaafar M, Hemadeh N. Predictors and outcomes of patient safety culture in hospitals. BMC Health Serv Res. 2011;11:45. DOI: https://doi.org/10.1186/1472-6963-11-45

Schibler C. Les enjeux de l’hospitalisation privée. Les Tribunes de la santé. 2023;76(2):85-92. DOI: https://doi.org/10.3917/seve1.076.0085

Berwick DM, Calkins DR, McCannon CJ, Hackbarth AD. The 100,000 lives campaign: setting a goal and a deadline for improving health care quality. JAMA. 2006;295(3):324-7. DOI: https://doi.org/10.1001/jama.295.3.324

Saleh S, Sleiman J, Dagher D, Sbeit H, Natafgi N. Accreditation of hospitals in Lebanon: Is it a worthy investment? International journal for quality in health care: journal of the International Society for Quality in Health Care / ISQua. 02/13 2013;25. DOI: https://doi.org/10.1093/intqhc/mzt018

Ammar W, Khalife J, El-Jardali F, Romanos J, Harb H, Hamadeh G, et al. Hospital accreditation, reimbursement and case mix: links and insights for contractual systems. BMC Health Services Res. 2013;13(1):505. DOI: https://doi.org/10.1186/1472-6963-13-505

Dayekh AY, Naseridine M, Dakroub F, Olleik A. Impact, obstacles and boundaries of patient partnership: A qualitative interventional study in Lebanon. PLOS ONE. 2022;17(7):e0270654. DOI: https://doi.org/10.1371/journal.pone.0270654

Cervero RM, Gaines JK. The impact of CME on physician performance and patient health outcomes: an updated synthesis of systematic reviews. J Contin Educ Health Prof. Spring 2015;35(2):131-8. DOI: https://doi.org/10.1002/chp.21290

Organization WH. Global Patient Safety Action Plan 2021-2030. Available at: https://www.who.int/publications/i/item/9789240032705. Accessed on 14 March 2025.

WHO. Patient safety curriculum guide: multi-professional edition, 2011. Available at: https://www.who.int/publications/i/item/9789241501958. Accessed on 14 March 2025.

WHO. Global Ministerial Summits on Patient Safety. Available at: https://www.who.int/teams/ integrated-health-services/patient-safety/policy/ global-ministerial-summits-on-patient-safety#:~: text=The%20Fourth%20Global%20Ministerial%20Summit,the%20global%20patient%20harm%20burden. Accessed on 14 March 2025.

Abu-Saad Huijer H, Sailian SD, Fares S, Bassila J. Predictors of quality of life in older adult patients in Lebanon: a cross sectional study. Ann Palliat Med. 2023;12(2):356-64. DOI: https://doi.org/10.21037/apm-22-619

Downloads

Published

2025-06-30

How to Cite

M. Khamis, M., Akoum, H., & M. Adib, S. (2025). Patient safety knowledge and compliance among physicians in public hospitals in Lebanon. International Journal Of Community Medicine And Public Health, 12(7), 2932–2942. https://doi.org/10.18203/2394-6040.ijcmph20252080

Issue

Section

Original Research Articles