Chapter 5. Overall Results

Hospital Survey on Patient Safety Culture: 2010 User Comparative Database

This chapter presents the overall survey results for the database, showing the average percentage of positive responses across the database hospitals on each of the survey's items and composites. Reporting the average across hospitals ensures that each hospital receives an equal weight that contributes to the overall average. Reporting the data at the hospital level in this way is important because culture is considered to be a group of hospital characteristics and is not considered to be a solely individual characteristic. An alternative method would be to report a straight percentage of positive responses across all respondents, but this method would give greater weight to respondents from larger hospitals. There are almost twice as many respondents from larger hospitals as those from smaller hospitals (as noted in Chapter 3).

Highlights

  • Teamwork Within Units—the extent to which staff support each other, treat each other with respect, and work together as a team. This area was the patient safety culture composite with the highest average percent positive response (80 percent), indicating it is a strength for most hospitals.
  • Supervisor/Manager Expectations & Actions Promoting Patient Safety—the extent to which supervisors/managers consider staff suggestions for improving patient safety, praise staff for following patient safety procedures, and do not overlook patient safety problems. This area was the patient safety culture composite with the second highest average percent positive response (75 percent), indicating it is a strength for most hospitals.
  • Nonpunitive Response to Error—the extent to which staff feel that their mistakes and event reports are not held against them and that mistakes are not kept in their personnel file. This area was one of the two patient safety culture composites with the lowest average percent positive response (44 percent), indicating it is an area with potential for improvement for most hospitals.
  • Handoffs and Transitions—the extent to which important patient care information is transferred across hospital units and during shift changes. This area was the other patient safety culture composite with the lowest average percent positive response (44 percent), indicating it is also an area with potential for improvement for most hospitals.
  • On average, most respondents within hospitals (74 percent) gave their work area or unit a grade of "A-Excellent" (27 percent) or "B-Very Good" (47 percent) on patient safety; this was identified as an area of strength for most hospitals.
  • On average, most respondents within hospitals (53 percent) reported no events in their hospital over the past 12 months. It is likely that this represents underreporting of events and was identified as an area for improvement for most hospitals.

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Results: Composite and Item-Level Charts

The methods for calculating the percent positive scores at the item and composite level are described in the Notes section of this document. However, 46 hospitals did not administer the entire survey; they excluded one or more of the non-demographic survey items. These 46 hospitals were excluded from the composite calculations because they omitted one or more of the items within a particular composite.

Composite-Level Results

 The composite-level results in Chart 5-1 show the average percent positive response for each of the 12 patient safety culture composites, across all hospitals in the database. The patient safety culture composites are shown in order from the highest average percent positive response to the lowest.

Teamwork Within Units—the extent to which staff support one another, treat one another with respect, and work together as a team. This area was the patient safety culture composite with the highest average percent positive response (80 percent), indicating it is an area of strength across the database hospitals (Chart 5-1.

Nonpunitive Response to Error—the extent to which staff feel that event reports and their own mistakes are not held against them, and that mistakes are not kept in their personnel file. This area was one of the two patient safety culture composites with the lowest average percent positive response (44 percent), indicating it is an area with potential for improvement across the database hospitals (Chart 5-1.

Handoffs and Transitions—the extent to which important patient care information is transferred across hospital units and during shift changes. This area was the other patient safety culture composite with the lowest average percent positive response (44 percent), indicating it is also an area with potential for improvement for most hospitals (Chart 5-1).

Item-Level Results

The item-level results in Chart 5-2 show the average percent positive response for each of the 42 survey items. The survey items are grouped by the patient safety culture composite they are intended to measure. Within each composite, the items are presented in the order in which they appear in the survey. The survey items with the highest average percent positive response (86 percent) were from the patient safety culture composite Teamwork Within Units: "People support one another in this unit," and, "When a lot of work needs to be done quickly, we work together as a team to get the work done."

The survey item with the lowest average percent positive response (35 percent) was from the patient safety culture composite Nonpunitive Response to Error: "Staff worry that mistakes they make are kept in their personnel file" (that is, an average of only 35 percent of respondents in each hospital Strongly disagreed or Disagreed with this negatively worded item).

Patient Safety Grade—Results from the item that asked respondents to give their hospital work area/unit an overall grade on patient safety are shown in Chart 5-3. The chart shows the average percentage of respondents within each hospital providing grades from "A-Excellent" to "E-Failing." On average across hospitals, most respondents were positive, with 74 percent giving their work area or unit a patient safety grade of "A-Excellent" (27 percent) or "B-Very Good" (47 percent). Very few (5 percent) gave their work area/unit a "Poor" (4 percent) or "Failing" (1 percent) grade.

Number of Events Reported—Results from the item that asked respondents to indicate the number of events they had reported over the past 12 months are shown in Chart 5-4. The chart shows the average percentage of respondents within each hospital who indicated that they reported "No event reports" up to "21 or more event reports." On average across hospitals, most respondents (53 percent) reported no events in their hospital over the past 12 months. Event reporting was identified as an area for improvement for most hospitals. Underreporting of events means potential patient safety problems may not be recognized or identified and therefore may not be addressed.

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Current as of March 2010
Internet Citation: Chapter 5. Overall Results: Hospital Survey on Patient Safety Culture: 2010 User Comparative Database. March 2010. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/professionals/quality-patient-safety/patientsafetyculture/hospital/2010/hospdb10ch5.html