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Legislation/Regulation > Congressional Testimony
Patient Safety: Supporting a Culture of Continuous Quality Improvement in Hospitals and Other Health Care Organizations.
Testimony before the Permanent Subcommittee on Investigations of the Senate Committee of Governmental Affairs, 108th Cong, 1st Sess (June 11, 2003) (statement of Carolyn M. Clancy, MD).
In this statement, AHRQ Director Carolyn Clancy reviews the work of the Agency for Healthcare Research and Quality and other health care entities to build support for research and improvements in patient safety.
Committee on the Work Environment for Nurses and Patient Safety, Board on Health Care Services, Page A, ed. Washington, DC: National Academies Press; 2004.
This AHRQ-funded Institute of Medicine study identifies solutions to problems in hospital, nursing home, and other health care organization work environments that threaten patient safety in nursing care. The report provides a blueprint of actions for all health care organizations that rely on nurses. The report's findings and recommendations address the related issues of management practices, workforce capability, work design, and organizational safety culture.
Journal Article > Study
Measuring administrators' and direct care workers' perceptions of the safety culture in assisted living facilities.
Castle NG, Wagner LM, Sonon K, Ferguson-Rome JC. Jt Comm J Qual Patient Saf. 2012;38:375-385.
More than 1.5 million Americans reside in nursing homes, and prior research has shown that safety culture is relatively poor among frontline workers in this setting. This study used a modified version of the Nursing Home Survey on Patient Safety Culture to assess safety culture in assisted living facilities, another type of long-term care intended for less complex patients. The findings mirrored the results of safety culture assessments in nursing homes and hospitals in that frontline workers—nurses and nursing assistants—generally viewed safety culture more negatively than did administrators and managers. The issues surrounding patient safety in long-term care are discussed in an AHRQ WebM&M commentary.
Journal Article > Study
Halligan MH, Zecevic A, Kothari AR, Salmoni AW, Orchard T. J Patient Saf. 2014;10:192-201.
Sorra J, Famolaro T, Yount N, Burns W, Liu H, Shyy M. Rockville, MD: Agency for Healthcare Research and Quality; November 2014. AHRQ Publication No. 15-0004-EF.
The AHRQ Nursing Home Survey on Patient Safety Culture, a validated tool for measuring safety culture, was initially released in 2008. This comprehensive national survey of registered nurses, nursing aides, and support staff garnered a high response rate. While respondents rated overall safety perceptions highly, similar to outpatient and hospital safety culture surveys, they expressed concerns about adequacy of staffing, as prior reports of adverse events in nursing homes would suggest. Even though most respondents believed that feedback and communication about safety problems was positive, many did not endorse a nonpunitive response to error. Instead, there was concern about individual blame. As with multiple studies, managers reported a more positive safety climate than frontline staff, suggesting that leadership on safety climate has not changed on-the-ground staff perceptions despite increasing awareness of safety culture. Given that prior work has demonstrated a link between positive safety climate and patient outcomes in nursing homes, it will be critical to address the problems raised in this analysis. A past AHRQ WebM&M commentary discussed the safety and quality of long-term care, and a previous AHRQ WebM&M interview with Nicholas Castle explored unique issues surrounding patient safety in the nursing home population.