AHRQ Hospital Survey on Patient Safety Culture
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- Deirdre Stanley
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1 AHRQ Hospitl Survey on Ptient Sfety Culture Sfety Culture Definition: The sfety culture of n orgniztion is the product of individul nd group vlues, ttitudes, perceptions, competencies, nd ptterns of behvior tht determine the commitment to, nd the style nd proficiency of, n orgniztion s helth nd sfety mngement. Orgniztions with positive sfety culture re chrcterized by communictions founded on mutul trust, by shred perceptions of the importnce of sfety, nd by confidence in the efficcy of preventtive mesures. Who should complete the survey? Hospitl stff who hve direct contct or interction with ptients (clinicl stff such s nurses or nonclinicl stff such s unit clerks) Hospitl stff who my not hve direct contct or interction with ptients but whose work directly ffects ptient cre (stff in units such s phrmcy, lbortory, pthology) Hospitl-employeed physicins who spend most of their work hours in the hospitl (emergency deprtment physicins, hospitlists, pthologists) Hospitl supervisors, mngers, nd dministrtors Wht re the dimensions mesured in the survey? Supervisor/Mnger expecttions nd ctions promoting sfety Orgniztionl lerning continuous improvement Communiction openness Feedbck nd communiction bout error Nonpunitive response to error Stffing Hospitl mngement support for ptient sfety Temwork cross hospitl units Hospitl hndoffs nd trnsitions Outcome vribles Four re included: Overll perceptions of sfety Frequency of event reporting Ptient sfety grde (of hospitl unit) Number of events reported Updted 11/18/08
2 Vlues to hospitls prticipting in the TCPS Survey: You cn t fix wht you don t mesure TCPS provides the online survey, free, to ll hospitl sfety prtners Survey results from TCPS provide: (Chrt exmples below) - Demogrphic chrcteristics of responders - Four overll ptient sfety outcomes (s described bove in Outcome Vribles) - Scores on ten dimensions of culture pertining to ptient sfety Exmples of feedbck/chrts given to fcilities from TCPS fter completion of the survey: Demogrphic Chrcteristics of Responders 1. Primry hospitl work re, deprtment or clinicl re where respondents spend most of their work time: 6% Mny different units / No specific unit 9% Intensive cre unit (ny type) 12% Medicine (non-surgicl) 0% Psychitry / mentl helth 10% Surgery 4% Rehbilittion 5% Obstetrics 6% Phrmcy 4% Peditrics 12% Lbortory 1% Emergency deprtment 5% Rdiology 26% Other 1% Anesthesiology Overll Ptient Sfety Grde 60% Overll Ptient Sfety Grde Tennessee Hospitl, 2008 Plese give your work re/unit in this hospitl n overll grde on ptient sfety. 50% 51% Percent of Respondents 40% 30% 20% 28% 19% 10% 0% A - Excellent B - Good C - Acceptble D - Poor E - Filing 2% 0% Note: 0% of respondents did not nswer Updted 11/18/08
3 Composite Scores Sfety Culture Composites Tennessee Hospitl's Composite Score Averge % of positive responses 2008 Ntionl Comprtive Dt from AHRQ Averge % of positive responses Overll Perceptions of Sfety (4 items--% Agree/Strongly Agree) 68% 64% Frequency of Events Reported (3 items--% Most of the time/alwys) 71% 60% Supervisor/Mnger Expecttions & Actions Promoting Ptient Sfety (4 items--% Agree/Strongly 83% 75% Orgniztionl Lerning--Continuous Improvement (3 items--% Agree/Strongly Agree) 79% 70% Temwork Within Units (4 items--% Agree/Strongly Agree) 80% 79% Communiction Openness (3 items--% Most of the time/alwys) 67% 62% Feedbck & Communiction About Error (3 items--% Most of the time/alwys) 68% 62% Nonpunitive Response to Error (3 items--% Agree/Strongly Agree) 42% 44% Stffing survey items (4 Items --% Agree/Strongly Agree) 56% 55% Hospitl Mngement Support for Ptient Sfety (3 items--% Agree/Strongly Agree) 74% 70% Temwork Across Hospitl Units (4 survey items--% Agree/Strongly Agree) 57% 57% Hospitl Hndoffs & Trnsitions (4 survey items--% Agree/Strongly Agree) 43% 45% Overll Fcility Score Overll Perceptions of Sfety 1. Ptient sfety is never scrificed to get more work done. 2. Our procedures nd systems re good t preventing errors from hppening. R3. It is just by chnce tht more serious mistkes don t hppen round here. R4. We hve ptient sfety problems in this unit. Positive Neutrl Negtive 64% 15% 21% 76% 17% 7% 65% 20% 15% 68% 17% 15% Updted 11/18/08
4 Overll Fcility Score, cont. Temwork Across Hospitl Units 1. There is good coopertion mong hospitl units tht need to work together. (F4) Positive Neutrl Negtive 56% 27% 16% 2. Hospitl units work well together to provide the best cre for ptients. (F10) 68% 22% 9% R3. Hospitl units do not coordinte well with ech other. (F2) 44% 27% 28% R4. It is often unplesnt to work with stff from other hospitl units. (F6) 59% 26% 15% Overll Fcility Score, cont. Communiction Openness 1. Stff will freely spek up if they see something tht my negtively ffect ptient cre. (C2) 2. Stff feel free to question the decisions or ctions of those with more uthority. (C4) Positive Neutrl Negtive 80% 17% 3% 49% 29% 22% R3. Stff re frid to sk questions when something does not seem right. (C6) 71% 23% 7% Updted 11/18/08
5 Plese note: survey respondent comments will lso be given in feedbck reports. To obtin ccess to the AHRQ Sfety Culture Survey, visit the Tennessee Center for Ptient Sfety website. If you hve ny questions regrding the survey, plese contct Drlene Swrt, VP & Project Director t dswrt@th.com or Lriss Lee, Project Mnger t llee@th.com. Updted 11/18/08
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