AHRQ's Patient Safety Culture Survey Targets Improvement at Cincinnati Children's Hospital

Patient Safety
February 2006

During 2005, Cincinnati Children's Hospital Medical Center began using AHRQ's Hospital Survey on Patient Safety Culture. Jane Dresselhaus, RN, MSN, the hospital's Senior Director of Patient Safety, explains that the staff carefully chose the time frame for the survey, making the last week to respond to the survey coincide with Patient Safety Week in mid-March. The hospital staff plans to administer the survey at the same time every year.

The survey was disseminated and completed exclusively on-line and produced 1,579 usable responses. Employees surveyed included all those with direct and indirect patient care responsibilities. Staff with indirect patient contact included, among others, registration and medical records personnel.

AHRQ's Hospital Survey on Patient Safety Culture brought in more responses than previous employee surveys conducted at the hospital. Although the 36 percent total response rate was lower than desired, it was still considerably higher than the responses to other culture surveys done in 2002 and 2003. This was also the first time responses included the department in the report results.

The highest-scoring results were in the categories called "teamwork within hospital units" and "hospital management support for patient safety." The lowest areas were for "non-punitive response to error" and "hospital handoffs and transitions." Results were consistent across departments and different types of employees for both the high- and low-scoring categories.

Cincinnati Children's has had many safety initiatives going on simultaneously with the survey, and some of the categories the survey revealed as areas with potential for improvement had already been targeted. Patient handoffs and transitions were already being addressed, but the focus will continue to improve this important area.

"The low score for non-punitive response to error was surprising to us," Dresselhaus admits, "because we had been working on that for some time. We are reviewing the literature now to see how other hospitals are improving that, but there's not a lot out there."

Hospital board members and department managers were given survey results first; now the staff as a whole is being informed about the findings. Department heads are each selecting one area to work on with their staff for improvement. By the end of December, Dresselhaus expects that survey results will be posted on the hospital's intranet for all employees to review.

Cincinnati Children's has 423 patient beds and nearly 7,800 employees. It is the only Level 1 pediatric trauma center in Southwestern Ohio, Northern Kentucky, and Southeastern Indiana, with the only pediatric cardiac intensive care unit in the region. In 2004, the hospital treated patients from 47 states and 53 countries.

Impact Case Study Identifier: 
AHRQ Product(s): Hospital Survey on Patient Safety Culture
Topics(s): Patient Safety
Geographic Location: Indiana, Kentucky, Ohio
Implementer: Cincinnati Children's Hospital Medical Center
Date: 02/01/2006

Hospital Survey on Patient Safety Culture. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/qual/patientsafetyculture/ (Contract No. 290-96-0004)

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