Maturity Model and Safety Culture in Healthcare: A Systematic Review

Background: Research on safety culture maturity in hospitals is rare and still focuses on patient safety, not yet involved safety and occupational accidents. Previous research uses the Manchester Patient Safety Framework (Ma PSaF) instrument to measure 5 levels of patient safety culture maturity: Pathological, Reactive, Bureaucratic, Proactive and Generative. This study aims to investigate the level of patient safety culture maturity in hospitals. Method: This study used a systematic literature review of 5 databases: PubMed, EBSCO, Proquest, Science Direct and Scopus. Inclusion criteria in this study are articles related to patient safety criteria; research outcome in this study is patient safety maturity level; 3) articles in the form of results obtained from the keywords used;articles have been published since 2009-2019; the article is an academic journal;english articles. 498 articles were obtained and after screening 2 articles selected. Results: The two articles involved 2 countries: United Kingdom and Indonesia. There are 10 indicators examined in both studies which one developed 10 indicators with 24 dimensions. Study in UK, using univariate quantitative method. Research in Indonesia uses a qualitative method by interviewing experts and literature studies, there is a change in the definition of maturity in 3 dimensions to maintain research reliability, such as safety, communication and teamwork. Maturity of patient safety culture in the UK is proactive level. Conclusions: There are 10 keys indictors for maturity of a patient safety culture: commitment to overall continuous improvement, priority given to safety, system errors and individual responsibility, recording incidents and best practices, evaluating incidents and practices best, study and make changes, communication about safety issues, personnel management and safety issues, staff education and training, teamwork. At present the safety culture maturity measuring instrument only patient safety. Further research should measure the maturity of safety culture more comprehensive including patient safety, occupational safety and health (OSH).