Pharmacy personnel report declining patient safety climate

Swedish pharmacy personnel report a deteriorating climate as regards patient safety, according to a study from the University of Gothenburg. Just under four in ten have a positive opinion of their working conditions.

The aim of the study, published in the journal BMJ Open, was to evaluate the patient safety climate among pharmacists at Swedish pharmacies and to compare the outcome with historical data. The group of pharmacists includes pharmacists and prescriptionists.

The patient safety climate was analyzed in two surveys, conducted in 2008 and 2022, in which all pharmacy personnel in Sweden were able to participate. The responses were processed anonymously without any links to employers.

Between the first and second surveys, the Swedish pharmacy market was deregulated. In 2009, the state monopoly came to an end and other stakeholders were able to pursue the retail sale of prescription and non-prescription medicines.

Lower ratings for working conditions

Now that the researchers have analyzed the 2022 survey and compared the outcome to 2008, almost all the variables studied have seen a decline. In the more recent survey, pharmacists give teamwork, safety climate, job satisfaction, management, and working conditions lower ratings.

Most affected is working conditions, with only 37 percent of pharmacists having a positive outlook, down from 53 percent. 68 percent are positive about the safety climate, as compared to 75 percent in 2008. The only real improvement is that a higher percentage recognize signs of stress in themselves.

Responsible for the study is Christina Ljungberg Persson, pharmacist and senior lecturer in community pharmacy at Sahlgrenska Academy, University of Gothenburg:

"One interesting aspect is that managers rate the patient safety climate higher than other pharmacists at the pharmacies, which raises questions about upward communication and problem resolution within the organizations. This is not only an issue for pharmacy companies, but also for government policy."

Stress increases the risk of mistakes 

While the study does not identify the role played by deregulation, Christina Ljungberg Persson notes that the work environment has changed. The goal of increased availability for customers has resulted in more smaller pharmacies, more generous opening hours, and more solitary work.

The study was conducted in collaboration with colleagues at Åbo Akademi University in Finland, and the researchers' joint conclusion is that the patient safety climate at pharmacies in Sweden appears to have deteriorated. Returning to Christina Ljungberg Persson:

"Working conditions affect patient safety. When stressed, there are increased risks of making mistakes, reading or dispensing incorrectly, not providing enough information, or not having time to call the physician to check matters. Such things can happen when you don't have enough time or resources," she ends.
 

Fact box:

Percentage of positive responses in the Safety Attitudes Questionnaire 2022 (2008)

Teamwork: 71.8% (81.2)

Safety climate: 68.2% (75.3) 

Job satisfaction: 62.1% (78.9)

Stress recognition: 73.0% (67.6)

Perceptions of management: 53.7% (68.3)

Working conditions: 37.3% (53.3)

Number of respondents in 2022: 1,931 (response rate 41%) and in 2008: 2,738 (response rate 69%)