Hospital Survey on Patient Safety Culture: 2014 User Comparative Database Report

Appendixes: Executive Summary

Part II—Appendixes A and B: Overall Results by Hospital and Respondent Characteristics

Appendixes A and B present data tables that show average percent positive scores on the survey composites and items across database hospitals broken down by the following hospital and respondent characteristics:

Appendix A: Results by Hospital Characteristics

  • Bed size.
  • Teaching status.
  • Ownership and control.
  • Geographic region.

Appendix B: Results by Respondent Characteristics

  • Work area/unit.
  • Staff position.
  • Interaction with patients.
  • Tenure in current work area/unit.

Highlights from these results by hospital and respondent characteristics were presented in the main body of the report, Part I: Comparative Database Report, at the end of Chapter 6 and are also shown below. Highlights were based on results for the 12 patient safety culture composites, patient safety grade, and number of events reported. In the bottom row of the composite-level tables, an overall average across composites is shown as a summary statistic when comparing across breakout categories.

Comparing Your Results

You can compare your hospital's percent positive scores on the patient safety culture composites and items against the averages shown in Appendix A for hospitals with your same bed size, teaching status, ownership and control, and geographic region. You can use a 5 percentage point difference as a rule of thumb for determining what differences to pay attention to.

To compare your hospital's results against Appendix B, your hospital will have to compute percent positive scores on the safety culture composites and items broken down by work area/unit, staff position, interaction with patients, and tenure in current work area/unit. You can then compare your hospital's percent positive scores against the averages shown in the tables. Again, you can use a 5 percentage point difference as a rule of thumb.

Highlights from Appendix A: Overall Results by Hospital Characteristics

Bed Size (Tables A-1, A-3)

  • The smallest hospitals (6-24 beds) had the highest percent positive average across all composites (69 percent); larger hospitals (400 beds or more) had the lowest (61 percent positive).
  • Smaller hospitals (6-24 beds) had the highest percentage of respondents who gave their work area/unit a patient safety grade of "Excellent" or "Very Good" (82 percent); larger hospitals (400 beds or more) had the lowest (71 percent).

Teaching Status and Ownership and Control (Tables A-5, A-8)

  • Nonteaching hospitals on average scored higher than teaching hospitals by 5 percentage points or more on 6 of the 12 composites.
  • Non–government-owned hospitals had a higher percentage of respondents who reported one or more events in the past year (45 percent) than government-owned hospitals (37 percent).

Geographic Region (Tables A-9, A-11, A-12)

  • East South Central hospitals had the highest average percent positive response across all composites (68 percent positive); Mid-Atlantic hospitals had the lowest (60 percent positive).
  • East South Central hospitals had the highest percentage of respondents who gave their work area/unit a patient safety grade of "Excellent" or "Very Good" (80 percent); Mid-Atlantic hospitals had the lowest (69 percent).
  • West North Central hospitals had the highest percentage of respondents who reported one or more events in the past year (47 percent); the lowest percentage of respondents reporting one or more events was in the West South Central region (40 percent).

Highlights from Appendix B: Overall Results by Respondent Characteristics

Work Area/Unit (Tables B-1, B-3, B-4)

  • Respondents in Rehabilitation had the highest average percent positive response across the composites (70 percent positive); Emergency had the lowest (59 percent positive).
  • Rehabilitation had the highest percentage of respondents who gave their work area/unit a patient safety grade of "Excellent" or "Very Good" (86 percent); Emergency had the lowest (65 percent).
  • ICU (Any Type) had the highest percentage of respondents reporting one or more events in the past year (61 percent); Rehabilitation had the lowest (38 percent).

Staff Position (Tables B-5, B-7, B-8)

  • Respondents in Administration/Management had the highest average percent positive response across the composites (75 percent positive); Pharmacists had the lowest (62 percent positive).
  • Administration/Management had the highest percentage of respondents who gave their work area/unit a patient safety grade of "Excellent" or "Very Good" (87 percent); registered nurse, licensed vocational nurse, or licensed practical nurse and Pharmacists had the lowest (71 percent).
  • Pharmacists had the highest percentage of respondents reporting one or more events in the past year (73 percent); Unit Assistants/Clerks/Secretaries had the lowest (14 percent).

Interaction with Patients (Tables B-9, B-11, B-12)

  • Respondents with direct patient interaction were more positive than those without direct interaction on Handoffs and Transitions (49 percent positive compared with 42 percent positive) but less positive on Management Support for Patient Safety (71 percent positive compared with 77 percent positive).
  • Respondents without direct patient interaction had a higher percentage of respondents who gave their work area/unit a patient safety grade of "Excellent" or "Very Good" (81 percent) than respondents with direct patient interaction (75 percent).
  • More respondents with direct patient interaction reported one or more events in the past year (48 percent) than respondents without direct patient interaction (29 percent).

