@article{7089, author = {Lori A. Paine and Beryl J. Rosenstein and Bryan Sexton and Paula Kent and Christine G. Holzmueller and Peter Pronovost}, title = {Assessing and improving safety culture throughout an academic medical centre: a prospective cohort study.}, abstract = {

OBJECTIVES: To describe the authors' hospital-wide efforts to improve safety climate at a large academic medical centre.

DESIGN AND SETTING: A prospective cohort study used multiple interventions to improve hospital-wide safety climate. 144 clinical units in an urban academic medical centre are included in this analysis.

INTERVENTIONS: The comprehensive unit-based safety programme included steps to identify hazards, partner units with a senior executive to fix hazards, learn from defects, and implement communication and teamwork tools. Hospital-level interventions were also implemented.

MAIN OUTCOME MEASURES: Safety climate was assessed annually using the safety attitudes questionnaire. The safety culture goal was to meet or exceed the 60% minimum positive score or improve the score by ≥10 points.

RESULTS: Response rates were 77% (2006) and 79% (2008). For safety climate, 55% of units in 2006 and 82% in 2008 achieved the culture goal. For teamwork climate, 61% of units in 2006 and 83% in 2008 achieved the culture goal. The mean safety climate improvement (difference score) for 79 units at or above 60% in 2006 was 0.201 in 2008; the mean improvement for the 65 units below the threshold was 18.278. The mean teamwork climate improvement (difference score) for the 89 units at or above 60% in 2006 was 0.452 in 2008; the mean improvement for the 55 units below the threshold was 16.176. Climate scores improved significantly from 2006 to 2008 in every domain except stress recognition.

CONCLUSIONS: Hospital-wide interventions were associated with improvements in safety climate at a large academic medical centre.

}, year = {2010}, journal = {Qual Saf Health Care}, volume = {19}, pages = {547-54}, month = {12/2010}, issn = {1475-3901}, doi = {10.1136/qshc.2009.039347}, language = {eng}, }