Patient Safety Culture unit level

Smits, M., Wagner, C., Spreeuwenberg, R, van der Wal, G. and Groenewegen, P.P. 2009. Measuring patient safety culture An assessment of the clustering of responses at unit level and hospital level. Quality and Safety in Health Care, 18(4), 292-6. 

Based on the literature review, key dimensions of hospital patient safety culture were identified and items drafted to measure those dimensions. Items were written to obtain a staff-level perspeetive of the extent to which a hospital organisation s culture supports patient safety and event reporting. In addition, most of the items were foeused on the respondent s own work area or unit beeause unit-level eulture is more salient and relevant and has the most immediate influenee on staff attitudes and behaviors. Sinee eulture varies aeross units, it was important to foeus respondents on their own unit s eulture by asking them to identify and seleet their unit first and then answer the questions in the survey about that unit. However, some patient safety eulture issues cut across units, so the last part of the survey foeused specifically on hospital-wide patient safety eulture, ineluding handoffs and transitions, pereeptions of management support and teamwork aeross units. 

Clearly more empirical studies are needed linking patient safety culture scores to patient safety and quality outcome data Such studies should examine linkages at the hospital level and at the unit level where relationships may be stronger. The difficulty of this research is that large numbers of hospitals with both safety culture and outcome data are needed to detect these relationships. 

Clearly, there is a need to measure sources of variation in safety culture perceptions relating to individual and hospital characteristics within hospitals, in order to implement targeted interventions (Jackson et al. 2010). For instance, it is hypothesised that members with the same educational background share a common set of cultural features. In addition, hospitals comprise many different types of wards and units, with a high diversity in offered services, patient populations, organisational stractures and protocols, which might explain variability inpatient safety culture perceptions. So it can be assumed that safety culture is associated with specific professions and with the levels of complexity and intrinsic hazards associated with healthcare delivered in different work areas (Singer et al. 2009). 

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