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PSNet: Patient Safety Network
Journal Article

Perceptions of hospital safety climate and incidence of readmission.

Hansen LO, Williams M, Singer SJ. Health services research. 2011;46:596-616.

Fostering a positive safety culture is a growing strategy in health care organizations to reduce errors, yet interventions to sustain such efforts are challenging. While the relationship between safety culture and adverse events is emerging, causality is often difficult to demonstrate. This study examined the relationship between safety culture and hospital readmissions, events increasingly viewed as preventable and as opportunities for organizational learning. Investigators conducted a cross-sectional analysis of nearly 70 hospitals and found a significant association between lower safety culture and higher 30-day readmission rates for acute myocardial infarction and heart failure. Interestingly, frontline provider perceptions of safety culture were associated with readmission rates, but those of senior management were not. Two cases of preventable readmissions are discussed in an AHRQ WebM&M commentary.