The AHRQ Surveys on Patient Safety Culture: Setting the Standard for Patient Safety Culture Around the Globe

On September 19, 2011, Joann Sorra made this presentation at the 2011 Annual Conference. Select to access the PowerPoint® presentation (820 KB). Plugin Software Help.

Slide 1

The AHRQ Surveys on Patient Safety Culture: Setting the Standard for Patient Safety Culture Around the Globe

AHRQ Annual Meeting
September 19, 2011

Joann Sorra, Ph.D.
Senior Study Director
Westat
joannsorra@westat.com

Slide 2

Objectives

• Define patient safety culture.
• Discuss reasons to assess patient safety culture.
• Discuss international use of the AHRQ Surveys on Patient Safety Culture.

Slide 3

What is Patient Safety Culture?

"The way we do things around here".

Flow chart showing the following text:

Exists at multiple levels:

• System.
• Organization.
• Department.
• Unit.

Beliefs, values & norms.

Shared by staff.

What is:

• Rewarded.
• Supported.
• Expected.

Slide 4

AHRQ Surveys on Patient Safety Culture (SOPS)

• Assess provider & staff opinions about patient safety culture in:
  • Hospitals (2004).
  • Nursing homes (2008).
  • Medical offices (2009).
  • Retail pharmacies (Expected Summer 2012).

Slide 5

Dimensions Assessed

• Teamwork.
• Staffing.
• Training.
• Handoffs.
• Communication.
• Organizational learning.
• Management support for patient safety.
• Nonpunitive response to mistakes.
• Overall perceptions of patient safety.

Slide 6

Why Assess Patient Safety Culture?

• Raise staff awareness.
• Diagnose & assess the status of patient safety culture.
• Identify strengths & areas for improvement.
• Evaluate the impact of patient safety initiatives.
• Examine trends & track change over time.
• Satisfy directives or regulatory requirements.
• Compare with other organizations.

Slide 7

Free Toolkit Materials

• User's guide.
• Survey feedback report PPT template.
• Resource list of patient safety initiatives.
• Reference list (coming soon�includes international publications).
• Data entry & analysis tool.
• Comparative database reports.
• Research data sets (for de-identifiable data).
• Translation guidelines.
• International users contact the User Network:
  • To connect with other international users.
  • Obtain information about existing translations.

http://www.ahrq.gov/qual/patientsafetyculture

Slide 8

41 Countries

Image: A map of the world is shown with 41 countries highlighted in red.

Slide 9

41 Countries

Australia
Bahrain
Belgium
Brazil
Canada
China
Croatia
Denmark
El Salvador
Finland
France
Germany
Greece
Iceland
India
Italy
Iran
Japan
Jordan
Lebanon
Malaysia
Malta
Netherlands
New Zealand
Norway
Pakistan
Portugal
Saudi Arabia
Serbia
Singapore
Slovenia
South Korea
Spain
Sudan
Sweden
Switzerland
Taiwan
Turkey
United Kingdom
United Arab emirates
Qatar

Slide 10

22 Languages

Arabic
Chinese—Mandarin
Croatian
Danish
Dutch
Finnish
Flemish
French
German
Greek
Icelandic
italian
Japanese
Norwegian
Persian
Portuguese
Serbian
Slovene
Spanish
Swedish
Thai
Turkish

Slide 11

International Initiatives

• The European Network for Patient Safety (EUNetPaS).
• World Health Organization (WHO) High 5s Patient Safety Initiative.
• Other regional collaboratives.

Slide 12

EUNetPaS

• 78% of EU citizens consider medical errors to be an important issue in their country.
• Officially launched in 2008 in Utrecht, Netherlands.
• Aims to establish an umbrella network of all 27 EU Member States to encourage collaboration in patient safety.

Slide 13

EUNetPaS Goals

1. Establish common principles at the EU level:
   • Integrating knowledge, experiences and expertise from Member States.
2. Facilitate the development of patient safety programs in Member States.
3. Support countries less advanced in patient safety.

Slide 14

Key Topic Areas

• Promoting a culture of patient safety.
• Structuring education and training in patient safety in Member States.
• Proposing a core European curricula for patient safety in higher education.
• Implementing reporting and learning systems.
• Piloting the implementation of medication safety programs in hospitals.

Slide 15

AHRQ Survey Endorsement

• EUNetPaS published a two-volume report in 2010 reviewing patient safety culture instruments:
  • AHRQ Hospital SOPS (HSOPS)—One of only 3 patient safety culture instruments officially recommended after an extensive review of available tools.

Slide 16

WHO High 5s

• Launched in 2006 to reduce the frequency of 5 challenging patient safety problems in 5 countries over 5 years.
• Focus has been on 3 initiatives:
  • Medication reconciliation at transitions in care.
  • Performing correct site surgery.
  • Managing concentrated injectable medicines.
• Seven countries:
  • UK, France, Netherlands, Germany, Singapore, Australia & Canada.

Slide 17

High 5s & HSOPS

• Administered the HSOPS in 2009 and 2010.
• 23,520 respondents from 59 hospitals in 6 countries.
• Produced feedback reports:
  • For participating hospitals, countries, and an international comparative report.
• Hope to examine relationships between patient safety culture and implementation of the High 5s patient safety initiatives.

Slide 18

Other Regional Collaboratives

• Middle East Regional Network For Patient Safety Culture & Human Factors:
  • Egypt, Jordan, Kuwait, Libya, Qatar, Saudi Arabia, United Arab Emirates.
  • Over 20 researchers and representatives from hospitals and health systems.
  • Goals: Obtain WHO & AHRQ support; hold regional meetings; establish a patient safety culture database for comparative purposes; adopt standard Arabic translations of the AHRQ SOPS surveys.
• PaSCAL�Patient Safety Culture Alliance in Italy:
  • Organized by the European Institute of Oncology (Instituto Europeo di Oncologia—IEO).
  • 23 participating hospitals.
  • Held a Quality Week conference in November 2010.

Slide 19

International Comparisons

• The general finding:
  • The U.S. typically scores higher on most dimensions.
  • Notable exceptions where other countries have much higher scores than the U.S.

Slide 20

Challenges of International Comparisons

• Quality and comparability of translations.
• Translations have shown variable psychometric properties (factor structure & reliability).
• Differences in the structure and delivery of healthcare.
• Cultural influences on how respondents interpret and answer survey questions.

Slide 21

AHRQ SOPS: Setting the Standard

• 2011 Hospital SOPS Comparative Database Report:
  • 1,032 hospitals and 472,397 staff.
• Largest non-proprietary, free in the public domain, patient safety culture database in the world.
• The Nursing Home and Medical Office SOPS surveys are likely to follow:
  • NH-SOPS Database report released August 2012.
  • MO SOPS Database open for data submission through October 15—Report available Spring 2012.

Slide 22

• E-mail: safetyculturesurveys@ahrq.hhs.gov.
• joannsorra@westat.com.