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Establishing a high culture of patient safety in hospitals is one of the main ways to prevent or reduce errors and improve the overall quality of healthcare. The aim of the study is to assess the perceptions on patient safety culture among healthcare specialists in Bulgarian hospitals. A national cross-sectional survey was conducted among 620 healthcare specialists. The study was conducted using the web-based Bulgarian Version of the Hospital Survey on Patient Safety Culture Questionnaire (B-HSOPSC). The B-HSOPSC includes 42 questions, grouped in 12 different dimensions measuring patient safety culture. No personal identification was possible of the participations in the survey using the e-platform. The data was analyzed with descriptive statistics and non-parametric tests. The results of the study show in general that the respondents demonstrate a positive attitude regarding patient safety culture. The dimensions “Staffing” and “Non-punitive response to error” are most problematic, as their percentage of positive response rates (PRRs) are lowest - 35.16% and 39.62%, respectively. However, “Handoffs and transitions” and “Overall perceptions of safety“ show the highest PRRs – 66.65% and 65.48%, respectively. From all participants, 74.7% have never reported an adverse event or error. Non-parametric tests did not find significant statistical differences in “Patient safety grade” between physicians and other health care specialists. Based on the evidence, the hospital managements need to focus on improving problem areas.

Medical education marks a considerable stage in its development, significantly affected by the global Covid-19 pandemic. The introduction of e-learning added new dimensions to the traditional educational process. The aim of the study is to investigate the effectiveness of digital teacher-student interaction during e-learning. A cross-sectional online survey was conducted among 249 university lecturers from two medical universities. The obtained results outlined the shortcomings of online learning, such as the weakening of the teacher-student relationship, the presence of passive participation and weaker responsibility on the part of students in the conducted classes. Positive attitude towards e-learning was shared mainly by lecturers holding higher academic positions, such as 'associate professor' and 'professor', as well as those working in the theoretical educational units, compared to the pre-clinical and clinical departments. Effective interaction between teachers and students is an essential aspect of the quality of the educational process and remains a topical issue in the context of continuing distance learning in medical universities

Patient safety culture is a key component of the organizational culture and a critical measure of the quality of healthcare. The aim of this study was to gain an insight into the problems concerning patient safety culture, based on the analysis of data, collected after interviewing healthcare specialists working in surgical and nonsurgical units in selected Bulgarian hospitals. This was a cross-sectional online study using a web-platform and the Bulgarian Version of Hospital Survey on Patient Safety Culture. It was conducted among healthcare workers (n = 620) in 2021. The B-HSOPSC incudes 42 scales grouped in 12 different domains. We compared the percentage of positive ratings and outcome dimensions between surgical and other hospital departments with the nonparametric Mann–Whitney U test, χ2 tests, Fisher’s Exact Test, and OR. The results showed that there are no statistically significant differences between the ratings on Patient Safety Culture given by the surgical and the nonsurgical staff except for the dimension “Hospital management support for patient safety”. Results from the study highlighted that the most important aspect of hospital patient safety is the shortage of medical staff in both surgical and nonsurgical hospital units. Communication, work shift organization, handoffs and transitions between shifts and among different hospital units, as well as communication with line managers were rated as satisfactory in Bulgarian hospitals.

