This scoping review maps the existing research on patient safety culture within chiropractic, how well the profession has studied its own attitudes, systems and practices around keeping patients safe. It screened over 3,000 articles down to 65 relevant studies from 1990 to 2024.
What was studied?
The review identified eight research themes, including adverse events, safety attitudes, clinical decision-making, informed consent and clinic hygiene, and measured this evidence against a recognised safety-culture framework and WHO patient safety standards.
What did they find?
Only 2 of the 65 studies were randomised trials. Research has focused heavily on safety performance and processes, but far less on the underlying beliefs and values that shape genuine safety culture, with gaps around patient engagement, leadership and interprofessional working.
Why it matters
This is honest self-reflection rather than a simple reassurance that care is safe. It shows where the evidence base is strong, such as safety incidents and processes, and where it remains thin.
Why we included it
It shows the value of a profession auditing its own evidence base honestly, identifying where research is thin as clearly as where it's strong, rather than only presenting findings that are reassuring.
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What was studied?
The review identified eight research themes, including adverse events, safety attitudes, clinical decision-making, informed consent and clinic hygiene, and measured this evidence against a recognised safety-culture framework and WHO patient safety standards.
What did they find?
Only 2 of the 65 studies were randomised trials. Research has focused heavily on safety performance and processes, but far less on the underlying beliefs and values that shape genuine safety culture, with gaps around patient engagement, leadership and interprofessional working.
Why it matters
This is honest self-reflection rather than a simple reassurance that care is safe. It shows where the evidence base is strong, such as safety incidents and processes, and where it remains thin.
Why we included it
It shows the value of a profession auditing its own evidence base honestly, identifying where research is thin as clearly as where it's strong, rather than only presenting findings that are reassuring.