PATIENT SAFETY IN RESOURCES-CONSTRAINED HEALTHCARE SETTINGS: A QUALITATIVE ANALYSIS OF CHALLENGES AND OPPORTUNITIES IN PAKISTAN

Abstract

Patient safety is a major issue in healthcare systems, especially in low-resource environments where human, budgetary, structural and technical resources are limited and lead to higher risk of preventable harm. This study aimed to explore patient safety issues and address the challenges and opportunities in resource-limited health care settings in Pakistan. Secondary data analysis of qualitative descriptive research design adopted. Peer-reviewed relevant articles from literature, policy documents, government publications, institutional reports and international health reports were purposively selected and thematically analyzed. The evidence was then coded and then summarized based on Braun and Clarke's thematic analysis framework into common themes for patient-safety issues, organizational and systemic issues and opportunities for improvement. The results revealed five themes that were interrelated: resource and staffing limitations, the lack of a strong safety culture and error reporting, communication and teamwork, healthcare-worker training and competencies, and opportunities for system-level improvement. Analysis reveals that the factors that pose the greatest risk to patients' safety are insufficient staffing, too heavy a workload, insufficient infrastructure, insufficient reporting systems, and insufficient consequences for errors. Organizational learning, teamwork, professional education, better leadership and incident reporting, however, are good opportunities for enhancing safety practices. In conclusion, the study suggests that patient safety in Pakistan needs to be handled in a systems-based and context-sensitive approach, taking into account resource constraints and practices. Building the capacity of the healthcare workforce, safety culture, communication, reporting and learning systems, and institutional governance can play a role in mitigating preventable harm and promoting the quality and safety of healthcare services.