Views and experiences of decision-makers on organisational safety culture and medication errors

Derek Stewart* (Corresponding Author), Katie MacLure, Abdulrouf Pallivalapila, Andrea Dijkstra, Kerry Wilbur, Kyle Wilby, Ahmed Awaisu, James S McLay, Binny Thomas, Cristin Ryan, Wessam El Kassem, Rajvir Singh, Moza S H Al Hail

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

6 Citations (Scopus)
4 Downloads (Pure)


BACKGROUND: In 2017, the World Health Organization published "Medication Without Harm, WHO Global Patient Safety Challenge," to reduce patient harm caused by unsafe medication use practices. While the five objectives emphasise the need to create a framework for action, engaging key stakeholders and others, most published research has focused on the perspectives of health professionals. The aim was to explore the views and experiences of decision-makers in Qatar on organisational safety culture, medication errors and error reporting.

METHOD: Qualitative, semi-structured interviews were conducted with healthcare decision-makers (policy-makers, professional leaders and managers, lead educators and trainers) in Qatar. Participants were recruited via purposive and snowball sampling, continued to the point of data saturation. The interview schedule focused on: error causation and error prevention; engendering a safety culture; and initiatives to encourage error reporting. Interviews were digitally recorded, transcribed and independently analysed by two researchers using the Framework Approach.

RESULTS: From the 21 interviews conducted, key themes were the need to: promote trust within the organisation through articulating a fair blame culture; eliminate management, professional and cultural hierarchies; focus on team building, open communication and feedback; promote professional development; and scale-up successful initiatives. There was recognition that the current medication error reporting processes and systems were suboptimal, with suggested enhancements in themes of promoting a fair blame culture and open communication.

CONCLUSION: These positive and negative aspects of organisational culture can inform the development of theory-based interventions to promote patient safety. Central to these will be the further development and sustainment of a "fair" blame culture in Qatar and beyond.

Original languageEnglish
Article number13560
Number of pages7
JournalInternational Journal of Clinical Practice
Issue number9
Early online date15 Jun 2020
Publication statusPublished - 1 Sept 2020

Bibliographical note


The authors wish to acknowledge the contributions of all interviewees, as well as support departments at Hamad Medical Corporation, Doha, Qatar. This work was supported by NPRP grant NPRP 7‐388‐3‐095 from Qatar National Research Fund (a member of Qatar Foundation). The statements made herein are solely the responsibility of the authors.




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