DOI QR코드

DOI QR Code

A Strategy for Administration and Application of a Patient Safety Culture Survey

환자안전문화 측정을 위한 설문조사 수행 및 결과 활용 기법

  • Received : 2015.04.29
  • Accepted : 2015.06.20
  • Published : 2015.06.30

Abstract

Objectives : A safety culture is the bedrock for all patient safety improvement initiatives; thus, many resources have been invested in measuring hospital culture. However, many of these endeavors have failed to yield meaningful results. This article proposes a practical checklist to ensure successful administration of a safety culture survey and describes current methodologies for analyzing survey results to develop safety improvement programs. Methods : We reviewed currently used safety culture surveys and summarized their strengths and weaknesses. We also reviewed studies using safety culture surveys and found several pitfalls leading to failure in survey administration. With this information, we developed a checklist that covers critical items in the survey process. We also reviewed newly developed methodologies for survey results analysis and application and described them using the Korean version of the Safety Attitudes Questionnaire as an example. Results : The checklist consists of three steps: survey preparation, administration, and analysis and application. Each step contains clear action items. The content even describes how to get buy-in from hospital executives and manage communication channels with them. Also, common misunderstandings regarding survey scores are described and possible solutions are suggested. In the analysis section, we demonstrate new methods for obtaining more accurate survey results and how to utilize these methods to develop and implement hospital-wide safety improvement programs. Conclusion : A successful safety culture survey is the foundation of all future safety improvement projects. This review is intended to guide hospitals in enhancing safety.

