Table 1-1. Patient Safety Culture Composites and Definitions

Patient Safety Culture Composite Definition: The extent to which...
1. Communication openness Staff freely speak up if they see something that may negatively affect a patient, and feel free to question those with more authority
2. Feedback & communication about error Staff are informed about errors that happen, given feedback about changes implemented, and discuss ways to prevent errors
3. Frequency of events reported Mistakes of the following types are reported:
  • mistakes caught and corrected before affecting the patient
  • mistakes with no potential to harm the patient
  • mistakes that could harm the patient, but do not
4. Handoffs & transitions Important patient care information is transferred across hospital units and during shift changes
5. Management support for patient safety Hospital management provides a work climate that promotes patient safety and shows that patient safety is a top priority
6. Nonpunitive response to error Staff feel that their mistakes and event reports are not held against them, and that mistakes are not kept in their personnel file
7. Organizational learning–Continuous improvement There is a learning culture in which mistakes lead to positive changes and changes are evaluated for effectiveness
8. Overall perceptions of patient safety Procedures and systems are good at preventing errors and there is a lack of patient safety problems
9. Staffing There are enough staff to handle the workload and work hours are appropriate to provide the best care for patients
10. Supervisor/manager expectations & actions promoting safety Supervisors/managers consider staff suggestions for improving patient safety, praise staff for following patient safety procedures, and do not overlook patient safety problems
11. Teamwork across units Hospital units cooperate and coordinate with one another to provide the best care for patients
12. Teamwork within units Staff support one another, treat each other with respect, and work together as a team

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