County Health Department in Oregon Launches Performance Improvement Activities With AHRQ's Patient Safety Culture Survey

The Multnomah County Health Department in Portland, Oregon, initiated a patient safety culture project in 2005 using AHRQ's Hospital Survey on Patient Safety Culture. The project covers the county's 27 patient care delivery sites, which include primary care health centers (medical, dental, and WIC), school-based health centers, and the corrections health program, in addition to clinics serving HIV patients and those with sexually transmitted diseases (STDs) and tuberculosis (TB).

According to Mary Loos, BSN, MPH, Director of Quality, Support, and Public Health Programs for Multnomah County's Integrated Clinical Services division, the county modified the survey slightly to use language more applicable to an ambulatory care setting. "We worked to maintain the true content of each question, to ensure that the reliability and validity of the survey instrument would not be compromised," she says.

The survey was first used in the area of Corrections Health Services as a pilot site. Staff completed the survey in August 2005, and the analysis was completed that fall. The Corrections Health Quality Improvement Committee then began working with its management team to identify, prioritize, and initiate performance improvement activities in response to the survey data.

During February and March 2006, the school-based health centers, primary care health centers, and the HIV, STD, and TB clinics all participated in the survey process. The survey was administered to 578 employees at the various sites, and 360 responded—a 62 percent response rate. Staff at all levels, including management, completed surveys.

"This is an exciting project, as we will take the results and use them to develop process and system improvement plans for each service area and site. Improvement and sustainability are our objectives," Loos says.

Multnomah County Health Department serves a population of nearly 700,000.