Hospital Survey on Patient Safety Culture: 2008 Comparative Database Report

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Table C-2. Trending: Item-level Percent Positive Response by Respondent Work Area/Unit

Survey Items by Composite			Work Area/Unit
			Anes- thesio- logy	Emer- gency	ICU (any type)	Lab	Medi- cine	Obstet- rics	Pediatr.	Pharm.	Psych/ Mental Health	Radi- ology	Rehabil- itation	Surgery
			10 Hospi- tals both yrs	68 Hospi- tals both yrs	39 Hospi- tals both yrs	83 Hospi- tals both yrs	84 Hospi- tals both yrs	37 Hospi- tals both yrs	21 Hospi- tals both yrs	61 Hospi- tals both yrs	20 Hospi- tals both yrs	80 Hospi- tals both yrs	66 Hospi- tals both yrs	72 Hospi- tals both yrs
			170 Most Recent Respon- dents	1,035 Most Recent Respon- dents	1,315 Most Recent Respon- dents	1,102 Most Recent Respon- dents	2,702 Most Recent Respon- dents	586 Most Recent Respon- dents	497 Most Recent Respon- dents	617 Most Recent Respon- dents	504 Most Recent Respon- dents	1,066 Most Recent Respon- dents	546 Most Recent Respon- dents	1,984 Most Recent Respon- dents
			85 Previous Respon- dents	903 Previous Respon- dents	988 Previous Respon- dents	890 Previous Respon- dents	2,048 Previous Respon- dents	551 Previous Respon- dents	456 Previous Respon- dents	487 Previous Respon- dents	467 Previous Respon- dents	810 Previous Respon- dents	650 Previous Respon- dents	1,635 Previous Respon- dents
1. Team- work Within Units	A1—People support one another in this unit.	Most Recent	88%	89%	83%	85%	84%	86%	87%	87%	84%	85%	91%	86%
		Previous	96%	84%	88%	81%	81%	81%	79%	92%	83%	83%	93%	84%
		Change	-8%	5%	-5%	4%	3%	5%	8%	-5%	1%	2%	-2%	2%
	A3—When a lot of work needs to be done quickly, we work together as a team to get the work done.	Most Recent	99%	91%	92%	87%	84%	90%	92%	89%	85%	89%	94%	89%
		Previous	90%	89%	94%	87%	84%	87%	79%	90%	80%	91%	89%	89%
		Change	9%	2%	-2%	0%	0%	3%	13%	-1%	5%	-2%	5%	0%
	A4—In this unit, people treat each other with respect.	Most Recent	98%	80%	73%	80%	76%	80%	82%	85%	80%	75%	90%	81%
		Previous	94%	77%	84%	77%	71%	75%	74%	86%	77%	78%	87%	79%
		Change	4%	3%	-11%	3%	5%	5%	8%	-1%	3%	-3%	3%	2%
	A11—When one area in this unit gets really busy, others help out.	Most Recent	54%	74%	66%	74%	59%	68%	73%	70%	65%	71%	82%	68%
		Previous	81%	73%	67%	73%	61%	63%	69%	72%	68%	73%	75%	69%
		Change	-27%	1%	-1%	1%	-2%	5%	4%	-2%	-3%	-2%	7%	-1%
2. Supv/ Mgr Ex- pecta- tions & Actions Promot- ing Patient Safety	B1—My supv/mgr says a good word when he/she sees a job done according to established patient safety procedures.	Most Recent	60%	68%	59%	67%	68%	76%	67%	73%	75%	69%	80%	78%
		Previous	81%	69%	72%	64%	63%	74%	60%	75%	70%	69%	75%	70%
		Change	-21%	-1%	-13%	3%	5%	2%	7%	-2%	5%	0%	5%	8%
	B2—My supv/mgr seriously considers staff suggestions for improving patient safety.	Most Recent	71%	75%	65%	73%	73%	75%	80%	82%	75%	78%	87%	80%
		Previous	88%	72%	77%	79%	69%	79%	72%	80%	81%	73%	87%	78%
		Change	-17%	3%	-12%	-6%	4%	-4%	8%	2%	-6%	5%	0%	2%
	B3—Whenever pressure builds up, my supv/mgr wants us to work faster, even if it means taking shortcuts.	Most Recent	67%	77%	72%	80%	77%	77%	80%	83%	78%	81%	85%	76%
		Previous	89%	76%	71%	81%	72%	78%	69%	84%	79%	76%	79%	77%
		Change	-22%	1%	1%	-1%	5%	-1%	11%	-1%	-1%	5%	6%	-1%
	B4—My supv/mgr overlooks patient safety problems that happen over and over.	Most Recent	79%	79%	70%	77%	77%	79%	81%	87%	78%	84%	87%	83%
		Previous	90%	75%	76%	75%	75%	81%	72%	83%	79%	76%	86%	79%
