Chapter 5. Overall Results

Hospital Survey on Patient Safety Culture: 2012 User Comparative Database Report

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 characteristic 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 from smaller hospitals.)

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Highlights

  • Teamwork Within Units—This composite had the highest average percent positive response (80 percent), indicating it is a strength for most hospitals.
  • Supervisor/Manager Expectations and Actions Promoting Patient Safety—This composite had the second highest average percent positive response (75 percent), indicating it is a strength for most hospitals.
  • Nonpunitive Response to Error—This composite had the lowest average percent positive response (44 percent), indicating it is an area with potential for improvement for most hospitals.
  • Handoffs and Transitions—This composite had the second lowest average percent positive response (45 percent), indicating it is an area with potential for improvement for most hospitals.
  • On average, most respondents within hospitals (75 percent) gave their work area or unit a grade of "A-Excellent" (30 percent) or "B-Very Good" (45 percent) on patient safety; this was identified as an area of strength for most hospitals.
  • On average, most respondents within hospitals (55 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.

This section provides the overall item and composite-level results. The method for calculating the percent positive scores at the item and composite level is described in the Notes section of this document. 

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Composite-Level Resultsvii

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

Areas of Strength

  • 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.
  • Supervisor/Manager Expectations and 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 patient safety culture composite had the second highest average percent positive response (75 percent).
  • Organizational Learning—Continuous Improvement— the extent to which mistakes have led to positive changes and changes are evaluated for effectiveness. This patient safety culture composite tied for the third highest average percent positive response (72 percent).
  • Management Support for Patient Safety— the extent to which hospital management provides a work climate that promotes patient safety and shows that patient safety is a top priority. This patient safety culture composite tied for the third highest average percent positive response (72 percent).

Areas With Potential for Improvement

  • 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 patient safety culture composite had the lowest average percent positive response (44 percent), indicating it is an area with potential for improvement across the database hospitals.
  • Handoffs and Transitions—the extent to which important patient care information is transferred across hospital units and during shift changes. This patient safety culture composite had the second lowest average percent positive response (45 percent).
  • Staffing— the extent to which there are enough staff to handle the workload and work hours are appropriate to provide the best care for patients. This patient safety culture composite had the third lowest average percent positive response (56 percent).

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Item-Level Results

Chart 5-2 shows 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.

Areas of Strength

  • 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."

Areas With Potential for Improvement

  • 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." (In other words, an average of only 35 percent of respondents in each hospital Strongly disagreed or Disagreed with this negatively worded item.)

Patient Safety GradeChart 5-3 shows the results from the item that asked respondents to give their hospital work area/unit an overall grade on patient safety. On average across hospitals, most respondents were positive, with 75 percent giving their work area or unit a patient safety grade of "A-Excellent" (30 percent) or "B-Very Good" (45 percent). 

Number of Events ReportedChart 5-4 shows the results from the item that asked respondents to indicate the number of events they reported over the past 12 months. On average across hospitals, most respondents (55 percent) reported no events in their hospital over the past 12 months. Event reporting was identified as an area for improvement for most hospitals because underreporting of events means potential patient safety problems may not be recognized or identified and therefore may not be addressed.


vii. Some hospitals excluded one or more survey items and are therefore excluded from composite-level calculations when the omitted items pertain to a particular composite. For the 2012 report, 44 hospitals were excluded from one or more composite-level calculations for this reason.

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Current as of December 2012
Internet Citation: Chapter 5. Overall Results : Hospital Survey on Patient Safety Culture: 2012 User Comparative Database Report. December 2012. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/professionals/quality-patient-safety/patientsafetyculture/hospital/2012/hosp12ch5.html