New Hospital Survey on Patient Safety Culture: 2011 User Comparative Database Report Is Available

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From the AHRQ (Agency for Healthcare Research and Quality) press release

Based on data from 1,032 U.S. hospitals, the Hospital Survey on Patient Safety Culture: 2011 User Comparative Database Report provides initial results that hospitals can use to compare their patient safety culture to other U.S. hospitals.  In addition, the 2011 report presents results showing change over time for 512 hospitals that submitted data more than once.  The report consists of a narrative description of the findings and four appendixes, presenting data by hospital characteristics and respondent characteristics for the database hospitals overall and separately for the 512 trending hospitals.

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Excerpts from the Executive Summary

Survey Content

The hospital survey, released in November 2004, was designed to assess hospital staff opinions about patient safety issues, medical errors, and event reporting. The survey includes 42 items that measure 12 areas, or composites, of patient safety culture:

1. Communication openness.
2. Feedback and communication about error.
3. Frequency of events reported.
4. Handoffs and transitions.
5. Management support for patient safety.
6. Nonpunitive response to error.
7. Organizational learning—continuous improvement.
8. Overall perceptions of patient safety.
9. Staffing.
10. Supervisor/manager expectations and actions promoting safety.
11. Teamwork across units.
12. Teamwork within units.

Areas of Strength for Most Hospitals

Three areas of strength emerged. Results are expressed in terms of percent positive response. Percent positive is the percentage of positive responses (e.g., Agree, Strongly agree) to positively worded items (e.g., “People support one another in this unit”) or negative responses (e.g., Disagree) to negatively worded items (e.g., “We have safety problems in this unit”).

Teamwork Within Units (average 80 percent positive response)—This composite is defined as the extent to which staff support each other, treat each other with respect, and work together as a team. This composite had the highest average percent positive response.

Supervisor/Manager Expectations & Actions Promoting Patient Safety (average 75 percent positive response)—This composite is defined as the extent to which supervisors/managers consider staff suggestions for improving patient safety, praise staff for following patient safety procedures, and do not overlook patient safety problems. This composite had the second highest average percent positive response.

Patient Safety Grade—On average, most respondents within hospitals (75 percent) gave their work area or unit a grade of either “A-Excellent” (29 percent) or “B-Very Good” (46 percent) on patient safety.

Areas With Potential for Improvement for Most Hospitals

Three areas showed potential for improvement.

Nonpunitive Response to Error (average 44 percent positive response)—This composite is defined as the extent to which staff feel that their mistakes and event reports are not held against them and that mistakes are not kept in their personnel file. This composite had the lowest average percent positive response.

Handoffs and Transitions (average 45 percent positive response)—This composite is defined as the extent to which important patient care information is transferred across hospital units and during shift changes. This composite had the second lowest average percent positive response.

Number of Events Reported—On average, most respondents within hospitals (54 percent) reported no events in their hospital over the past 12 months. It is likely that events were underreported. This is an area for improvement for most hospitals because underreporting of events means potential patient safety problems may not be recognized or identified and therefore may not be addressed.

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