Nursing Home Survey on Patient Safety Culture
Chapter 5. Overall Results
This chapter presents the overall survey results for the database, showing the average percentage of positive responses across the database nursing homes on each of the survey's items and composites. Reporting the average across nursing homes ensures that each nursing home receives an equal weight that contributes to the overall average. Reporting the data at the nursing home 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 nursing homes. (There are more than twice as many respondents from larger nursing homes as those from smaller nursing homes.)
Results: Composite and Item-Level Charts
This section provides the overall item and composite level results. The method for calculating the percent positive scores at the item and composite level are described in the Notes section of this document.
Chart 5-1 shows the average percent positive response for each of the 12 patient safety culture composites across nursing homes 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
- Overall Perceptions of Resident Safety—the extent to which residents are well cared for and safe. This patient safety culture composite had the highest average percent positive response (86 percent), indicating it is an area of strength across the database nursing homes.
- Feedback and Communication About Incidents—the extent to which staff discuss ways to keep residents safe, tell someone if they see something that might harm a resident, and talk about ways to keep incidents from happening again. This patient safety culture composite had the second highest average percent positive response (84 percent).
Areas With Potential for Improvement
- Nonpunitive Response to Error—the extent to which staff are not blamed when a resident is harmed, are treated fairly when they make mistakes, and feel safe reporting their mistakes. This patient safety culture composite had the lowest average percent positive response (51 percent), indicating it is an area with potential for improvement across the database nursing homes.
- Staffing—the extent to which there are enough staff to handle the workload, meet residents' needs during shift changes, and keep residents safe because there is not much staff turnover. This patient safety culture composite had the second lowest average percent positive response (52 percent).
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 item with the highest average percent positive response (87 percent) was from the patient safety culture composite Feedback and Communication About Incidents: "Staff tell someone if they see something that might harm a resident."
Area With Potential for Improvement
- The survey item with the lowest average percent positive response (35 percent) was from the patient safety culture composite Staffing: "Staff have to hurry because they have too much work to do" (that is, an average of only 35 percent of respondents in each nursing home Strongly disagreed or Disagreed with this negatively worded item).
Nursing Home Recommendation—Chart 5-3 shows the results from the item that asked respondents whether they would tell their friends that this is a safe nursing home for their family. On average across nursing homes, most respondents were positive, with 76 percent saying yes.
Overall Rating on Resident Safety—Chart 5-4 shows the results from the item that asked respondents to give their nursing home an overall rating on resident safety. On average across nursing homes, most respondents were positive, with 62 percent giving their nursing home a rating of "Excellent" (25 percent) or "Very Good" (37 percent).
iv Some nursing homes excluded one or more survey items and are therefore excluded from composite-level calculations when the omitted items pertain to a particular composite. For this 2011 report, 10 nursing homes were excluded from one or more composite-level calculations for this reason.