Hospital Safety Culture Survey

Research has been carried out to test the psychometric properties of the Safety Attitudes Questionnaire and AHRQ Hospital Safety Culture Survey (Nieva and Sorra 2003 Sexton et al. 2006 Sorra and Nieva 2004). However, there have been important misapplications of survey tools in healthcare. A proliferation of climate surveys now exist, including many where the factor stmcture and construct validity have not been tested. Many hospitals have developed their own bespoke survey tools and these are poorly designed because basic survey design rules have not been followed. One common issue is surveys that do not counter-balance positive and negative statements, thus increasing the risk of response set bias where the... 

In this section, results obtained in a case study (Itoh and Andersen 2008, 2010) will be reviewed to illustrate the contribution of safety culture to safety outcome. In a case study, a questioimaire-based survey concerning staff reactions after the adverse event introduced in the last section, was conducted in addition to the safety culture survey. At the same time, incident reports for three years (2004-06) submitted by nurses were obtained from one of the hospitals (Hospital M) that participated in the safety culture survey. Hospital M was a private, acute-type general hospital, located in Tokyo. This hospital covered almost all clinical specialties and, at the time of the survey in 2006, it had about 500 inpatient beds, 160 full-time doctors and 360 full-time nurses. Nurses belonged to any one of 18 clinical work units 14 inpatient wards, an outpatient clinic, operating room, kidney centre, and medical examination unit. 

Singer, S., Meterko, M., Baker, L., Gaba, D., Falwell, A. and Rosen, A. 2007. Workforce perceptions of hospital safety culture Development and vahdation of the patient safety climate in healthcare organizations survey. Health Services Research, 42(5), 1999-2021. 

In order to identify areas of organisational culture that could be targeted to improve patient safety in Scottish hospitals, a safety culture survey was conducted. The aims of the study were first, to obtain a measure of safety culture from a sample of NHS acute hospitals in Scotland and then to test whether these culture scores were associated with clinical workers safety behaviours and patient and worker injuries. This would also provide a measure of safety culture within the Scottish acute hospital sector and contribute an organisational cultural perspective to the... 

Despite the great data and information that are now available as a result of the Hospital SOPS database, one big deficit has been in our understanding of what hospitals are doing between their patient safety culture survey assessments. What initiatives are hospitals implementing How successful are those initiatives in improving patient safety culture and, ultimately, patient safety ... 

An early criticism of patient safety culture survey data was that there was not sufficient evidence that culture was related to medical error, patient safety or quality or patient outcomes. There are still very few empirical studies linking the Hospital SOPS to these important outcomes and many more studies are needed. However, there have been a few key studies showing positive relationships between Hospital SOPS scores and outcomes. 

Etchegaray, J.M. and Thomas, E.J. 2012. Comparing two safety culture surveys Safety Attitudes Questionnaire and Hospital Survey on Patient Safety. BMJ... 

The Hospital Survey on Patient Safety Culture examines patient safety culture from a hospital staff perspective and allows hospitals to assess their safety culture and track changes over time. Hospitals that administer the patient safety culture survey can voluntarily submit their data to the Comparative Database, a resource for hospitals wishing to compare their survey results to similar types of hospitals (AHRQ Publication No. 04-0041). 

Around 2004 the first safety culture tools designed for healthcare began to appear. Maity of these tools are in the form of survey instruments or questioimaires, the two most well-known being the Hospital Survey on Patient Safety Culture (HSPSC) developed by the US Agency for Healthcare Research and Quality (AHRQ) and the Safety Attitudes Questionnaire (SAQ - Sexton et al. 2006). Both instruments are described in detail within the book and illustrated with... 

In addition to Hospital M, we obtained incident reporting statistics submitted by nurses from 10 hospitals that were also surveyed for safety culture (Itoh 2011). 

Itoh, K., Abe, T. and Andersen, H.B. 2005. A questionnaire-based survey on healthcare safety culture from six thousand Japanese hospital staff Organisational, professional and department/ward differences. InR. Tartagha,... 

Itoh, K. and Andersen, H.B. 2008. A national survey on healthcare safety culture in Japan Analysis of 20,000 staff responses from 84 hospitals. Proceedings of the International Conference on Healthcare Systems Ergonomics and Patient Safety, HEPS 2008. Strasbourg, France, June 2008 (CD-ROM). 

Sorra, J., Famolaro, T., Dyer, N., Nelson, D. andKhanna, K. 2009. Hospital Survey on Patient Safety Culture 2009 Comparative Database Report. Agency for Healthcare Research and CJrrality, AHRQ Ptrblication No. 09-0030, Rockville, MD. 

Smits, M., Christiaans-Dingelhoff, 1., Wagner, C., van der Wal, G. and Groenewegen, P.P. 2008. The psychometric properties of the Hospital Survey on Patient Safety Culture in Dutch hospitals. Biomed Central Health Services... 

Sorra, J.S. and Nieva, YE 2004. Hospital Survey on Patient Safety Culture. Rockville, MD Agency for healthcare research and quality. Available at www.ahrq.gov/qual/hospculture/hospcult.pdf (last accessed on 16 April 2014). 

Agency for Healthcare Research and Quality (AHRQ 2012). 2012 User Comparative Database Report Hospital Survey on Patient Safety Culture. AHRQ, Rockville, MD. Available at http //www.ahrq.gov/qual/hospsurveyl2/ (last accessed on 14 June 2013). 

Bodur, S. andFiliz, E. 2010. Validity and reliabihty of Turkish version of Hospital Survey on Patient Safety Culture and perception of patient safety in pubhc hospitals in Turkey. BMC Health Service Research, 10,28. 

Chen, I.-C. and Li, H.-H. 2010. Measuring patient safely culture in Taiwan using the Hospital Survey on Patient Safety Culture (HSOPSC). BMC Health Service Research, 10, 152. 

Pfeiffer, Y. and Manser, T. 2010. Development of the German version of the Hospital Survey on Patient Safety Culture Dimensionality and psychometric properties. Safety Science, 48(10), 1452-62. 

Sarac, C., Flin, R., Meams, K. and Jackson, J. 2011. Hospital Survey on Patient Safety Culture Psychometric analysis on a Scottish sample. BMJ Quality Safety, 20, 842-8. 

Waterson, RE. and Hutchinson, A. 2011. Use of the Hospital Survey of Patient Safety Culture - A review of the current evidence base, in S. Albolino, S. Bagnara, T. Bellandi, J. Llaneza, G. Rosal-Lopez and R. TartagUa (eds). Healthcare Economics and Patient Safety (HEPS 2011), 22-4 June 2011, Oviedo, Spain. Taylor Francis CRC Press, 473-4. 

Scottish Hospital Survey on Patient Safety Culture (SHSPSC)... 

Paper based surveys are more useful than web based surveys for hospital staff. Significant local support is required to increase participation in the survey. Safety culture factors explained more variance in safety behaviour measures than they did variance of worker and patient injury rates. 

Blegen, M.A., Gearhart, S., O Brien, R., Sehgal, N.L. and Alldredge, B.K. 2009. AHRQ s hospital survey on patient safety culture Psychometric analyses. Journal of Patient Safety, 5,139-44. 

Olsen, E. 2008. Reliability and validity of the Hospital Survey on Ratient Safety Culture at a Norwegian hospital. In J. Ovretveit and R. Sousa (eds). Quality... 

---