Hospital Survey on Patient Safety Culture: 2009 Comparative Database Report. Table C-2

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Hospital Survey on Patient Safety Culture: 2009 Comparative Database Report

Table C-2. Trending: Item-Level Average Percent Positive Response by Bed Size

Survey Items by Composite			Bed Size
			6-24 beds	25-49	50-99 beds	100-199 beds	200-299 beds	300-499 beds	500+ beds
			21 Hospitals Both Years	42 Hospitals Both Years	37 Hospitals Both Years	32 Hospitals Both Years	22 Hospitals Both Years	26 Hospitals Both Years	24 Hospitals Both Years
			1,054 Most Recent Respondents	3,550 Most Recent Respondents	4,360 Most Recent Respondents	8,886 Most Recent Respondents	8,408 Most Recent Respondents	15,678 Most Recent Respondents	27,605 Most Recent Respondents
			1,362 Previous Respondents	3,401 Previous Respondents	4,686 Previous Respondents	7,573 Previous Respondents	8,108 Previous Respondents	14,300 Previous Respondents	25,891 Previous Respondents
1. Teamwork Within Units	A1—1. People support one another in this unit.	Most Recent	88%	88%	83%	84%	83%	84%	84%
		Previous	86%	86%	82%	78%	73%	81%	83%
		Change	2%	2%	1%	6%	10%	3%	1%
	A3—2. When a lot of work needs to be done quickly, we work together as a team to get the work done.	Most Recent	91%	90%	84%	84%	85%	84%	82%
		Previous	89%	89%	85%	79%	76%	82%	82%
		Change	2%	1%	-1%	5%	9%	2%	0%
	A4—3. In this unit, people treat each other with respect.	Most Recent	80%	82%	75%	77%	76%	76%	75%
		Previous	80%	80%	76%	72%	68%	74%	75%
		Change	0%	2%	-1%	5%	8%	2%	0%
	A11—4. When one area in this unit gets really busy, others help out.	Most Recent	74%	73%	69%	69%	66%	67%	65%
		Previous	70%	71%	67%	64%	59%	64%	66%
		Change	4%	2%	2%	5%	7%	3%	-1%
2. Supervisor/Manager Expectations & Actions Promoting Patient Safety	B1—1. My supv/mgr says a good word when he/she sees a job done according to established patient safety procedures.	Most Recent	71%	76%	70%	72%	72%	70%	72%
		Previous	69%	74%	69%	67%	65%	67%	71%
		Change	2%	2%	1%	5%	7%	3%	1%
	B2—2. My supv/mgr seriously considers staff suggestions for improving patient safety.	Most Recent	77%	81%	75%	77%	75%	73%	74%
		Previous	77%	80%	75%	71%	67%	71%	75%
		Change	0%	1%	0%	6%	8%	2%	-1%
	B3R—3. Whenever pressure builds up, my supv/mgr wants us to work faster, even if it means taking shortcuts.	Most Recent	80%	80%	75%	75%	71%	71%	68%
		Previous	78%	78%	73%	73%	67%	69%	69%
		Change	2%	2%	2%	2%	4%	2%	-1%
	B4R—4. My supv/mgr overlooks patient safety problems that happen over and over.	Most Recent	76%	82%	77%	77%	74%	73%	75%
		Previous	76%	80%	75%	72%	67%	71%	73%
		Change	0%	2%	2%	5%	7%	2%	2%
3. Organizational Learning-Continuous Improvement	A6—1. We are actively doing things to improve patient safety.	Most Recent	83%	86%	83%	83%	81%	81%	79%
		Previous	82%	85%	81%	75%	71%	79%	80%
		Change	1%	1%	2%	8%	10%	2%	-1%
	A9—2. Mistakes have led to positive changes here.	Most Recent	67%	68%	63%	65%	61%	62%	60%
		Previous	64%	67%	61%	59%	53%	59%	61%
		Change	3%	1%	2%	6%	8%	3%	-1%
	A13—3. After we make changes to improve patient safety, we evaluate their effectiveness.	Most Recent	69%	73%	69%	70%	67%	67%	65%
		Previous	68%	70%	66%	62%	60%	64%	66%
		Change	1%	3%	3%	8%	7%	3%	-1%
