A socio-cultural perspective on patient safety in a bilateral healthcare project

Abstract

This paper describes patient safety development in a bilateral health care project using activity theory. A regional Swedish health care provider engages in several international collaborations to exchange knowledge and insights with other organizations. The heath care provider has had a collaboration focused on patient safety with a Kenyan health care provider since 2015. The purpose of this study was to explore how the how patient safety development in a low and middle-income country healthcare system was supported, described as an activity system. Data was collected by conducting interviews with six participants involved in the patient safety collaboration, by visiting the Kenyan setting, and through analysis of available and relevant policy documents. Patient safety was analyzed using the activity system concepts activity, subject, objective, object, mediating artefacts, rules and regulations, community, and division of labor. The results showed that several factors are involved in patient safety development, both within an organization and in supporting the development. Health care organizations should strive for commitment to patient safety at all levels of the organization, striving for a safety culture where staff members are comfortable reporting errors. The management should pursue patient safety questions and put aside resources for patient safety development. As the Swedish and Kenyan health care providers are different in many aspects, it's important to be attentive to and understanding of differences triggered by available resources, cultural norms, rules, and organizational structures. Identified factors create opportunities for project participants to be inspired and question current methods and norms in respective organization, which can result in improvements. It is important to stress that both partners learn from the collaboration