Patient safety culture research within the chiropractic profession: a scoping review
Bibliographic record
Abstract
INTRODUCTION: A proactive patient safety culture is crucial in healthcare to minimize preventable harm and improve patient outcomes. This scoping review explores key themes, trends, and gaps in patient safety culture research within the chiropractic profession. METHODS: A comprehensive literature search was conducted across 5 databases from inception to December 2024. Peer-reviewed, English-language studies focusing on chiropractic patient safety culture were included. Following scoping review methodology, articles were screened, data were extracted, and both qualitative and quantitative analyses were conducted. External consultants from patient safety-focused chiropractic groups were sought to review findings. Trends and themes were identified, and findings were compared against established patient safety frameworks to highlight research gaps and future directions. RESULTS: Of the 3,039 screened articles, 65 met the inclusion criteria, spanning from 1990 to 2024, with 2 identified as randomized trials. Eight major themes were organized: (1) adverse event research, (2) clinical trial safety reporting, (3) patient safety attitudes, (4) clinical decision making, (5) informed consent, (6) reporting and learning systems, (7) office sanitization, and (8) general safety topics. Mapping these studies onto the Patient Safety Culture Pyramid framework revealed that 95% addressed safety performance, 81% covered safety processes, and only 23% explored beliefs and values. Comparisons with the WHO Global Patient Safety Action Plan framework highlighted advancements in clinical process safety while revealing research gaps in patient engagement, policy development, leadership, and interprofessional collaboration. Key recommendations include standardizing adverse event reporting, improving communication strategies, and developing structured approaches to patient and provider safety. External consultation provided minimal feedback requiring modifications. CONCLUSION: This review underscores significant advancements and gaps in chiropractic patient safety culture research, particularly in leadership, policy, and interprofessional engagement. Future research should focus on implementing and evaluating evidence-based safety interventions to enhance transparency, improve patient outcomes, and build public trust in chiropractic care. Direct stakeholder engagement, including with patients, is necessary to determine the most effective strategies for integrating patient safety within the global chiropractic profession.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.035 | 0.141 |
| Meta-epidemiology (narrow) | 0.002 | 0.002 |
| Meta-epidemiology (broad) | 0.004 | 0.005 |
| Bibliometrics | 0.032 | 0.032 |
| Science and technology studies | 0.003 | 0.003 |
| Scholarly communication | 0.007 | 0.007 |
| Open science | 0.003 | 0.004 |
| Research integrity | 0.005 | 0.003 |
| Insufficient payload (model declined to judge) | 0.004 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".