Hospital Survey on Patient Safety Culture: 2008 Comparative Database Report

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Table A-10. Item-level Average Percent Positive Response by Hospital Geographic Region

Survey Items By Composite		Region
		Mid Atlantic/ New England	South Atlantic	East North Central	East South Central	West North Central	West South Central	Mountain	Pacific
		32 Hospitals	89 Hospitals	113 Hospitals	29 Hospitals	92 Hospitals	37 Hospitals	57 Hospitals	70 Hospitals
		17,875 Respond- ents	29,200 Respond- ents	40,643 Respond- ents	7,350 Respond- ents	19,255 Respond- ents	11,121 Respond- ents	13,301 Respond- ents	21,431 Respond- ents
1. Teamwork Within Units	A1- People support one another in this unit.	82%	83%	81%	86%	86%	87%	86%	85%
	A3—When a lot of work needs to be done quickly, we work together as a team to get the work done.	83%	85%	82%	89%	88%	88%	87%	84%
	A4—In this unit, people treat each other with respect.	75%	77%	74%	81%	79%	80%	78%	78%
	A11—When one area in this unit gets really busy, others help out.	63%	67%	66%	70%	70%	71%	70%	67%
2. Supervisor/ Manager Expectations & Actions Promoting Patient Safety	B1—My supv/mgr says a good word when he/she sees a job done according to established patient safety procedures.	69%	73%	67%	76%	69%	76%	72%	71%
	B2—My supv/mgr seriously considers staff suggestions for improving patient safety.	74%	77%	72%	79%	76%	79%	76%	76%
	B3 R—Whenever pressure builds up, my supv/mgr wants us to work faster, even if it means taking shortcuts.	70%	76%	73%	77%	77%	76%	75%	72%
	B4 R—My supv/mgr overlooks patient safety problems that happen over and over.	72%	79%	73%	80%	79%	80%	74%	73%
3. Management Support for Patient Safety	F1—Hospital mgmt provides a work climate that promotes patient safety.	76%	80%	77%	84%	83%	81%	80%	77%
	F8—The actions of hospital mgmt show that patient safety is a top priority.	70%	72%	68%	77%	74%	75%	72%	69%
	F9 R—Hospital mgmt seems interested in patient safety only after an adverse event happens.	57%	59%	58%	63%	64%	63%	59%	55%
4. Organizational Learning—Continuous Improvement	A6—We are actively doing things to improve patient safety.	80%	83%	77%	85%	83%	84%	81%	81%
	A9—Mistakes have led to positive changes here.	58%	64%	58%	66%	65%	66%	64%	61%
	A13—After we make changes to improve patient safety, we evaluate their effectiveness.	67%	70%	63%	74%	69%	72%	66%	60%
5. Overall Perceptions of Patient Safety	A10 R—It is just by chance that more serious mistakes don't happen around here.	56%	57%	58%	61%	67%	63%	63%	57%
	A15—Patient safety is never sacrificed to get more work done.	63%	65%	61%	68%	68%	66%	66%	61%
	A17 R—We have patient safety problems in this unit.	57%	60%	60%	65%	69%	67%	66%	57%
	A18—Our procedures and systems are good at preventing errors from happening.	68%	69%	66%	74%	72%	74%	69%	66%
6. Feedback and Communication About Error	C1—We are given feedback about changes put into place based on event reports.	53%	54%	51%	55%	50%	56%	53%	52%
	C3—We are informed about errors that happen in this unit.	64%	66%	61%	71%	64%	69%	65%	60%
	C5—In this unit, we discuss ways to prevent errors from happening again.	68%	71%	65%	73%	71%	73%	73%	69%
7. Communication Openness	C2—Staff will freely speak up if they see something that may negatively affect patient care.	75%	75%	74%	77%	76%	77%	77%	76%
	C4—Staff feel free to question the decisions or actions of those with more authority.	49%	47%	45%	49%	46%	49%	50%	49%
	C6 R—Staff are afraid to ask questions when something does not seem right.	60%	63%	60%	64%	63%	66%	64%	63%
8. Frequency of Events Reported	D1—When a mistake is made, but is caught and corrected before affecting the patient, how often is this reported?	53%	51%	47%	57%	53%	56%	52%	49%
	D2—When a mistake is made, but has no potential to harm the patient, how often is this reported?	56%	55%	51%	60%	59%	58%	56%	54%
	D3— When a mistake is made that could harm the patient, how often is this reported?	72%	72%	70%	78%	77%	75%	72%	72%
9. Teamwork Across Units	F2 R—Hospital units do not coordinate well with each other.	43%	44%	44%	51%	50%	45%	45%	40%
	F4—There is good cooperation among hospital units that need to work together.	54%	58%	56%	65%	63%	60%	60%	55%
	F6 R—It is often unpleasant to work with staff from other hospital units.	55%	58%	56%	61%	63%	57%	59%	57%
	F10—Hospital units work well together to provide the best care for patients.	64%	66%	64%	73%	73%	68%	68%	65%
10. Staffing	A2—We have enough staff to handle the workload	46%	52%	52%	51%	63%	55%	55%	52%
	A5 R—Staff in this unit work longer hours than is best for patient care.	45%	51%	52%	52%	57%	53%	51%	51%
	A7 R—We use more agency/temporary staff than is best for patient care.	59%	63%	64%	63%	71%	64%	60%	59%
	A14 R—We work in "crisis mode" trying to do too much, too quickly.	44%	49%	46%	49%	57%	52%	52%	46%
11. Handoffs & Transitions	F3 R—Things "fall between the cracks" when transferring patients from one unit to another.	38%	41%	39%	46%	49%	43%	41%	36%
	F5 R—Important patient care information is often lost during shift changes.	48%	49%	48%	52%	54%	48%	49%	45%
	F7 R—Problems often occur in the exchange of information across hospital units.	40%	41%	40%	47%	48%	42%	43%	39%
	F11 R—Shift changes are problematic for patients in this hospital.	42%	44%	44%	47%	54%	44%	46%	42%
12. Nonpunitive Response to Error	A8 R—Staff feel like their mistakes are held against them.	47%	49%	49%	53%	56%	53%	54%	48%
	A12 R—When an event is reported, it feels like the person is being written up, not the problem.	43%	43%	42%	46%	49%	46%	48%	42%
	A16 R—Staff worry that mistakes they make are kept in their personnel file.	31%	33%	33%	36%	42%	37%	38%	33%

Note: The item’s survey location is shown to the left. An “R” indicates a negatively worded item, where the percent positive response is based on those who responded “Strongly disagree” or “Disagree,” or “Never” or “Rarely” (depending on the response category used for the item).

*Note: States are categorized into AHA-defined regions as follows:

Region	States
Mid Atlantic/New England	NY, NJ, PA, ME, NH, VT, MA, RI, CT
South Atlantic	DE, MD, DC, VA, WV, NC, SC, GA, FL
West North Central	MN, IA, MO, ND, SD, NE, KS
West South Central	AR, LA, OK, TX
East North Central	OH, IN, IL, MI, WI
East South Central	KY, TN, AL, MS
Mountain	MT, ID, WY, CO, NM, AZ, UT, NV
Pacific	WA, OR, CA, AK, HI

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