Hospital Survey on Patient Safety Culture: 2008 Comparative Database Report. Notes

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Table C-6. Trending: Item-level Percent Positive Response by Respondent Staff Position

Patient Safety Culture Composites			Staff Position
			Admin/ Mgmt	Attending/ Physician/ Resident/ PA or NP	Dietician	Pat Care Asst/Aide/ Care Partner	Pharmacist	RN/LVN/ LPN	Technician (EKG, Lab, Radiology)	Therapist (Respiratory, Phys, Occup, Speech)	Unit Asst/ Clerk/ Secretary
			92 Hospi- tals both yrs	53 Hospi- tals both yrs	27 Hospi- tals both yrs	58 Hospi- tals both yrs	41 Hospi- tals both yrs	98 Hospi- tals both yrs	70 Hospi- tals both yrs	66 Hospi- tals both yrs	89 Hospi- tals both yrs
			1,201 Most Recent Respon- dents	1,656 Most Recent Respon- dents	117 Most Recent Respon- dents	1,160 Most Recent Respon- dents	297 Most Recent Respon- dents	7,452 Most Recent Respon- dents	2,113 Most Recent Respon- dents	891 Most Recent Respon- dents	1,270 Most Recent Respon- dents
			1,046 Previous Respon- dents	1,118 Previous Respon- dents	83 Previous Respon- dents	1,062 Previous Respon- dents	235 Previous Respon- dents	6,560 Previous Respon- dents	1,513 Previous Respon- dents	814 Previous Respon- dents	1,105 Previous Respon- dents
1. Team- work Within Units	A1—People support one another in this unit.	Most Recent	94%	92%	86%	79%	89%	85%	84%	90%	83%
		Previous	90%	83%	87%	77%	91%	85%	79%	86%	85%
		Change	4%	9%	-1%	2%	-2%	0%	5%	4%	-2%
	A3—When a lot of work needs to be done quickly, we work together as a team to get the work done.	Most Recent	93%	90%	93%	84%	90%	88%	86%	86%	84%
		Previous	90%	83%	94%	82%	90%	87%	87%	88%	87%
		Change	3%	7%	-1%	2%	0%	1%	-1%	-2%	-3%
	A4—In this unit, people treat each other with respect.	Most Recent	89%	88%	82%	74%	89%	77%	76%	85%	73%
		Previous	84%	83%	86%	69%	78%	77%	75%	83%	77%
		Change	5%	5%	-4%	5%	11%	0%	1%	2%	-4%
	A11—When one area in this unit gets really busy, others help out.	Most Recent	79%	69%	78%	65%	71%	67%	70%	76%	70%
		Previous	73%	73%	85%	64%	72%	67%	69%	73%	72%
		Change	6%	-4%	-7%	1%	-1%	0%	1%	3%	-2%
2. Supv/ Mgr Ex- pecta- tions & Actions Promot- ing Patient Safety	B1—My supv/mgr says a good word when he/she sees a job done according to established patient safety procedures.	Most Recent	82%	66%	84%	74%	69%	69%	70%	77%	73%
		Previous	75%	59%	78%	69%	72%	68%	68%	72%	76%
		Change	7%	7%	6%	5%	-3%	1%	2%	5%	-3%
	B2—My supv/mgr seriously considers staff suggestions for improving patient safety.	Most Recent	87%	74%	86%	78%	80%	74%	76%	82%	73%
		Previous	86%	68%	77%	70%	85%	75%	79%	84%	83%
		Change	1%	6%	9%	8%	-5%	-1%	-3%	-2%	-10%
	B3—Whenever pressure builds up, my supv/mgr wants us to work faster, even if it means taking shortcuts.	Most Recent	85%	75%	77%	73%	86%	75%	83%	80%	79%
		Previous	81%	70%	67%	76%	79%	74%	80%	80%	81%
		Change	4%	5%	10%	-3%	7%	1%	3%	0%	-2%
	B4—My supv/mgr overlooks patient safety problems that happen over and over.	Most Recent	85%	76%	86%	75%	86%	76%	83%	75%	80%
		Previous	81%	72%	83%	80%	78%	75%	78%	81%	84%
		Change	4%	4%	3%	-5%	8%	1%	5%	-6%	-4%
3. Mgmt Support for Patient Safety	F1—Hospital mgmt provides a work climate that promotes patient safety.	Most Recent	91%	79%	79%	84%	78%	76%	85%	84%	87%
		Previous	91%	80%	86%	80%	75%	77%	84%	84%	87%
		Change	0%	-1%	-7%	4%	3%	-1%	1%	0%	0%
	F8—The actions of hospital mgmt show that patient safety is a top priority.	Most Recent	87%	76%	81%	82%	76%	68%	77%	69%	79%
		Previous	82%	63%	73%	74%	75%	67%	76%	73%	77%
		Change	5%	13%	8%	8%	1%	1%	1%	-4%	2%
