Hospital Survey on Patient Safety Culture: 2008 Comparative Database Report

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Table 7-7. Trending: Item-level Results

Item	Survey Items By Composite	Item Average Percent Positive Response
Item	Survey Items By Composite	Most Recent	Previous	Change	Maximum Increase	Maximum Decrease	Average Increase	Average Decrease
1.	Teamwork Within Units
A1	1. People support one another in this unit.	85%	83%	2%	19%	-18%	7%	-5%
A3	2. When a lot of work needs to be done quickly, we work together as a team to get the work done.	87%	87%	0%	15%	-24%	5%	-5%
A4	3. In this unit, people treat each other with respect.	78%	77%	1%	19%	-23%	6%	-5%
A11	4. When one area in this unit gets really busy, others help out.	69%	67%	2%	29%	-19%	7%	-6%
2.	Supervisor/Manager Expectations & Actions Promoting Patient Safety
B1	1. My supv/mgr says a good word when he/she sees a job done according to established patient safety procedures.	71%	69%	2%	30%	-19%	8%	-6%
B2	2. My supv/mgr seriously considers staff suggestions for improving patient safety.	76%	76%	0%	25%	-23%	7%	-7%
B3 R	3. Whenever pressure builds up, my supv/mgr wants us to work faster, even if it means taking shortcuts.	77%	75%	2%	23%	-18%	7%	-6%
B4 R	4. My supv/mgr overlooks patient safety problems that happen over and over.	78%	77%	1%	16%	-22%	5%	-7%
3.	Management Support for Patient Safety
F1	1. Hospital mgmt provides a work climate that promotes patient safety.	82%	82%	0%	27%	-32%	7%	-8%
F8	2. The actions of hospital mgmt show that patient safety is a top priority.	75%	72%	3%	31%	-18%	8%	-6%
F9 R	3. Hospital mgmt seems interested in patient safety only after an adverse event happens.	62%	60%	2%	36%	-27%	10%	-7%
4.	Organizational Learning—Continuous Improvement
A6	1. We are actively doing things to improve patient safety.	84%	81%	3%	31%	-15%	7%	-5%
A9	2. Mistakes have led to positive changes here.	66%	63%	3%	62%	-22%	10%	-5%
A13	3. After we make changes to improve patient safety, we evaluate their effectiveness.	71%	68%	3%	22%	-25%	9%	-6%
5.	Overall Perceptions of Patient Safety
A10 R	1. It is just by chance that more serious mistakes don't happen around here.	64%	61%	3%	29%	-18%	9%	-6%
A15	2. Patient safety is never sacrificed to get more work done.	69%	66%	3%	31%	-19%	9%	-6%
A17 R	3. We have patient safety problems in this unit.	67%	64%	3%	31%	-22%	8%	-7%
A18	4. Our procedures and systems are good at preventing errors from happening.	73%	70%	3%	23%	-21%	7%	-5%
6.	Feedback and Communication About Error
C1	1. We are given feedback about changes put into place based on event reports.	51%	50%	1%	32%	-27%	8%	-7%
C3	2. We are informed about errors that happen in this unit.	67%	66%	1%	23%	-23%	7%	-6%
C5	3. In this unit, we discuss ways to prevent errors from happening again.	72%	70%	2%	26%	-26%	8%	-6%
7.	Communication Openness
C2	1. Staff will freely speak up if they see something that may negatively affect patient care.	76%	75%	1%	28%	-23%	6%	-5%
C4	2. Staff feel free to question the decisions or actions of those with more authority.	48%	46%	2%	40%	-26%	9%	-7%
C6 R	3. Staff are afraid to ask questions when something does not seem right.	64%	62%	2%	36%	-28%	8%	-7%
8.	Frequency of Events Reported
D1	1. When a mistake is made, but is caught and corrected before affecting the patient, how often is this reported?	54%	52%	2%	21%	-34%	8%	-9%
D2	2. When a mistake is made, but has no potential to harm the patient, how often is this reported?	59%	57%	2%	25%	-21%	8%	-7%
D3	3. When a mistake is made that could harm the patient, but does not, how often is this reported?	75%	74%	1%	27%	-29%	7%	-6%
9.	Teamwork Across Units
F2 R	1. Hospital units do not coordinate well with each other.	49%	46%	3%	45%	-20%	11%	-6%
F4	2. There is good cooperation among hospital units that need to work together.	63%	61%	2%	34%	-25%	9%	-7%
F6 R	3. It is often unpleasant to work with staff from other hospital units.	61%	59%	2%	31%	-23%	9%	-6%
F10	4. Hospital units work well together to provide the best care for patients.	72%	70%	2%	22%	-22%	7%	-7%
10.	Staffing
A2	1. We have enough staff to handle the workload.	57%	57%	0%	33%	-23%	10%	-8%
A5 R	2. Staff in this unit work longer hours than is best for patient care.	54%	54%	0%	32%	-34%	8%	-9%
A7 R	3. We use more agency/temporary staff than is best for patient care.	64%	66%	-2%	50%	-37%	8%	-9%
A14 R	4. We work in "crisis mode" trying to do too much, too quickly.	54%	52%	2%	34%	-20%	9%	-6%
11.	Handoffs & Transitions
F3 R	1. Things "fall between the cracks" when transferring patients from one unit to another.	47%	46%	1%	45%	-20%	8%	-6%
F5 R	2. Important patient care information is often lost during shift changes.	52%	51%	1%	37%	-28%	7%	-7%
F7 R	3. Problems often occur in the exchange of information across hospital units.	47%	44%	3%	54%	-21%	9%	-7%
F11 R	4. Shift changes are problematic for patients in this hospital.	50%	49%	1%	29%	-26%	8%	-8%
12.	Nonpunitive Response to Error
A8 R	1. Staff feel like their mistakes are held against them.	54%	53%	1%	34%	-20%	7%	-6%
A12 R	2. When an event is reported, it feels like the person is being written up, not the problem.	47%	44%	3%	33%	-25%	9%	-6%
A16 R	3. Staff worry that mistakes they make are kept in their personnel file.	39%	37%	2%	28%	-18%	7%	-6%

Note: Based on data from 98 hospitals that repeated survey administration and data submission; the number of respondents was 20,902 in the most recent database and 17,868 in the previous database. The item’s survey location is shown to the left. An “R” indicates a negatively worded item, where the percent positive response is based on those who responded “Strongly disagree” or “Disagree,” or “Never” or “Rarely” (depending on the response category used for the item).

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