Patient safety is currently of primary interest in healthcare and is in part based on numerous reports raising concern about such areas as medical errors, medication errors, and error reporting. It is for this reason that a recent release of the Hospital Survey on Patient Safety Culture is very timely (September 2004).
The Agency for Healthcare Research and Quality (AHRQ) has sponsored the development of the survey.
The researchers developed the Hospital Survey on Patient Safety Culture by reviewing the literature and conducting interviews with hospital staff. The developed survey was then pretested, piloted, and revised. To produce a survey with sound psychometric properties.
The survey is intended to measure patient safety culture from a hospital staff perspective and therefore is best suited for hospital staff having direct contact with patients or for hospital staff whose work directly affects patient care. The following safety culture dimensions are measured in the survey:
* Supervisor/Manager Expectations & Actions Promoting Safety
* Organizational Learning-Continuous Improvement
* Teamwork Within Units
* Communication Openness
* Feedback and Communication About Error
* Non-punitive Response to Error
* Staffing
* Hospital Management Support for Patient Safety
* Teamwork Across Hospital Units
* Hospital Handoffs and Transitions
* Overall Perceptions of Safety
* Frequency of Event Reporting
* Patient Safety Grade
* Number of Events Reported
Besides the survey materials, a Survey User's Guide is available on the Internet (September 2004) and is very thorough. It includes information mentioned heretofore plus information on how to modify or customize the survey, planning the project, selecting a sample, determining data collection methods, establishing data collection procedures, preparing and analyzing data, and producing reports. In addition, there is a PowerPoint presentation for the Survey Feedback Report that can be downloaded and presented by entering the specific hospital data.
Although the survey can be customized and modified, suggestions in the Survey User's Guide are to do it cautiously. With limited modification, hospitals will be able to compare their survey results to other hospitals' results. A system, for example, will be able to gather data about all member hospitals and compare results, using strengths identified in each for the improvement of all.
The dimensions measured in the Survey are complex dimensions, and hospitals committed to improving patient safety culture will gain valuable information. Doing the organizational work to improve a dimension will take planning and concentrated effort, even for a dimension as seemingly simple as "Frequency of Event Reporting." Tackling a more complex dimension such as "Communication Openness" may require extensive planning and effort.
Conveniently, the survey is designed to be used at a unit level, so a manager of a unit such as pharmacy may find the survey useful, even if the hospital chooses not to use the Survey hospital-wide. It is through such efforts unit and hospital-wide, however, that many organizations can initiate actions and improve patient survey culture.
SueEllen Pinkerton, RN, PhD, FAAN
Editor-in-Chief
INTERNET CITATION
Sorra JS, Nieva VF. Hospital Survey on Patient Safety Culture. AHRQ Publication No. 04-0041, September 2004. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/qual/hospculture/ (accessed November 5, 2004).