Table 4.

Strategies to improve patient safety

Themes	Participant statements
Instituting governance for patient safety	‘One thing is to constitute committees, especially relevant committees like clinical governance committees. […] […] We have to have regular updates, discussions […] Certain bodies like quality control, mortality committee and clinical governance are very important.’ (Medical doctor)
Development/improvement of physical infrastructure/environment	‘[…] the infrastructure should be such that it promotes smooth flow of patients. Patients should not get confused. They should not get lost in a health facility. […] the infrastructure should be in a normal condition, for example, the air flow, the exposure to sun should be good, so that we use minimum advance technologies like heating system, cooling system […].’ (Senior manager) ‘[…] we need some trolleys, the oxygen and everything should be there and IV stands. We have the elevator here but it is not always working. So the patient sometimes gets locked inside the elevator. We need good electricity.’ (Ward manager)
Providing adequate resources	‘To improve patient safety in district hospital like ours, I think the first and foremost things we should have is enough staff. We should have enough equipment.’ (Nurse)
Providing patient safety training and education for healthcare professionals	‘I think first and foremost most of the health workers don’t have the concept of patient safety. Even doctors we are trained in different countries.’ (Medical doctor)
Promoting communication and information systems	‘There should be proper communication between patient and the visitors and patient themselves, and also among healthcare workers because often a time there is a lot of miscommunication. This could ultimately pose a threat to patient safety.’ (Nurse)
Changing the attitudes and behaviours of healthcare professionals	‘First and foremost is the notion that keeping patient safety is not the responsibility of the managers or the leaders. Every individual should take each and every service or an activity in line with patient safety. […] Patient safety has to be on our mind all the time.’ (Medical doctor) ‘It is not easy to change the attitude of people but maybe through our education system or through the training centre curriculum from day one till they leave the institute might have a role in changing the attitude and providing better safety to patient.’ (Senior manager)