4. Management Support for Patient Safety	F1—1. Hospital mgmt provides a work climate that promotes patient safety.	Most Recent	85%	86%	80%	80%	75%	76%	73%
		Previous	85%	86%	78%	74%	71%	76%	75%
		Change	0%	0%	2%	6%	4%	0%	-2%
	F8—2. The actions of hospital mgmt show that patient safety is a top priority.	Most Recent	78%	78%	71%	73%	69%	70%	67%
		Previous	76%	78%	69%	66%	60%	67%	69%
		Change	2%	0%	2%	7%	9%	3%	-2%
	F9R—3. Hospital mgmt seems interested in patient safety only after an adverse event happens.	Most Recent	67%	68%	58%	59%	55%	56%	52%
		Previous	66%	66%	57%	55%	51%	54%	52%
		Change	1%	2%	1%	4%	4%	2%	0%
5. Overall Perceptions of Patient Safety	A10R—1. It is just by chance that more serious mistakes don't happen around here.	Most Recent	69%	67%	61%	60%	56%	59%	45%
		Previous	65%	64%	61%	57%	52%	55%	54%
		Change	4%	3%	0%	3%	4%	4%	-9%
	A15—2. Patient safety is never sacrificed to get more work done.	Most Recent	77%	73%	63%	65%	61%	59%	55%
		Previous	75%	69%	64%	60%	52%	56%	58%
		Change	2%	4%	-1%	5%	9%	3%	-3%
	A17R—3. We have patient safety problems in this unit.	Most Recent	74%	70%	63%	62%	57%	58%	44%
		Previous	72%	68%	62%	58%	51%	56%	55%
		Change	2%	2%	1%	4%	6%	2%	-11%
	A18—4. Our procedures and systems are good at preventing errors from happening.	Most Recent	75%	76%	71%	71%	69%	68%	65%
		Previous	70%	73%	67%	64%	60%	66%	66%
		Change	5%	3%	4%	7%	9%	2%	-1%
6. Feedback & Communication About Error	C1—1. We are given feedback about changes put into place based on event reports.	Most Recent	52%	53%	52%	54%	53%	54%	54%
		Previous	53%	53%	50%	49%	48%	53%	56%
		Change	-1%	0%	2%	5%	5%	1%	-2%
	C3—2. We are informed about errors that happen in this unit.	Most Recent	72%	67%	65%	65%	61%	61%	60%
		Previous	69%	68%	65%	60%	58%	60%	60%
		Change	3%	-1%	0%	5%	3%	1%	0%
	C5—3. In this unit, we discuss ways to prevent errors from happening again.	Most Recent	73%	74%	70%	70%	67%	68%	66%
		Previous	75%	74%	69%	64%	60%	67%	68%
		Change	-2%	0%	1%	6%	7%	1%	-2%
7. Communication Openness	C2—1. Staff will freely speak up if they see something that may negatively affect patient care.	Most Recent	78%	78%	75%	75%	74%	74%	72%
		Previous	80%	76%	75%	70%	68%	74%	74%
		Change	-2%	2%	0%	5%	6%	0%	-2%
	C4—2. Staff feel free to question the decisions or actions of those with more authority.	Most Recent	50%	48%	46%	48%	47%	46%	46%
		Previous	50%	47%	45%	44%	44%	47%	48%
		Change	0%	1%	1%	4%	3%	-1%	-2%
	C6R—3. Staff are afraid to ask questions when something does not seem right.	Most Recent	67%	66%	61%	62%	59%	61%	59%
		Previous	66%	63%	60%	59%	55%	61%	60%
		Change	1%	3%	1%	3%	4%	0%	-1%
8. Frequency of Events Reported	D1—1. When a mistake is made, but is caught and corrected before affecting the patient, how often is this reported?	Most Recent	55%	56%	51%	55%	52%	53%	51%
		Previous	55%	54%	51%	50%	47%	51%	51%
		Change	0%	2%	0%	5%	5%	2%	0%
	D2—2. When a mistake is made, but has no potential to harm the patient, how often is this reported?	Most Recent	61%	61%	56%	59%	55%	55%	53%
		Previous	61%	59%	55%	54%	50%	52%	52%
		Change	0%	2%	1%	5%	5%	3%	1%
	D3—3. When a istake is made that could harm the patient, but does not, how often is this reported?	Most Recent	77%	78%	73%	73%	70%	71%	68%
		Previous	78%	77%	72%	70%	65%	69%	67%
