Impact of the Comprehensive Unit-Based Safety Program (CUSP) on safety culture in a surgical inpatient unit.

Efforts to improve safety culture within an institution may be limited by the fact that hospital units may vary widely in their perception of safety. The comprehensive unit-based safety program (CUSP) focuses on improving important determinants of safety culture—teamwork, management involvement, and reporting and learning from errors—by engaging staff at all levels in a continuous quality improvement process. The specific CUSP interventions in this study, conducted in a surgical inpatient unit at an academic hospital, included implementation of a daily goals sheet, geographic localization of patients, and integration of nurses into physicians' daily rounds. The CUSP resulted in a significant and sustained improvement in 6 of 7 safety culture domains. The study's senior author, Dr. Pronovost, recently published a book on his trailblazing patient safety career.