First national survey to measure patient safety culture within heathcare facilities in France

Patient safety culture is a set of behaviours and attitudes that contribute to patient safety and that are shared collectively throughout the organisation (teams, healthcare facilities).

French background

In France, the patient safety culture is one of the assessment items for healthcare facility certification. Before putting in place actions aimed at developing a safety culture, it is first of all necessary to assess its level. To this end, the French National Federation of Regional Quality and Safety Support Organisations (FORAP) and the French National Authority for Health (HAS) have been promoting this type of survey since 2010 and wanted to conduct the first national survey to measure the healthcare patient safety culture within healthcare facilities in France in 2023.

Survey method

The survey was proposed to all French healthcare facilities between 1 May and 30 June 2023, via a dedicated platform. A validated French-language version of the “Hospital Survey On Patient Safety Culture” (Agency for Healthcare Research and Quality) was used. Interested healthcare facilities identified the work collective(s) that would be participating in the survey and appointed an internal survey steering team (members of the governance body, healthcare professionals, members of the Quality or Risk Management teams, …). 

Survey results

Out of a total of 2,431 French healthcare facilities (private and public), 661 participated in the survey, corresponding to 50,078 respondents, 47,974 of whom completed 50% or more of the questionnaire. We only retained the work collectives with a participation rate of at least 60%. The analysis of the results ultimately focused on 27,406 respondents.

Of the ten safety culture dimensions measured, five of them had an average score below 50 % and therefore appear to require the implementation of priority improvement actions. These concerned human resources (32 %), a non-punitive response to errors (35 %), teamwork between the facility’s departments (39 %), management support for healthcare safety (44 %) and the overall perception of safety (48 %). The average scores of the other five dimensions (adverse event report frequency; teamwork within the department; etc.) were all between 50 and 74 %, highlighting potential room for improvement.    

Roll-out of actions following the national survey and future prospects

In September 2023, after the initial analysis of the survey, each healthcare facility had an opportunity to present its results, provided by the Regional Quality and Safety Support Organisation, to all of its work collectives. The first national results were presented during a webinar held in November 2023. Several tools have been proposed to healthcare facilities to improve patient safety culture, such as safety walkarounds, the guide to analysing care-related adverse events, the continuous improvement programme for teamwork, and many more.

Measures to improve patient safety culture were also included in the National Roadmap on “Improving the Safety of Patients and Residents” 2023-2025 (improving teamwork, promoting a culture of fairness and supporting the analysis and reporting of care-related adverse events to facilitate the provision of feedback to healthcare professionals).

A new national survey is expected to be conducted in healthcare facilities in 2026 as part of the National Roadmap to Improve Patient Safety. This new measure is intended to quantify any improvement in the patient safety culture after the implementation of the actions set out in the roadmap.