Patient safety culture and climate are essential for improving healthcare quality and reducing harm. An organization’s culture reflects its long-term values and norms, and climate captures employees’ current perceptions and experiences. In Estonia, these aspects have not yet been comprehensively studied. This study aims to assess patient safety culture and climate in Estonian hospitals from the perspective of employees and to examine the relationship with employee background characteristics.

A cross-sectional study was conducted in three Estonian hospitals during 2022. Data were collected using the Estonian and Russian language versions of HSOPSC 2.0 and SAQ. Descriptive statistics, chi-square tests, and regression analyses were performed.

A total of 594 (31%) hospital employees responded, with 51% completing the survey in Estonian and 49% in Russian. The highest ratings for patient safety culture and climate were observed in the subscales ‘Job satisfaction’ (85%) and ‘Teamwork climate’ (79%), lowest ratings were reported for ‘Staffing and work pace’ (55%) and ‘Response to error’ (55%). Perceptions of safety culture and climate were significantly associated with language group, membership in a leadership position, department work experience, and whether the employee was a healthcare professional, emerging as the most influential factors.

Differences across language groups, leadership position, department work experience, and healthcare professional positions should be considered when developing strategies to strengthen patient safety culture and climate. Using HSOPSC 2.0 and SAQ together may offer complementary perspectives on the dimensions of patient safety culture and climate in Estonia.