Tenure in Current Work Area/Unit (Tables B-13, B-15, B-16)

  • Respondents with less than a year in their current work area/unit had the highest average percent positive response across the composites (68 percent positive); respondents with 1 to 10 years had the lowest (63 percent positive).
  • Respondents with less than a year in their current work area/unit had the highest percentage of respondents who gave their work area/unit a patient safety grade of "Excellent" or "Very Good" (82 percent); respondents with 1 to 5 years had the lowest (74 percent).
  • Respondents with 6 to 10 years in their current work area/unit had the highest percentage reporting one or more events in the past year (47 percent); respondents with less than a year had the lowest (30 percent).

Part III—Appendixes C & D: Trending Results by Hospital and Respondent Characteristics

Appendixes C and D show trends over time for the 359 hospitals (of the 653 total database hospitals) that administered the survey and submitted data twice since July 2009. Average percent positive scores across hospitals from the most recent and previous administrations are shown for the survey composites and items, broken down by the following characteristics:

Appendix C: Trending Results by Hospital Characteristics

  • Bed size.
  • Teaching status.
  • Ownership and control.
  • Geographic region.

Appendix D: Trending Results by Respondent Characteristics

  • Work area/unit.
  • Staff position.
  • Interaction with patients.
  • Tenure in current work area/unit.

To ensure hospital confidentiality, a rule was established requiring at least 10 hospitals to be in a particular breakout category before data would be displayed by that category.

Tables 1 and 2 show examples of the statistics in this appendix. The tables show the average percentage of respondents who answered positively among the trending hospitals for the hospitals' most recent survey administration (top row) and their previous administration (middle row). The change over time is shown in the bottom row as a negative number if the most recent administration showed a decline or a positive number if the most recent administration showed an increase. Changes in scores of 5 percentage points or more, whether positive or negative, are shown in bold in the tables.

Table 1. Example of Decrease in Average Score Over Time (Negative Change)

Most Recent 85%
Previous 90%
Change -5%

Table 2. Example of Increase in Average Score Over Time (Positive Change)

Most Recent 70%
Previous 60%
Change 10%

Highlights of the findings from the breakout tables in these appendixes are provided below.

Highlights From Appendix C: Trending Results by Hospital Characteristics

Bed Size (Tables C-1, C-3)

  • Hospitals with 100-199 beds increased up to 3 percentage points on 11 patient safety composites.
  • Hospitals with 100-199 beds had the greatest increase in the percentage of respondents who gave their work area/unit a patient safety grade of "Excellent" or "Very Good" (a 2 percentage point increase, from 76 percent to 78 percent).

Teaching Status and Ownership and Control (Table C-5)

  • Teaching hospitals increased up to 3 percentage points on nine patient safety composites; nonteaching hospitals showed increases up to 2 percentage points on eight composites and decreased by 1 percentage point on Supervisor/Manager Expectations and Staffing.
  • Government-owned hospitals increased up to 2 percentage points across 10 composites and non–government-owned hospitals showed increases up to 3 percentage points across 9 composites; both government-owned and non–government-owned hospitals decreased by 1 percentage point on Staffing.

Geographic Region (Table C-9)

  • East North Central hospitals increased up to 3 percentage points on 11 patient safety composites and decreased by 1 percentage point on Staffing.

Highlights From Appendix D: Trending Results by Respondent Characteristics

Work Area/Unit (Table D-1)

  • Pharmacy increased up to 4 percentage points on 11 patient safety composites.

Staff Position (Table D-5)

  • Pharmacists increased up to 3 percentage points on nine patient safety composites.

Interaction With Patients (Table D-9)

  • Respondents with direct interaction with patients increased up to 2 percentage points across 10 patient safety culture composites; respondents without direct interaction increased up to 3 percentage points across 7 composites.

Tenure in Current Work Area/Unit (Table D-13)

  • Respondents with less than 1 year in their work area/unit showed increases up to 3 percentage points across 11 patient safety culture composites; respondents with 16 to 20 years in their work area/unit increased up to 3 percentage points across 9 composites.

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Current as of March 2014
Internet Citation: Hospital Survey on Patient Safety Culture: 2014 User Comparative Database Report: Appendixes: Executive Summary. March 2014. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/professionals/quality-patient-safety/patientsafetyculture/hospital/2014/hosp14appsumm.html