	F9—Hospital mgmt seems interested in patient safety only after an adverse event happens.	Most Recent	76%	67%	54%	63%	70%	57%	64%	58%	63%
		Previous	74%	60%	61%	54%	67%	57%	59%	58%	66%
		Change	2%	7%	-7%	9%	3%	0%	5%	0%	-3%
4. Organ- izational Learn- ing— Contin- uous Improve- ment	A6—We are actively doing things to improve patient safety.	Most Recent	90%	84%	82%	90%	89%	85%	82%	87%	81%
		Previous	86%	82%	80%	79%	91%	83%	78%	83%	83%
		Change	4%	2%	2%	11%	-2%	2%	4%	4%	-2%
	A9—Mistakes have led to positive changes here.	Most Recent	83%	74%	71%	67%	76%	62%	67%	60%	62%
		Previous	81%	65%	81%	59%	77%	63%	61%	63%	60%
		Change	2%	9%	-10%	8%	-1%	-1%	6%	-3%	2%
	A13—After we make changes to improve patient safety, we evaluate their effectiveness.	Most Recent	81%	69%	74%	77%	77%	70%	70%	68%	68%
		Previous	76%	69%	79%	73%	66%	68%	67%	73%	75%
		Change	5%	0%	-5%	4%	11%	2%	3%	-5%	-7%
5. Over- all Per- ceptions of Patient Safety	A10 R—It is just by chance that more serious mistakes don’t happen around here.	Most Recent	75%	60%	60%	59%	68%	62%	70%	71%	61%
		Previous	71%	67%	81%	49%	66%	60%	61%	70%	63%
		Change	4%	-7%	-21%	10%	2%	2%	9%	1%	-2%
	A15—Patient safety is never sacrificed to get more work done.	Most Recent	75%	70%	63%	68%	70%	62%	74%	73%	75%
		Previous	70%	65%	76%	67%	62%	58%	74%	68%	75%
		Change	5%	5%	-13%	1%	8%	4%	0%	5%	0%
	A17 R—We have patient safety problems in this unit.	Most Recent	68%	62%	69%	60%	70%	62%	76%	72%	89%
		Previous	69%	58%	73%	53%	62%	60%	73%	71%	71%
		Change	-1%	4%	-4%	7%	8%	2%	3%	1%	-2%
	A18—Our procedures and systems are good at preventing errors from happening.	Most Recent	77%	69%	81%	71%	83%	68%	78%	78%	77%
		Previous	77%	62%	76%	70%	78%	65%	80%	76%	75%
		Change	0%	7%	5%	1%	5%	3%	-2%	2%	2%
6. Feed- back and Com- munica- tion About Error	C1—We are given feedback about changes put into place based on event reports.	Most Recent	61%	53%	62%	57%	57%	48%	50%	56%	49%
		Previous	58%	48%	70%	52%	51%	49%	50%	57%	58%
		Change	3%	5%	-8%	5%	6%	-1%	0%	-1%	-9%
	C3—We are informed about errors that happen in this unit.	Most Recent	79%	60%	74%	66%	74%	59%	73%	69%	69%
		Previous	76%	57%	75%	62%	72%	60%	70%	72%	72%
		Change	3%	3%	-1%	4%	2%	-1%	3%	-3%	-3%
	C5—In this unit, we discuss ways to prevent errors from happening again.	Most Recent	87%	75%	78%	68%	79%	68%	72%	75%	71%
		Previous	81%	63%	86%	62%	75%	66%	71%	76%	76%
		Change	6%	12%	-8%	6%	4%	2%	1%	-1%	-5%
7. Com- munica- tion Open- ness	C2—Staff will freely speak up if they see something that may negatively affect patient care.	Most Recent	85%	76%	76%	72%	80%	75%	78%	81%	73%
		Previous	80%	70%	88%	71%	83%	75%	75%	81%	74%
		Change	5%	6%	-12%	1%	-3%	0%	3%	0%	-1%
	C4—Staff feel free to question the decisions or actions of those with more authority.	Most Recent	67%	62%	47%	41%	71%	44%	46%	55%	42%
		Previous	61%	47%	70%	36%	56%	46%	41%	50%	45%
		Change	6%	15%	-23%	5%	15%	-2%	5%	5%	-3%
	C6 R—Staff are afraid to ask questions when something does not seem right.	Most Recent	76%	70%	64%	56%	78%	62%	65%	70%	60%
		Previous	70%	58%	55%	53%	74%	62%	66%	70%	65%
		Change	6%	12%	9%	3%	4%	0%	-1%	0%	-5%
8. Freq- uency of Events Report- ed	D1—When a mistake is made, but is caught and corrected before affecting the patient, how often is this reported?	Most Recent	58%	54%	59%	61%	52%	52%	51%	46%	62%
		Previous	56%	54%	55%	56%	37%	48%	50%	49%	63%
		Change	2%	0%	4%	5%	15%	4%	1%	-3%	-1%
	D2—When a mistake is made, but has no potential to harm the patient, how often is this reported?	Most Recent	64%	57%	59%	62%	63%	65%	54%	46%	60%
		Previous	60%	57%	55%	54%	47%	59%	55%	54%	62%
		Change	4%	0%	4%	8%	16%	6%	-1%	-8%	-2%