Background and aims. Patient safety culture (PSC) is an essential component of the quality of healthcare. Improving PSC is considered a priority in many developed countries. A specialized software platform for registration and evaluation of hospital patient safety culture has been developed with the support of the Medical University Plovdiv Project №11/2017. The aim of the study is to assess the status of PSC in Bulgarian hospitals and to compare it to that in USA and Croatian hospitals. Methods. The study was conducted from June 01 to July 31, 2018 using the web-based Bulgarian Version of the Hospital Survey on Patient Safety Culture Questionnaire (B-HSOPSC). Two hundred and forty-eight medical professionals from different hospitals in Bulgaria participated in the study. In order to quantify the differences of positive scores distributions for each of the 42 HSOPSC items between Bulgarian, Croatian and USA samples, the χ2-test was applied. The research hypothesis assumed that there were no significant differences between the Bulgarian, Croatian and US PSCs. Results. The results revealed 14 significant differences in the positive scores between the Bulgarian and Croatian PSCs and 15 between the Bulgarian and the USA PSC, respectively. Bulgarian medical professionals provided less positive responses to 12 items compared with Croatian and USA respondents. The Bulgarian respondents were more positive compared to Croatians on the feedback and communication of medical errors (Items - C1, C4, C5) as well as on the employment of locum staff (A7) and the frequency of reported mistakes (D1). Bulgarian medical professionals were more positive compared with their USA colleagues on the communication of information at shift handover and across hospital units (F5, F7). The distribution of positive scores on items: “Staff worry that their mistakes are kept in their personnel file” (RA16), “Things ‘fall between the cracks’ when transferring patients from one unit to another” (RF3) and “Shift handovers are problematic for patients in this hospital” (RF11) were significantly higher among Bulgarian respondents compared with Croatian and US respondents. Conclusions. Significant differences of positive scores distribution were found between Bulgarian and USA PSC on one hand and between Bulgarian and Croatian on the other. The study reveals that distribution of positive responses could be explained by the cultural, organizational and healthcare system differences.

To investigate the attitudes and willingness of the general practitioners (GPs) as well as their actual participation in the voluntary colorectal cancer (CRC) screening campaign without additional financial incentives for them, combining quantitative and qualitative approaches.A multiple-case practice based study was designed using a mixed method, triangulation techniques and a sequential explanatory design strategy. The study included all 41 GPs practices in the Municipality of Asenovgrad. A questionnaire, face-to-face semi-structured interviews, nonparticipant direct structured observations and documentation review were used to collect data. Variation analysis, alternative analysis for percentage calculation and Mann-Whitney U test to compare two independent groups and Fisher's Exact Test were used. Statistical significance of the null hypothesis was assumed at p0.05.Older GPs (p=0.015) and those working with a practice nurse (p=0.000) were more inclined to participate in the CRC screening campaign. GPs more knowledgeable of the importance of CRC screening with iFOBT (immunochemical faecal occult blood test), (p=0.002) and those trusting its quality (p=0.007) were more willing and ready to take part in the screening campaign. Among barriers that GPs encountered in the present screening campaign were lack of knowledge and experience about iFOBT, lack of materials and insufficient incentives.Some limitations influence the voluntary participation of GPs in CRC screening campaign that have to be considered before decisions can be made on the implementation of population-based CRC screening programme in Bulgaria in accordance with European guidelines on best practice.

BACKGROUND: Patient safety (PS) is one of the essential elements of health care quality and a priority of healthcare systems in most countries. Thus the creation of validated instruments and the implementation of systems that measure patient safety are considered to be of great importance worldwide.AIM: The present paper aims to illustrate the process of linguistic validation, cross-cultural verification and adaptation of the Bulgarian version of the Hospital Survey on Patient Safety Culture (B-HSOPSC) and its test-retest reliability.METHODS: The study design is cross-sectional. The HSOPSC questionnaire consists of 42 questions, grouped in 12 different subscales that measure patient safety culture. Internal con­sistency was assessed using Cronbach’s alpha. The Wilcoxon signed-rank test and the split-half method were used; the Spear­man-Brown coefficient was calculated.RESULTS: The overall Cronbach’s alpha for B-HSOPSC is 0.918. Subscales 7 Staffing and 12 Overall perceptions of safety had the lowest coefficients. The high reliability of the instrument was confirmed by the Split-half method (0.97) and ICC-coefficient (0.95). The lowest values of Spearmen-Broun coefficients were found in items A13 and A14.CONCLUSION: The study offers an analysis of the results of the linguistic validation of the B-HSOPSC and its test-retest reliability. The psychometric characteristics of the questions revealed good validity and reliability, except two questions. In the future, the instrument will be administered to the target population in the main study so that the psychometric properties of the instrument can be verified.