AHRQ’s Hospital Survey on Patient Safety (SOPS) is used by hundreds of hospitals in the US to assess hospital patient safety culture. This study describes the development and testing of a “workplace safety supplement,” intended to be used in conjunction with the SOPS to assess how organizational culture supports workplace safety. Included survey items measured perceptions around protection from workplace hazards; moving, transferring, or lifting patients; workplace aggression; management and leadership support for workplace safety; and workplace safety reporting.

… which is consistent with other earlier findings. … Yount N, Zebrak KA, Famolaro T, et al. Linking patient safety culture to quality …

The health care environment is known to struggle with spreading innovations. This commentary discusses a 2-year Agency for Healthcare Research and Quality learning community initiative. The learning communities focused on patient-centered care, improving medication therapy for distinct populations, and reducing inappropriate use of emergency services. The authors reveal the strategies the program used to disseminate the learnings and help organizations adapt them for local use.

Measuring hospital safety culture is considered a best practice supported by both the Agency for Healthcare Research and Quality (AHRQ) and the Leapfrog Group. Although the data linking positive safety culture to patient outcomes is inconclusive, establishing a strong culture of safety is considered essential to patient safety. Researchers analyzed AHRQ Survey on Patient Safety Culture data submitted by 536 hospitals from 2007 through 2014 and identified 6 large (> 400 beds) hospitals demonstrating significant improvement over time. They then conducted interviews with quality leaders from those institutions. Qualitative analysis of interview transcripts revealed common best practices across those hospitals, including systematic safety culture measurement, widespread communication of results, both leadership and frontline engagement in improvement efforts, and implementation of patient safety initiatives. A PSNet perspective discussed how to improve safety culture.

Safety culture surveys of health care workers are often used to determine whether programs or interventions improve patient safety. This cross-sectional study examined the relationship between the AHRQ Hospital Survey on Patient Safety Culture score, a widely used metric for safety culture, and the Consumer Reports Hospital Safety Score, calculated using a combination of patient experience and adverse event data by an independent nonprofit organization. Among 164 hospitals in the United States, higher staff perceptions of safety culture were associated with better overall safety, as measured by a composite of reported harms and patient satisfaction. These results lend support to continued measurement and reporting of safety culture. A recent PSNet perspective provided insights for organizations seeking to achieve culture change.

Studies of safety culture have consistently found that management has more positive perceptions of safety than frontline workers. This analysis of data from the AHRQ Medical Office Survey on Patient Safety Culture explored this finding in greater depth. The study examines the specific areas where perceptions of safety diverged between medical office management, physicians, and staff from more than 800 clinics. The investigators found that staff (including physicians and nurses) had markedly lower perceptions of the quality of staff training in patient safety and the openness of communication around safety issues compared with management. Consistent with other studies, management also had a much higher perception of overall safety than staff. As high reliability organizations rely on shared goals and open communication to ensure situational awareness, variations in perceptions of safety culture across professional roles will impair an organization's ability to address safety issues.

A growing body of evidence links the development of a culture of safety to a lower incidence of preventable errors in hospitalized patients. This AHRQ-funded study examined the relationship between safety culture (as measured by the AHRQ Hospital Survey on Patient Safety Culture) and patient satisfaction, and found evidence that a strong safety culture is associated with improved patient satisfaction scores. A prior study also found that family members of intensive care unit patients reported greater satisfaction with care at hospitals with higher safety culture measures, meaning that efforts to improve safety culture may also have positive effects on patient perceptions of the quality of care.

This study supports the notion that a positive safety culture, measured by the AHRQ Hospital Survey on Patient Safety Culture, is associated with fewer hospital-based adverse events. Adverse events were measured by the AHRQ Patient Safety Indicators. The authors highlight the need for further investigation to determine if improving safety culture actually leads to reduced adverse events.

This survey found an overall positive safety culture in hospital transfusion services, but respondents noted that workarounds were common.