	D3—When a mistake is made that could harm the patient, but does not, how often is this reported?	Most Recent	78%	78%	77%	75%	78%	80%	77%	66%	73%
		Previous	76%	73%	75%	66%	67%	78%	76%	71%	76%
		Change	2%	5%	6%	9%	11%	2%	1%	-5%	-3%
9. Team- work Across Units	F2 R—Hospital units do not coordinate well with each other.	Most Recent	54%	51%	54%	44%	50%	48%	48%	57%	48%
		Previous	51%	46%	53%	51%	44%	44%	45%	46%	52%
		Change	3%	5%	1%	-7%	6%	4%	3%	11%	-4%
	F4—There is good cooperation among hospital units that need to work together.	Most Recent	69%	65%	58%	64%	62%	62%	61%	67%	63%
		Previous	65%	65%	71%	64%	59%	58%	60%	65%	67%
		Change	4%	0%	-13%	0%	3%	4%	1%	2%	-4%
	F6 R—It is often unpleasant to work with staff from other hospital units.	Most Recent	66%	71%	60%	61%	69%	61%	59%	63%	58%
		Previous	60%	65%	76%	63%	58%	59%	59%	63%	62%
		Change	6%	6%	-16%	-2%	11%	2%	0%	0%	-4%
	F10—Hospital units work well together to provide the best care for patients.	Most Recent	78%	68%	71%	73%	74%	68%	70%	69%	76%
		Previous	75%	70%	78%	73%	62%	67%	69%	69%	79%
		Change	3%	-2%	-7%	0%	12%	1%	1%	0%	-3%
10. Staff- ing	A2—We have enough staff to handle the workload.	Most Recent	69%	64%	66%	42%	50%	54%	59%	54%	48%
		Previous	68%	67%	73%	43%	53%	54%	59%	57%	51%
		Change	1%	-3%	-7%	-1%	-3%	0%	0%	-3%	-3%
	A5 R—Staff in this unit work longer hours than is best for patient care.	Most Recent	61%	56%	63%	43%	63%	56%	57%	58%	51%
		Previous	55%	58%	59%	43%	61%	58%	58%	58%	57%
		Change	6%	-2%	4%	0%	2%	-2%	-1%	0%	-6%
	A7 R—We use more agency/temporary staff than is best for patient care.	Most Recent	68%	65%	53%	54%	67%	70%	68%	75%	57%
		Previous	68%	71%	76%	58%	57%	70%	68%	73%	65%
		Change	0%	-6%	-23%	-4%	10%	0%	0%	2%	-8%
	A14 R—We work in "crisis mode" trying to do too much, too quickly.	Most Recent	62%	63%	56%	48%	58%	53%	57%	59%	54%
		Previous	56%	56%	70%	42%	57%	52%	50%	58%	57%
		Change	6%	7%	-14%	6%	1%	1%	7%	1%	-3%
11. Hand- offs & Transiti- ons	F3 R—Things "fall between the cracks" when transferring patients from one unit to another.	Most Recent	47%	55%	41%	45%	34%	50%	36%	44%	51%
		Previous	46%	45%	52%	51%	33%	46%	38%	37%	53%
		Change	1%	10%	-11%	-6%	1%	4%	-2%	7%	-2%
	F5 R—Important patient care information is often lost during shift changes.	Most Recent	53%	53%	50%	54%	30%	57%	46%	48%	56%
		Previous	51%	49%	48%	58%	41%	55%	45%	49%	53%
		Change	2%	4%	2%	-4%	-11%	2%	1%	-1%	3%
	F7 R—Problems often occur in the exchange of information across hospital units.	Most Recent	49%	57%	38%	40%	34%	50%	43%	48%	49%
		Previous	49%	49%	59%	44%	34%	45%	37%	44%	48%
		Change	0%	8%	-21%	-4%	0%	5%	6%	4%	1%
	F11 R—Shift changes are problematic for patients in this hospital.	Most Recent	53%	46%	43%	49%	35%	55%	43%	41%	53%
		Previous	53%	47%	56%	49%	35%	51%	46%	39%	53%
		Change	0%	-1%	-13%	0%	0%	4%	-3%	2%	0%
12. Nonpuni- tive Response to Error	A8 R—Staff feel like their mistakes are held against them.	Most Recent	70%	53%	54%	43%	75%	52%	52%	64%	47%
		Previous	67%	53%	59%	42%	72%	52%	49%	61%	55%
		Change	3%	0%	-5%	1%	3%	0%	3%	3%	-8%
	A12 R—When an event is reported, it feels like the person is being written up, not the problem.	Most Recent	70%	42%	60%	38%	70%	47%	42%	55%	39%
		Previous	65%	42%	57%	29%	72%	45%	40%	49%	41%
		Change	5%	0%	3%	9%	-2%	2%	2%	6%	-2%
	A16 R—Staff worry that mistakes they make are kept in their personnel file.	Most Recent	55%	28%	36%	30%	66%	37%	40%	50%	37%
		Previous	51%	31%	54%	26%	61%	36%	38%	45%	36%
		Change	4%	-3%	-18%	4%	5%	1%	2%	5%	1%

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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