Institutionalizing Patient Safety Culture: A Strategic Priority for Healthcare in India

Fledgling steps in the form of policy measures, surveillance mechanisms and safety initiatives have been taken in the Indian healthcare context to address the increasing evidence base of patient safety events. The paper examines whether structural and processual measures alone would contribute to safer care. The article posits that healthcare organisations in India need to look beyond the structural-procedural efforts and evaluate an essential component of healthcare which serves to bind these efforts; that of safety culture. The paper draws on literature from health services and safety culture research as well as news articles in order to examine adverse incidents in care, safety theories and assess whether structural and procedural efforts would alone contribute to safer care. The review examines the current burden of adverse events in care as well as patient safety initiatives in the Indian context. An emergent strategy comprising policy, regulatory and structural measures has evolved over a period of time to address various facets of patient safety. Global research evidence over the years suggests that such structural-processual measures alone have not been able to address the burden of adverse events in care. Safety culture has emerged as an important concept binding quality and performance measures in most high-risk organizations including healthcare. Institutionalizing safety culture has become a strategic priority in most health care organisations globally. Taking a complex adaptive system perspective, the paper argues that synergizing policy, regulatory and structural-processual measures with safety culture engineering at multiple levels would fetch greater dividends in the Indian patient safety landscape.