Nursing Home Survey on Patient Safety Culture Feedback Results

Evaluation Report

This report presents the results of the Agency for Healthcare Research and Quality's (AHRQ)'s Nursing Home Survey on Patient Safety Culture, which is specifically designed to measure the culture of resident safety in nursing homes (NH) from a staff perspective. The NH Survey assesses staff attitudes and beliefs about resident safety.

May 2009

Prepared by
Tara N Brown, MPH, CQA
Evaluation Specialist
GMCF
9th Scope of Work

Contents

Introduction
Results
Conclusion
Appendices 
   A. Evaluation (Page 1 & 2 only)
   B. Graphs
   C. Item Level Results
   D. Participants' Comment

Introduction

Centers for Medicare & Medicaid Services

The Centers for Medicare & Medicaid Services (CMS) is a federal agency within the United States Department of Health and Human Services (DHHS). CMS manages several national health care programs, including the Medicare and Medicaid programs, and evaluates the quality of health care facilities and services for Medicare and Medicaid beneficiaries.

CMS also directs a national network of 53 Quality Improvement Organizations (QIOs) in each state and territory of the United States and the District of Columbia. The mission of the QIOs, as set forth by the Social Security Act and amended by the Peer Review Improvement Act of 1982, is to improve the effectiveness, efficiency, economy, and quality of services delivered to the Medicare beneficiaries. The QIOs work with consumers, physicians, hospitals, and other health care providers to ensure that patients receive appropriate care at the precise time it is needed.

GMCF

The Georgia Medical Care Foundation, or GMCF, is the QIO for the state of Georgia. Through the 9th Scope of Work (SOW) contract, awarded on August 1, 2008, GMCF conducts activities designed to improve the quality of care for Medicare beneficiaries in Georgia through collaboration with stakeholders from various health care provider and beneficiary associations.

Nursing Home Survey

The nursing home survey is an expansion of the Agency for Healthcare Research and Quality's (AHRQ) Hospital Survey on Patient Safety Culture http://www.ahrq.gov/professionals/quality-patient-safety/patientsafetyculture/index.html. It was specifically designed to measure the culture of resident safety in nursing homes (NH) from a staff perspective. AHRQ NH Survey assesses staff attitudes, beliefs about resident safety and many areas similar to the hospital survey. AHRQ NH survey was pilot tested in 2007 in 40 U.S. nursing homes with 3,698 respondents. The final survey was released on AHRQ Web site in 2008. The Utilization & Compliance Review (UCR) of GMCF administered the AHRQ NH survey on May 19, 2009. Survey areas included overall perceptions of resident safety, organizational learning, training and skill, and compliance with procedures, among many other categories. The nursing home staff was encouraged to stop by and complete the survey. Participants were also asked to provide comments and suggestions (go to Appendix A for evaluation). 

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Results

________ employs 150 day, evening, and night shift employees. 88 Staff members completed the AHRQ NH survey for a response rate of 59%. ________ home received an overall score on staff perception in resident safety of 72% (go to Appendix B for graphs).

Table 1

Nursing Home Patient Safety Culture Composites Home Score Average % of positive responses
Overall Perceptions of Resident Safety
(3 items--% Agree/Strongly Agree)
72%
Feedback & Communication About Incidents
(4 items--% Most of the time/Always)
78%
Supervisor Expectations & Actions Promoting Resident Safety
(3 survey items--% Agree/Strongly Agree)
71%
Organizational Learning
(4 survey items--% Agree/Strongly Agree)
63%
Management Support for Resident Safety
(3 survey items--% Agree/Strongly Agree)
59%
Training & Skills
(3 items--% Agree/Strongly Agree)
70%
Compliance with Procedures
(3 items--% Agree/Strongly Agree)
63%
Teamwork
(4 items--% Agree/Strongly Agree)
44%
Handoffs
(4 items--% Most of the time/Always)
45%
Communication Openness
(3 items--% Most of the time/Always)
40%
Nonpunitive Response to Mistakes
(4 items--% Agree/Strongly Agree)
53%
Staffing
(4 items--% Agree/Strongly Agree)
35%

* Composite scores are not calculated when any item in the composite has fewer than three respondents.

Demographic Data about Respondents for __________ home

1. Staff position in the Nursing Home:

6% Administrator/Manager
0% Physician
1% Other Provider
30% Licensed Nurse
5% Other, please specify
40% Nursing Assistant/Aide
4% Direct Care Staff
6% Administrative Support Staff
8% Support Staff

2. Work area in the Nursing Home:

62% Many different areas or units in the nursing home / No specific area or unit
6% Alzheimer's / Dementia Unit
6% Rehab Unit
19% Skilled nursing unit
7% Other area of unit (please specify)

3. Tenure with Nursing Home:

0% Less than 2 months
7% 2 to 11 months
15% 1 to 2 years
22% 3 to 5 years
24% 6 to 10 years
32% 11 years or more

4. Hours Worked per Week:

2% 15 or fewer hours per week
0% 16 to 24 hours per week
81% 25 to 40 hours per week
16% More than 40 hours per 16% week

5. Time of Work:

71% Days
20% Evenings
9% Nights

6. Percentage of Respondents Paid by Staffing Agency:: 4% 

7. Percentage of Respondents with Direct Interaction or Contact with Residents:: 81%

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Conclusion

In May 2009, GMCF administered the AHRQ NH survey _________. 88 People completed the survey, giving a response rate of 59 %. __________ home staff's overall perception of resident safety was 81%. Of the respondents, 60% would recommend this nursing home to a friend or a family member. Some areas emerged that may need improvement: Staffing issues, communication openness and teamwork (Go to Appendix C for participants' comments). Most respondents gave _________ home an overall very good or good rating on patient safety (go to Appendix B for graphs).

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Current as of October 2010
Internet Citation: Nursing Home Survey on Patient Safety Culture Feedback Results: Evaluation Report. October 2010. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/professionals/quality-patient-safety/patientsafetyculture/nursing-home/resources/sampeval.html