Safety is a core dimension of health care quality. Measurement of patient safety culture in OECD countries has been increasingly conducted as part of efforts to monitor patient safety and to contribute to health system performance assessment. Building on four years of work, a second OECD data collection on patient safety culture was conducted in 2022-2023, with the support of the members of OECD Expert Group on Patient Safety Culture. Data from almost 650,000 health care workers, from over 3,000 different sites/hospitals, across 14 countries was added in this round of data collection. This report documents the state-of-the-art of patient safety measurement using the Hospital Survey of Patient Safety Culture (HSPSC) and is the first report to document international comparisions using the HSPSC v2, which has been recently adopted by ten countries who submitted data. Despite many commonalities between countries in the implementation of PSC measurements, there remains differences in the scope of implementation and survey response rates. Moreover, survey findings show general deficits in staff perceptions of safe staffing and workpace levels and response to errors among hospital workers, areas that could be targeted for policy action to improve patient safety.