Main Line Health System Uses Patient Safety Culture Survey in Suburban Philadelphia Facilities

Patient Safety
December 2012

Main Line Health System (MLH) in suburban Philadelphia has used AHRQ's "Hospital Survey on Patient Safety Culture" since 2009 in an ongoing effort to embed a reliable culture of patient safety across its hospitals. The survey is part of the system's comprehensive patient safety program and has yielded measurable benefits for patients.

After completing its first survey in 2009 with physicians and staff, MLH conducted subsequent surveys in 2010 and 2012. The 2012 survey involved MLH's acute care facilities Bryn Mawr, Paoli, and Riddle Hospitals; Lankenau Medical Center; Bryn Mawr Rehabilitation Hospital; and Mirmont Treatment Center. The findings showed that 39 percent of the 5,687 staff and physicians surveyed responded, representing a 22 percent increase from the 2010 response rate.

Denise Murphy, RN, MPH, Vice President of Patient Safety and Quality, says, "The survey contributes greatly to MLH's patient safety culture initiative, which includes training hospital leaders, staff, and physicians to embed safety best practices in every patient encounter; conducting daily unit safety huddles; managers who 'round to influence'; sharing success stories; and other ongoing efforts. Results of the patient safety culture survey are threaded through these activities, shared throughout the administration, and included in the monthly organizational dashboard. Our hospitals score better than the national average on many outcomes indicators tracked by the Centers for Medicare & Medicaid Services."

For the past 3 years, AHRQ's survey implementation has been the responsibility of the MLH team led by Joel Telles, PhD, System Director for Data Management and Analysis. Sandeep Sarawgi, MBA, Quality Consultant, also provided data analysis. According to Telles, the 2012 scores compared with the 2009 scores demonstrate that the hospitals are scoring higher than the median and starting to score in the top quartile; composite scores have risen in seven of 12 composite areas.

Telles says, "One opportunity we identified based on the 2010 survey was 'handoffs.' In the 2012 survey, Main Line had significantly higher scores on teamwork across units and handoffs than the national average. 'Management support,' which is critical, improved from 70 percent in the 2010 survey to 73 percent in 2012. Additionally, the overall patient safety grade improved from 71 to 74 percent."

Survey results are complemented by process changes at the facilities. Some of these process changes include device-related infection bundles; bar code medication administration; and a smart collect specimen labeling system. Sharing survey findings within the organization has increased awareness and led to the development of initiatives for improving patient safety. For example, since 2010, mislabeled specimens have decreased by 73 percent, all hospital central line-related bloodstream infections have decreased by 51 percent, and pressure ulcers rated at stage II or worse have decreased by 44 percent.

MLH is a nonprofit health system consisting of five acute care hospitals, rehabilitation and treatment centers, clinics, laboratories, and other types of providers. The hospitals serve 80,000 patients and handle 136,000 emergency department visits annually.

Impact Case Study Identifier: 
AHRQ Product(s): Hospital Survey on Patient Safety Culture
Topics(s): Patient Safety
Geographic Location: Pennsylvania
Implementer: Main Line Health System
Date: 12/01/2012

Hospital Survey on Patient Safety Culture. Agency for Healthcare Research and Quality, Rockville, MD

Page last reviewed December 2012