Members of the University community are hereby invited to an Inter-College Lecture being organized by the College of Humanities as follows:
Lecturer: Professor Aaron Asibi Abuosi, Department of Public Administration and Health Services Management
School: University of Ghana Business School.
Title: "From a blame to a just culture: an imperative for patient safety in Ghanaian hospitals"
Date: 7th April, 2022
Time: 4:30 p.m.
Venue: University of Ghana Business School Auditorium
Chairman: Prof. Daniel Frimpong Ofori, Provost, College of Humanities
Abstract
Patient safety is fundamental to the provision of health care in all settings. However, avoidable adverse events, errors and risks associated with health care remain major challenges for patient safety globally. Every year, large numbers of patients are harmed or die because of unsafe health care, creating a high burden of death and disability worldwide, especially in low- and middle-income countries. On average, an estimated one in 10 patients is subject to an adverse event while receiving hospital care in high-income countries. Available evidence suggests that 134 million adverse events due to unsafe care occur in hospitals in low- and middle-income countries, contributing to around 2.6 million deaths every year. According to recent estimates, the social cost of patient harm can be valued at US$ 1 trillion to 2 trillion a year.
There is growing debate on whether the healthcare system can adopt the principles of High Reliability Organizations (HROs) such as the aviation and nuclear industries to improve upon patient safety during health care. One of the principles of HROs that contributes to their low records of accidents and other adverse events is the promotion of a just culture, that is, a culture that encourages non-punitive response to error, among others, and rather encourages error-reporting to ensure organisational learning. Another principle is the acknowledgement of human fallibility and the inevitability of error.
It is acknowledged that healthcare is a very complex system consisting of a mixture of health professionals of varied background, the use of complex equipment, and so on, and thus prone to errors. Unfortunately, the healthcare system is largely characterised by a blame culture rather than a just culture. A blame culture is characterised by finger-pointing and punitive response to error. Unlike a just culture that tends to ask ‘what’ caused an incident; thus encouraging investigations beyond the ‘person’ to the ‘system’, a blame culture tends to be fixated on the question ‘who’ caused the incident; thus, investigations are aimed at gathering evidence to implicate the staff involved. Blame culture is a deterrent to error-reporting, as people find ways of shelving errors for fear of blame and its attendant consequences. This does not promote organisational learning, thus making the tendency for the recurrence of errors high. Previous studies in Ghana found that three out twelve patient safety culture dimensions recorded low positive response rates (≤50%). However, the study was done in only three hospitals in one district of Ghana.
We have done a cross-sectional survey of 15 hospitals across levels of care and ownership type in three regions of Ghana to assess their patient safety culture and adverse events, among others. Consistent with emerging literature, we found that four out of ten safety culture dimensions recorded positive response rates below the benchmark standard rates (≥70%). On the other hand, reporting of adverse events remains averagely very low (42%) across all indicators. These findings provide evidence for the prevalence of a blame culture in Ghanaian healthcare institutions, and points to the need for a shift from the blame to a just culture.
This presentation is the preliminary results of our study funded by the University of Ghana UGRF Multi-disciplinary grant for 2020.
1. Organization, W.H., Global patient safety action plan 2021–2030: towards eliminating avoidable harm in health care. 2021.
2. Akologo, A., A.A. Abuosi, and E.A. Anaba, A cross-sectional survey on patient safety culture among healthcare providers in the Upper East region of Ghana. PloS one, 2019. 14(8): p. e0221208.
Profile of Prof. Aaron Asibi Abuosi
Prof. Aaron Abuosi is an Associate Professor of Health Policy and Management in the University of Ghana Business School. He holds a Ph.D in Health Services Management, MBA in Health Services Administration and BA in Nursing and Psychology. Prior to joining academia, Prof. Abuosi worked with the Ministry of Health in various capacities, including general nursing, Nursing Tutor, Hospital Administrator and General Manager for close to two decades. He has taught, researched, and published extensively in collaboration with many Ghanaian and international researchers on quality of care, patient safety, health insurance and access to healthcare, non-communicable diseases, and sexual and reproductive health and more. He has also supervised several undergraduate and graduate students’ dissertations in the University of Ghana. He has over 40 peer reviewed journal publications and book chapters. He consults for the Ministry of Health, the Ghana Health Service, and the World Health Organization on quality of care, patient safety and health financing. He has won several local and international grants together with other researchers where he serves as the principal or co-investigator. His recent grants include the University of Ghana grant to undertake research on patient safety (PI); the DigiFi Africa pilot grant to conduct an impact evaluation study on Ghana’s National Health Insurance mobile money renewal scheme (PI); and the DIWA/CEGA grant to conduct an impact evaluation study on access to prenatal care by village women in the context of traditional cultural beliefs that pose barriers to accessing modern prenatal healthcare (PI).
Prof. Abuosi has presented several papers in international conferences and participated or moderated panel discussions on same. He also serves as reviewer for nine renowned peer reviewed journals. He has also reviewed for grant awards for the UK Medical Research Council and the Swiss National Science Foundation. He is an Editorial Board Member of BMC Health Services Research journal with immense experience in editing papers. He is also a Fellow of the International Society for Quality in Healthcare (ISQua), a Fellowship Tutor for the ISQua Fellowship programme and an Editorial Apprentice for the International Journal for Quality in Healthcare. He is a member of Health Systems Global, an international organization fully dedicated to promoting health systems research and knowledge translation; a member of Sigma, an International Honor Society of Nursing, with a mission of advancing world health and celebrating nursing excellence in scholarship, leadership, and service; and a member of Association of Health Services Administrators, Ghana (AHSAG).
Prof. Abuosi has served as resource person for several seminars and workshops in the Ministry of Health and health professional associations, among others. Within the University of Ghana, Prof. Abuosi has played several non-teaching roles and served in several committees. He is a Tutor in Jubilee/International Students Hostel and School Examination Officer of the University of Ghana Business School. He is a member of the Disciplinary Committee for Senior Members of the Academic Board.
