Mediating Role of Safety Climate in The Associations Between Safety Culture, Safety Education and Training, Reporting Attitudes with Medical Errors in Riyadh Hospitals

Abstract

Introduction: Medical errors pose significant challenges to healthcare systems globally. In Saudi Arabia, the alarming rise in medical error incidents since 2016 has eroded trust in the healthcare system, highlighting inadequacies in current policies and practices. This study investigated how safety climate mediates the relationship between safety culture, safety education and training attitudes, and reporting attitudes on medical errors among healthcare professionals in Riyadh public hospitals. Materials and Methods: This cross-sectional study collected data from 403 healthcare professionals across four Riyadh public hospitals. Descriptive analysis was conducted using SPSS, while AMOS was used for structural equation modelling. Results: Healthcare professionals perceiving stronger safety culture (b=0.53, p<0.001) and reporting attitudes (b=0.44, p<0.001) were more likely to commit medical errors, while those with positive safety education and training attitudes (b=-0.21, p<0.001) recorded fewer errors. Safety climate partially mediated relationships between safety culture and medical errors (p<0.001) and between safety education/training attitudes and medical errors (p<0.001), but not between reporting attitudes and medical errors (p=0.068). Conclusion: Safety climate crucially mediates the translation of organizational safety factors into medical error outcomes. Healthcare organizations should simultaneously develop strong safety cultures, positive safety climates, effective training programs, and non-punitive reporting systems to enhance organizational learning and improve patient safety outcomes in Saudi Arabian healthcare settings.