Keywords

Patient safety;Safety culture;Safety climate

References

  1. Jeong H-J, Pham JC, Kim M, Engineer C, Pronovost PJ. Major cultural-compatibility complex: considerations on cross-cultural dissemination of patient safety programmes. BMJ quality & safety, 2012;bmjqs-2011-000283.
  2. Jeong H-J, Jung SM, An EA, Kim SY, Yoon H, Kim M, et al. Development of the Safety Attitudes Questionnaire - Korean Version (SAQ-K) and Its Novel Analysis Methods for Safety Managers. Biometrics & Biostatistics International Journal 2015;2:00020.
  3. Morello RT, Lowthian JA, Barker AL, McGinnes R, Dunt D, Brand C. Strategies for improving patient safety culture in hospitals: a systematic review. BMJ quality & safety 2013;22:11-8. https://doi.org/10.1136/bmjqs-2011-000582
  4. Singer SJ, Falwell A, Gaba DM, Baker LC. Patient safety climate in US hospitals: variation by management level. Medical care 2008;46:1149-56. https://doi.org/10.1097/MLR.0b013e31817925c1
  5. Singer SJ, Lin S, Falwell A, Gaba DM, Baker LC. Relationship of safety climate and safety performance in hospitals. Health services research 2009;44:399-421. https://doi.org/10.1111/j.1475-6773.2008.00918.x
  6. Jeong H-J, Kim M, An EA, Kim SY, Song BJ. A Strategy to Develop Tailored Patient Safety Culture Improvement Programs with Latent Class Analysis Method. Biometics & Biostatistics International Journal 2015;2:00027.
  7. Timmel J, Kent PS, Holzmueller CG, Paine L, Schulick RD, Pronovost PJ. Impact of the Comprehensive Unit-based Safety Program (CUSP) on safety culture in a surgical inpatient unit. Joint Commission Journal on Quality and Patient Safety 2010;36:252-60. https://doi.org/10.1016/S1553-7250(10)36040-5
  8. http://www.ahrq.gov/professionals/quality-patient-safety/patientsafetyculture/hospital/userguide/hospdim.pdf.
  9. The Health Foundation, Report: Measuring safety culture. 2011; London.
  10. Blegen MA, Gearhart S, O'Brien R, Sehgal NL, Alldredge BK. AHRQ's hospital survey on patient safety culture: psychometric analyses. Journal of Patient Safety 2009;5:139-44. https://doi.org/10.1097/PTS.0b013e3181b53f6e
  11. Manchester Patient Safety Framework, Facilitator guidance. National Patient Safety Agency, The University of Manchester, 2006.
  12. http://www.nrls.npsa.nhs.uk/resources/entryid45=59796.
  13. Law M, Zimmerman R, Baker G, Smith T. Assessment of safety culture maturity in a hospital setting. Healthcare quarterly (Toronto, Ont.), 2010;13:110-5.
  14. http://www.primaris.org/sites/default/files/resources/Patient%20Safety/safety%20climate%20survey.pdf.
  15. Kho M, Carbone J, Lucas J, Cook D. Safety Climate Survey: reliability of results from a multicenter ICU survey. Quality and safety in health care 2005:14:273-8. https://doi.org/10.1136/qshc.2005.014316
  16. Sexton JB, Helmreich RL, Neilands TB, Rowan K, Vella K, Boyden J, et al. The Safety Attitudes Questionnaire: psychometric properties, benchmarking data, and emerging research. BMC Health Serv Res 2006;6:44. https://doi.org/10.1186/1472-6963-6-44
  17. Pronovost P, Sexton J. Assessing safety culture: guidelines and recommendations. Quality and safety in health care 2005;14:231-3. https://doi.org/10.1136/qshc.2005.015180
  18. Hoffmann B, Domanska O, Muller V, Gerlach F. Developing a questionnaire to assess the safety climate in general practices (FraSiK): transcultural adaptation: a method report. Zeitschrift fur Evidenz, Fortbildung und Qualitat im Gesundheitswesen, 2008;103:521-9.
  19. Lee W-C, Wung H-Y, Liao, H-H, Lo C-M, Chang F-L, Wang P-C, et al. Hospital safety culture in Taiwan: a nationwide survey using Chinese version safety attitude questionnaire. BMC Health Serv Res 2010;10:234. https://doi.org/10.1186/1472-6963-10-234
  20. Etchegaray JM, Thomas EJ. Comparing two safety culture surveys: safety attitudes questionnaire and hospital survey on patient safety. BMJ quality & safety 2012;21:490-8. https://doi.org/10.1136/bmjqs-2011-000449
  21. Sexton J, Helmreich R, Neilands T, Rowan K, Vella K, Boyden J, et al. The Safety Attitudes Questionnaire: psychometric properties, benchmarking data, and emerging research. BMC Health Serv Res, 2006;6:44. https://doi.org/10.1186/1472-6963-6-44
  22. Makary MA, Sexton JB, Freischlag JA, Holzmueller CG, Millman EA, Rowen L, et al. Operating room teamwork among physicians and nurses: teamwork in the eye of the beholder. Journal of the American College of Surgeons 2006;202:746-52. https://doi.org/10.1016/j.jamcollsurg.2006.01.017
  23. Huang DT, Clermont G, Kong L, Weissfeld LA, Sexton JB, Rowan KM, et al. Intensive care unit safety culture and outcomes: a US multicenter study. International Journal for Quality in Health Care 2010;22:151-61. https://doi.org/10.1093/intqhc/mzq017
  24. Pronovost PJ, Goeschel CA, Marsteller JA, Sexton JB, Pham JC. Berenholtz, SM. Framework for patient safety research and improvement. Circulation 2009;119:330-37. https://doi.org/10.1161/CIRCULATIONAHA.107.729848
  25. Jeong H-J, An EA, Kim SY, Song BJ. Combinational Effects of Clinical Area and Healthcare Workers' Job Type on the Safety Culture in Hospitals. Biometrics & Biostatistics International Journal 2015;2:00024.
  26. S RH, S A. Multilevel and Longitudinal Modeling Using Stata. 2008; Stata Press.
  27. Sinnema H, Franx G, Volker D, Majo C, Terluin B, Wensing M, et al. Randomised controlled trial of tailored interventions to improve the management of anxiety and depressive disorders in primary care. Implement Sci 2011;6:75. https://doi.org/10.1186/1748-5908-6-75
  28. Hawkins RP, Kreuter M, Resnicow K, Fishbein M, Dijkstra A. Understanding tailoring in communicating about health. Health education research 2008;23:454-66. https://doi.org/10.1093/her/cyn004
  29. Paik M, The generalized estimating equation approach when data are not missing completely at random. Journal of the American Statistical Association, 1997;92:1320-9. https://doi.org/10.1080/01621459.1997.10473653