Understanding the Concept of Patient Safety Culture: Constitutive and Operational Definitions for Health Care Organizations.

Background: Patient safety culture is crucial for improving health care quality, however, there is no consensus on its definition.

Purpose: This study aimed to clarify and update the concept of patient safety culture.

Methods: We employed Norris' 6-step concept clarification method. The content was organized through a scoping review of 4 databases. Twelve health professionals participated in focus groups and 10 experts participated in content validation. The content validity coefficient (CVC) was calculated for agreement between experts.

Results: Three patient safety culture domains were identified: organizational, professional, and patient and family participation. The experts rated the definitions favorably, with high CVC scores (>0.87), indicating good agreement. The operational definitions were reduced from 76 to 54 items after expert evaluation.

Conclusion: An updated definition of patient safety culture is provided, which can inform development of assessment instruments by managers and health care professionals.