Staff perceptions of hospital patient safety differ by department and position
How health care workers feel about patient safety at their hospital depends on whom you ask and where they work. For example, emergency department personnel have the worst safety climate perceptions, while workers in nonclinical areas hold a more favorable view, finds a new study. Researchers used the Patient Safety Climate in Healthcare Organizations survey, which includes 38 items capturing important safety climate features, to examine perceptions of the patient safety climate by hospital work area and staff position. A total of 18,361 completed surveys were received from a sample of 92 U.S. hospitals. In addition to sampling 100 percent of senior managers and physicians, the researchers included 10 percent of all other workers.
Overall, 17 percent of responses indicated that a safety climate was absent at the individual's organization. Among emergency department personnel, nurses perceived substantially lower levels of safety climate when compared with personnel in other areas and other emergency department personnel. The researchers also discovered that the patient safety climate was worse in hospital wards, with nurses again having the lowest perceptions. Both emergency department and ward nurses were concerned about the limited engagement by senior management and the lack of sufficient organizational resources.
Overall, nurses were more negative than physicians when it came to perceptions of safety climate. However, physicians were more likely than nurses to report a sense of shame and embarrassment when they made a mistake or asked for help. Status and authority differences between physicians and nurses may result in barriers that have a negative impact on safety culture. Any strategies used to improve safety climates should take into consideration these differences in work areas and disciplines, suggest the researchers. Their study was supported in part by the Agency for Healthcare Research and Quality (HS13920).
See "Patient safety climate in 92 US hospitals: Differences by work area and discipline," by Sara J. Singer, M.B.A., Ph.D., David M. Gaba, M.D., Laurence C. Baker, Ph.D., and others, in the January 2009 Medical Care 47(1), pp. 23-31.
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