Culture matters: indigenizing patient safety in Bhutan

Abstract Studies show that if quality of healthcare in a country is to be achieved, due consideration must be given to the importance of the core cultural values as a critical factor in improving patient safety outcomes. The influence of Bhutan’s traditional (core) cultural values on the attitudes a...

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Veröffentlicht in:Health policy and planning 2017-09, Vol.32 (7), p.1042-1048
Hauptverfasser: Pelzang, Rinchen, Johnstone, Megan-Jane, Hutchinson, Alison M
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creator Pelzang, Rinchen
Johnstone, Megan-Jane
Hutchinson, Alison M
description Abstract Studies show that if quality of healthcare in a country is to be achieved, due consideration must be given to the importance of the core cultural values as a critical factor in improving patient safety outcomes. The influence of Bhutan’s traditional (core) cultural values on the attitudes and behaviours of healthcare professionals regarding patient care are not known. This study aimed to explore the possible influence of Bhutan’s traditional cultural values on staff attitudes towards patient safety and quality care. Undertaken as a qualitative exploratory descriptive inquiry, a purposeful sample of 94 healthcare professionals and managers were recruited from three levels of hospitals, a training institute and the Ministry of Health. Interviews were transcribed verbatim and analysed using thematic analysis strategies. The findings of the study suggest that Bhutanese traditional cultural values have both productive and counterproductive influences on staff attitudes towards healthcare delivery and the processes that need to be in place to ensure patient safety. Productive influences encompassed: karmic incentives to avoid preventable harm and promote safe patient care; and the prospective adoption of the ‘four harmonious friends’ as a culturally meaningful frame for improving understanding of the role and importance of teamwork in enhancing patient safety. Counterproductive influences included: the adoption of hierarchical and authoritative styles of management; unilateral decision-making; the legitimization of karmic beliefs; differential treatment of patients; and preferences for traditional healing practices and rituals. Although problematic in some areas, Bhutan’s traditional cultural values could be used positively to inform and frame an effective model for improving patient safety in Bhutan’s hospitals. Such a model must entail the institution of an ‘indigenized’ patient safety program, with patient safety research and reporting systems framed around local patient safety concerns and solutions, including religious and cultural concepts, values and perspectives.
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subjects Adoption
Attitude of Health Personnel
Attitudes
Bhutan
Cultural values
Culture
Decision making
Employee attitude
Friendship
Healing
Health administration
Health care
Health care delivery
Health Personnel - psychology
Health services
Hospital Administration
Hospitals
Hospitals - standards
Humans
Incentives
Legitimacy
Medical personnel
Medical treatment
Medicine, Traditional - utilization
Patient Safety
Patients
Professional attitudes
Professionals
Qualitative Research
Quality of care
Quality of Health Care
Religious beliefs
Rituals
Safety
Safety programs
Safety research
Teamwork
Traditional medicine
Training
Treatment preferences
Unilateralism
title Culture matters: indigenizing patient safety in Bhutan
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