Exploring human factors that affect patient safety in dentistry: a qualitative study of hospital-based practice

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INTRODUCTION: This qualitative study explores how hospital-based dental professionals in Pakistan perceive and navigate human factors that influence patient safety, with particular attention to the structural and cultural contexts of low- and middle-income countries (LMICs) like Pakistan. MATERIALS AND METHODS: A qualitative exploratory design grounded in the SEIPS (Systems Engineering Initiative for Patient Safety) framework was employed. Purposive sampling was used to recruit participants with clinical experience in hospital-based dentistry. Interviews were audio-recorded, transcribed, and thematically analysed using Braun and Clarke's framework, with deductive mapping to SEIPS domains. Member checking and coder triangulation supported analytical rigour. RESULTS: Following interviews with 29 participants, three interrelated domains emerged: (1) Individual-level preconditions for safe practice, such as fatigue, emotional stress, and cultural sensitivity; (2) Team and process-level factors, including hierarchical barriers, communication gaps, and reliance on experienced support staff; and (3) Organisational and systemic conditions, including inadequate infrastructure, time pressure, and punitive supervisory cultures. These factors interact dynamically to affect clinical decision-making and procedural safety. CONCLUSION: Human factors shape patient safety in dental hospitals, particularly within LMIC contexts where structural limitations and cultural norms amplify existing risks. Addressing these challenges requires context-sensitive safety protocols, enhanced communication frameworks, ergonomic reforms, and supportive supervision. Findings underline the importance of integrating human factors education into dental curricula and governance to promote a culture of safety.

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