Hospital SOPS

Since the first annual comparative database report, published in 2007, which included data voluntarily submitted from 382 US hospitals, the number of hospitals and staff respondents included in the database report has grown each year. The Hospital SOPS 2012 Comparative Database Report displays results from 1,128 hospitals and 567,703 hospital staff respondents (Sorra et al. 2012). This large number of hospitals provides for a much more reliable and comprehensive set of benchmarks. 

Hospital work areas and staff asked to complete the survey When the Hospital SOPS was developed, it was not specifically designed and tested for use with non-clinical staff like those in honsekeeping, facilities, or human resources. Yet once the snrvey was released, it became very clear that hospitals wanted to survey all staff from all units and departments, with the understanding that every staff member plays an important role in ensuring patient safety. By being attentive and aware of patient safety risks, in an environment that encourages open communication and learning, even non-clinical staff can help prevent medication errors, patient identification errors and many other types of errors. Since one of the uses of the survey is as an education and awareness tool, it makes sense for hospitals to conduct the survey in a broad way across units and staff positions. 

Findings fivm the Hospital SOPS 2012 Comparative Database Report... 

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 ... 

Once hospitals use the survey to identify areas for improvement, their next step is to work out what they can do, what actions they can take, to improve patient safety culture. A resource list describing dozens of patient safety initiatives is available to survey users on the AHRQ web site, but hospitals still have to identify what will be effective and which initiatives are likely to be successful in their facilities. For the Hospital SOPS 2011 Comparative Database (Sorra et al. 2008), we asked 456 trending hospitals what types of patient safety initiatives they had implemented between survey assessments. The top five initiatives are shown in Table 12.2. 

Table 12.2 Percentages of Hospital SOPS trending hospitals that...

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. 

In another study, Sorra et al. (2012) examined relationships between Hospital SOPS and patients assessments of hospital cate, as measured by the Consumer Assessment of Healthcare Providers and Systems (CAHPS) Hospital Survey. 

The need for a valid and reliable instrument to assess safety culture is not restricted to the United States. The AHRQ Hospital SOPS instrument has been widely adopted in over 45 countries around the world and the instmment has been translated into more than 20 languages. It has become the de-facto international survey for measuring safety culture in healthcare. While other industries such as aviation, nuclear power and petrochemicals have been interested in assessing safety culture there is neither a standard nor agreement as to what to measure. However, in healthcare, the AHRQ instmment is a standard and it has created a shared mental model of safety culture that has become almost universal in healthcare throughout the world. 

Other international efforts have included the EUNetPaS (European Union Network for Patient Safety) which was officially launched in 2008 in Utrecht, the Netherlands to establish an umbrella netwoik of all European Union (EU) Member States to encourage collaboration in patient safety. EUNetPaS sought to establish common principles at the EU level, integrating knowledge, experiences and expertise from member states and offering support to countries that were less advanced in patient safety. EUNetPaS published a two-volume report in 2010 reviewing patient safety culture instraments (Kristensen and Bartels 2010). The AHRQ Hospital SOPS was one of only three patient safety culture instruments that was officially recommended after an extensive review of available tools. 

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