Hospital Survey on Patient Safety Culture: 2008 Comparative Database Report

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Table A-2. Item-level Average Percent Positive Response by Hospital Bed Size

Survey Items By Composite		Bed Size
		6-24 beds	25-49 beds	50-99 beds	100-199 beds	200-299 beds	300-399 beds	400 or more beds

		58 Hospitals	131 Hospitals	98 Hospitals	86 Hospitals	57 Hospitals	42 Hospitals	47 Hospitals
		3,601 Respond- ents	12,421 Respond- ents	14,243 Respond- ents	22,092 Respond- ents	27,730 Respond- ents	27,568 Respond- ents	52,521 Respond- ents
1. Teamwork Within Units	A1—People support one another in this unit.	87%	87%	85%	82%	80%	82%	81%
	A3—When a lot of work needs to be done quickly, we work together as a team to get the work done.	90%	89%	86%	82%	81%	84%	81%
	A4—In this unit, people treat each other with respect.	80%	80%	78%	75%	73%	75%	73%
	A11—When one area in this unit gets really busy, others help out.	73%	71%	68%	66%	64%	66%	63%
2. Super- visor/ Manager Expecta- tions & 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.	72%	73%	71%	70%	68%	69%	68%
	B2—My supv/mgr seriously considers staff suggestions for improving patient safety.	77%	80%	76%	74%	72%	72%	72%
	B3 R—Whenever pressure builds up, my supv/mgr wants us to work faster, even if it means taking shortcuts.	79%	79%	76%	72%	69%	70%	67%
	B4 R—My supv/mgr overlooks patient safety problems that happen over and over.	77%	80%	78%	75%	71%	73%	71%
3. Manage- ment Support for Patient Safety	F1—Hospital mgmt provides a work climate that promotes patient safety.	84%	85%	81%	76%	74%	76%	72%
	F8—The actions of hospital mgmt show that patient safety is a top priority.	75%	77%	72%	68%	67%	68%	65%
	F9 R—Hospital mgmt seems interested in patient safety only after an adverse event happens.	64%	66%	60%	56%	54%	55%	50%
4. Organ- izational Learning— Continuous Improve- ment	A6—We are actively doing things to improve patient safety.	83%	84%	82%	78%	77%	79%	77%
	A9—Mistakes have led to positive changes here.	65%	67%	63%	60%	58%	60%	58%
	A13—After we make changes to improve patient safety, we evaluate their effectiveness.	67%	71%	68%	65%	65%	64%	62%
5. Overall Perceptions of Patient Safety	A10 R—It is just by chance that more serious mistakes don't happen around here.	66%	66%	61%	57%	55%	57%	53%
	A15—Patient safety is never sacrificed to get more work done.	72%	71%	66%	60%	58%	57%	55%
	A17 R—We have patient safety problems in this unit.	69%	69%	64%	59%	56%	56%	52%
	A18—Our procedures and systems are good at preventing errors from happening.	70%	74%	71%	67%	65%	67%	64%
6. Feedback and Communi- cation About Error	C1—We are given feedback about changes put into place based on event reports.	52%	54%	51%	51%	52%	53%	53%
	C3—We are informed about errors that happen in this unit.	68%	67%	65%	61%	61%	61%	59%
	C5—In this unit, we discuss ways to prevent errors from happening again.	74%	74%	70%	68%	66%	66%	65%
7. Commun- ication Openness	C2—Staff will freely speak up if they see something that may negatively affect patient care.	79%	77%	76%	74%	72%	74%	72%
	C4—Staff feel free to question the decisions or actions of those with more authority.	51%	48%	47%	45%	46%	46%	46%
	C6 R—Staff are afraid to ask questions when something does not seem right.	66%	66%	62%	61%	58%	61%	60%
8. Freq- uency of Events Reported	D1—When a mistake is made, but is caught and corrected before affecting the patient, how often is this reported?	54%	53%	51%	50%	49%	51%	47%
	D2—When a mistake is made, but has no potential to harm the patient, how often is this reported?	60%	58%	55%	55%	52%	54%	50%
	D3—When a mistake is made that could harm the patient, but does not, how often is this reported?	77%	76%	73%	71%	69%	71%	67%
9. Teamwork Across Units	F2 R—Hospital units do not coordinate well with each other.	55%	51%	47%	42%	38%	40%	34%
	F4—There is good cooperation among hospital units that need to work together.	69%	64%	60%	54%	50%	53%	47%
	F6 R—It is often unpleasant to work with staff from other hospital units.	65%	64%	59%	55%	52%	54%	51%
	F10—Hospital units work well together to provide the best care for patients.	77%	73%	69%	63%	59%	62%	56%
10. Staffing	A2—We have enough staff to handle the workload.	64%	62%	56%	48%	46%	46%	45%
	A5 R—Staff in this unit work longer hours than is best for patient care.	58%	57%	53%	47%	48%	48%	48%
	A7 R—We use more agency/temporary staff than is best for patient care.	69%	68%	64%	60%	58%	61%	61%
	A14 R—We work in "crisis mode" trying to do too much, too quickly.	59%	57%	52%	43%	41%	42%	40%
11. Hand- offs & Transitions	F3 R—Things "fall between the cracks" when transferring patients from one unit to another.	55%	48%	44%	36%	33%	33%	29%
	F5 R—Important patient care information is often lost during shift changes.	57%	52%	50%	45%	44%	46%	44%
	F7 R—Problems often occur in the exchange of information across hospital units.	54%	48%	43%	38%	35%	36%	32%
	F11 R—Shift changes are problematic for patients in this hospital.	57%	51%	47%	41%	38%	40%	36%
12. Nonpun- itive Response to Error	A8 R—Staff feel like their mistakes are held against them.	55%	55%	52%	49%	46%	47%	44%
	A12 R—When an event is reported, it feels like the person is being written up, not the problem.	48%	48%	45%	43%	42%	42%	39%
	A16 R—Staff worry that mistakes they make are kept in their personnel file.	41%	39%	36%	34%	31%	31%	28%

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).

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