Patient Safety Reporting and Learning systems in the Kingdom of Saudi Arabia: A scoping review of lessons learned from the experiences of developed countries

Abstract

Background: Health organisations in the Kingdom of Saudi Arabia (KSA) are aggressively pursuing measures to improve the quality and safety of healthcare services in response to the growing awareness of patient safety incidents (PSIs) and increased public pressure and media attention. In 2017, policymakers in the KSA created the Saudi Patient Safety Center (SPSC), which fulfils one of the initiatives of the National Transformation Vision 2030. In 2018, the centre was assigned to deliver the first National Patient Safety Reporting and Learning System, which is called ‘‘SAWTAK’’, to all healthcare sectors. However, the KSA is considered to be in the early stages of adopting SAWTAK. It has been found that there is a knowledge gap in patient safety research in KSA, especially about these systems and their implementation mechanism, because they are relatively new. Objective: To explore lessons from developed countries' experiences in implementing incident reporting systems (IRSs) to maximise success and improve the adoption of such systems in the context of the Kingdom of Saudi Arabia. The research question that this dissertation seeks to answer is as follows: What lessons can KSA learn from the experience of developed countries in implementing electronic incident reporting and learning systems? Study Design and Methods: A scoping review (SR) was conducted in August 2022 in two databases, the Web of Science and Google scholar. Additionally, the reference lists of the included studies were also manually searched. The selection of studies was based on pre-defined eligibility criteria. The review was limited to peer-reviewed studies published between 2000 and 2022, and non-English content was excluded. The literature was synthesised using a descriptive summary and a thematic analysis. Findings: Eighteen publications were included for the review from seven developed countries, and the highest contributing studies were from the United Kingdom (UK). The review found many factors that can contribute to successful implementation, such as collaborative implementation efforts within and outside the organisation, avenues to increase employee engagement such as feedback and visible actions, training and education programmes, safety culture and effective leadership, as well as enablers related to system design and availability of financial resources and time. The results were interpreted from a socio-technical perspective and in the context of the current literature. It also highlighted the significant role of leadership and other organisational factors in implementation. Conclusion: The research concludes that introducing reporting systems or procuring new technology is insufficient to create a culture of patient safety and organisational learning. Instead, it entails significant changes in a complex system with many interrelated components that must work together to achieve an intended goal. The KSA should consider the common organisational factors reported in this review that help the successful implementation. Recommendations were proposed for the KSA based on the factors identified in this review and should be targeted for the successful implementation of the IRS.