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Objective : To assess the level of development of the “freedom of expression and non-punitive response to error” concept of patient safety culture among healthcare professionals at Farhat Hached University Hospital (Sousse – Tunisia).Materials and methods : A Cross-sectional study was conducted among 289 healthcare professionals working in 16 units of Farhat Hached University Hospital in Sousse (Tunisia), including 86 physicians and 203 paramedical staff using a valid questionnaire.Results : The global freedom of expression and non-punitive response to error score was 60.5%. The majority of respondents (71.2%) discussed the methods that can be used to limit errors. However, only about one-half of respondents (49.10%) felt free to question the decisions or actions of their superiors.Conclusions : This study provided an overview of healthcare professionals’ perception of patient safety based on analysis of the concept of freedom of expression and non-punitive response in order to identify and correct errors in our health system. This concept is a cornerstone of the patient safety culture among healthcare professionals and plays a central role in the quality improvement strategy.