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

Chapter 5. Overall Results

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 (i.e., 300 beds or more). More than half of respondents (53 percent) are from hospitals with 300 beds or more.

Highlights

  • The areas of strength, or the composites with the highest average percent positive responses, were:
    • Teamwork Within Units (81 percent positive).
    • Supervisor/Manager Expectations and Actions Promoting Patient Safety (76 percent positive).
    • Organizational Learning—Continuous Improvement (73 percent positive).
  • The areas with potential for improvement, or the composites with the lowest average percent positive responses, were:
    • Nonpunitive Response to Error—(44 percent positive).
    • Handoffs and Transitions—(47 percent positive).
    • Staffing (55 percent positive).
  • On average, most respondents within hospitals (76 percent) gave their work area or unit a grade of "Excellent" (33 percent) or "Very Good" (43 percent) on patient safety.
  • On average, less than half of respondents within hospitals (44 percent) reported at least one event in their hospital over the past 12 months. It is likely that this represents underreporting of events.

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.

Composite-Level Results

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

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 positive) 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 positive) 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 Grade

On average across hospitals, most respondents were positive, with 76 percent giving their work area or unit a patient safety grade of "Excellent" (33 percent) or "Very Good" (43 percent), as shown in Chart 5-3.

Number of Events Reported

On average across hospitals, less than half of respondents (44 percent) reported at least one event in their hospital over the past 12 months (Chart 5-4). 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.


viii. 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 2014 report, six hospitals were excluded from one or more composite-level calculations for this reason.


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Page last reviewed March 2014
Internet Citation: Hospital Survey on Patient Safety Culture: 2014 User Comparative Database Report: Chapter 5. Overall Results. March 2014. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/professionals/quality-patient-safety/patientsafetyculture/hospital/2014/hosp14ch5.html