		Change	-1%	1%	1%	3%	5%	2%	1%
9. Teamwork Across Units	F2R—1. Hospital units do not coordinate well with each other.	Most Recent	57%	54%	45%	45%	37%	39%	37%
		Previous	54%	52%	45%	42%	37%	37%	37%
		Change	3%	2%	0%	3%	0%	2%	0%
	F4—2. There is good cooperation among hospital units that need to work together.	Most Recent	71%	67%	59%	59%	51%	53%	50%
		Previous	68%	67%	60%	53%	47%	50%	51%
		Change	3%	0%	-1%	6%	4%	3%	-1%
	F6R—3. It is ften unpleasant to work with staff from other hospital units.	Most Recent	67%	65%	58%	58%	51%	54%	51%
		Previous	65%	63%	57%	53%	49%	52%	53%
		Change	2%	2%	1%	5%	2%	2%	-2%
	F10—4. Hospital units work well together to provide the best care for patients.	Most Recent	78%	75%	68%	68%	59%	62%	58%
		Previous	76%	75%	68%	62%	56%	59%	60%
		Change	2%	0%	0%	6%	3%	3%	-2%
10. Staffing	A2—1. We have enough staff to handle the workload.	Most Recent	64%	63%	53%	51%	47%	50%	44%
		Previous	63%	62%	54%	51%	43%	47%	47%
		Change	1%	1%	-1%	0%	4%	3%	-3%
	A5R—2. Staff in this unit work longer hours than is best for patient care.	Most Recent	61%	55%	51%	51%	48%	50%	45%
		Previous	56%	55%	51%	48%	45%	49%	46%
		Change	5%	0%	0%	3%	3%	1%	-1%
	A7R—3. We use more agency/temporary staff than is best for patient care.	Most Recent	69%	68%	63%	62%	64%	65%	61%
		Previous	69%	64%	65%	59%	55%	60%	60%
		Change	0%	4%	-2%	3%	9%	5%	1%
	A14R—4. We work in "crisis mode" trying to do too much, too quickly.	Most Recent	64%	59%	50%	48%	43%	43%	39%
		Previous	58%	55%	49%	47%	40%	41%	41%
		Change	6%	4%	1%	1%	3%	2%	-2%
11. Handoffs & Transitions	F3R—1. Things "fall between the cracks" when transferring patients from one unit to another.	Most Recent	58%	52%	44%	39%	32%	32%	32%
		Previous	55%	50%	45%	38%	31%	32%	32%
		Change	3%	2%	-1%	1%	1%	0%	0%
	F5R—2. Important patient care information is often lost during shift changes.	Most Recent	59%	55%	50%	48%	44%	45%	44%
		Previous	56%	55%	50%	45%	41%	44%	46%
		Change	3%	0%	0%	3%	3%	1%	-2%
	F7R—3. Problems often occur in the exchange of information across hospital units.	Most Recent	57%	51%	45%	42%	36%	36%	34%
		Previous	52%	49%	45%	37%	34%	34%	35%
		Change	5%	2%	0%	5%	2%	2%	-1%
	F11R—4. Shift changes are problematic for patients in this hospital.	Most Recent	61%	55%	47%	43%	37%	39%	36%
		Previous	58%	52%	44%	43%	37%	38%	38%
		Change	3%	3%	3%	0%	0%	1%	-2%
12. Nonpunitive Response to Error	A8R—1. Staff feel like their mistakes are held against them.	Most Recent	61%	57%	50%	51%	48%	47%	44%
		Previous	58%	55%	49%	49%	45%	45%	44%
		Change	3%	2%	1%	2%	3%	2%	0%
	A12R—2. When an event is reported, it feels like the person is being written up, not the problem.	Most Recent	53%	51%	44%	46%	43%	43%	41%
		Previous	48%	48%	42%	43%	41%	41%	40%
		Change	5%	3%	2%	3%	2%	2%	1%
	A16R—3. Staff worry that mistakes they make are kept in their personnel file.	Most Recent	45%	42%	36%	35%	33%	31%	28%
		Previous	41%	38%	35%	35%	30%	30%	28%
		Change	4%	4%	1%	0%	3%	1%	0%

Note: The item's survey location is shown to the left. An "R" indicates a negatively worded item, where the percent positive response is based on those who responded "Strongly disagree" or "Disagree," or "Never" or "Rarely" (depending on the response category used for the item).

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