		Change	-11%	4%	-6%	2%	2%	-2%	9%	4%	-1%	8%	1%	4%
3. Mgmt Support for Patient Safety	F1—Hospital mgmt provides a work climate that promotes patient safety.	Most Recent	67%	76%	64%	84%	78%	81%	86%	81%	68%	87%	82%	84%
		Previous	89%	75%	68%	83%	75%	81%	74%	80%	77%	86%	88%	81%
		Change	-22%	1%	-4%	1%	3%	0%	12%	1%	-9%	1%	-6%	3%
	F8—The actions of hospital mgmt show that patient safety is a top priority.	Most Recent	71%	70%	57%	74%	71%	72%	68%	74%	67%	76%	75%	75%
		Previous	83%	63%	58%	74%	65%	71%	62%	76%	71%	73%	78%	74%
		Change	-12%	7%	-1%	0%	6%	1%	6%	-2%	-4%	3%	-3%	1%
	F9—Hospital mgmt seems interested in patient safety only after an adverse event happens.	Most Recent	54%	58%	49%	60%	58%	60%	59%	67%	52%	67%	64%	64%
		Previous	75%	53%	48%	61%	52%	59%	53%	66%	55%	61%	67%	60%
		Change	-21%	5%	1%	-1%	6%	1%	6%	1%	-3%	6%	-3%	4%
4. Organ- izational Learn- ing— Contin- uous Improve- ment	A6—We are actively doing things to improve patient safety.	Most Recent	84%	79%	85%	79%	83%	83%	91%	91%	81%	84%	90%	92%
		Previous	89%	76%	86%	77%	78%	81%	82%	93%	85%	81%	88%	88%
		Change	-5%	3%	-1%	2%	5%	2%	9%	-2%	-4%	3%	2%	4%
	A9—Mistakes have led to positive changes here.	Most Recent	60%	60%	55%	70%	64%	64%	74%	79%	60%	68%	63%	69%
		Previous	78%	57%	60%	64%	57%	70%	58%	79%	65%	61%	66%	68%
		Change	-18%	3%	-5%	6%	7%	-6%	16%	0%	-5%	7%	-3%	1%
	A13—After we make changes to improve patient safety, we evaluate their effectiveness.	Most Recent	75%	66%	66%	69%	69%	68%	75%	80%	72%	70%	76%	83%
		Previous	87%	63%	73%	61%	63%	72%	61%	78%	71%	68%	77%	72%
		Change	-12%	3%	-7%	8%	6%	-4%	14%	2%	1%	2%	-1%	11%
5. Over- all Per- ceptions of Patient Safety	A10 R—It is just by chance that more serious mistakes don’t happen around here.	Most Recent	66%	56%	57%	70%	56%	67%	73%	68%	61%	74%	78%	72%
		Previous	77%	56%	61%	68%	56%	57%	66%	70%	60%	66%	75%	67%
		Change	-11%	0%	-4%	2%	0%	10%	7%	-2%	1%	8%	3%	5%
	A15—Patient safety is never sacrificed to get more work done.	Most Recent	46%	63%	50%	75%	58%	63%	67%	72%	71%	78%	78%	75%
		Previous	65%	58%	50%	74%	55%	57%	56%	71%	69%	81%	79%	71%
		Change	-19%	5%	0%	1%	3%	6%	11%	1%	2%	-3%	-1%	4%
	A17 R—We have patient safety problems in this unit.	Most Recent	70%	57%	60%	75%	58%	63%	67%	72%	71%	78%	78%	75%
		Previous	65%	57%	55%	74%	55%	57%	56%	71%	69%	81%	79%	71%
		Change	5%	0%	5%	1%	3%	6%	11%	1%	2%	-3%	-1%	4%
	A18—Our procedures and systems are good at preventing errors from happening.	Most Recent	69%	64%	65%	78%	65%	74%	82%	83%	63%	79%	82%	83%
		Previous	83%	62%	68%	81%	57%	70%	62%	82%	71%	75%	85%	80%
		Change	-14%	2%	-3%	-3%	8%	4%	20%	1%	-8%	4%	-3%	3%
6. Feed- back and Com- munica- tion About Error	C1—We are given feedback about changes put into place based on event reports.	Most Recent	49%	47%	40%	47%	44%	60%	64%	52%	54%	53%	62%	60%
		Previous	29%	47%	46%	51%	47%	58%	48%	55%	55%	53%	58%	48%
		Change	20%	0%	-6%	-4%	-3%	2%	16%	-3%	-1%	0%	4%	12%
	C3—We are informed about errors that happen in this unit.	Most Recent	63%	56%	60%	75%	57%	68%	67%	77%	66%	75%	78%	74%
		Previous	51%	57%	54%	70%	59%	67%	61%	78%	53%	72%	76%	72%
		Change	12%	-1%	6%	5%	-2%	1%	6%	-1%	13%	3%	2%	2%
	C5—In this unit, we discuss ways to prevent errors from happening again.	Most Recent	71%	65%	60%	72%	67%	73%	76%	80%	75%	72%	81%	81%
		Previous	87%	61%	62%	73%	59%	69%	69%	82%	69%	71%	81%	76%
		Change	-16%	4%	-2%	-1%	8%	4%	7%	-2%	6%	1%	-10%	5%
7. Com- munica- tion Open- ness	C2—Staff will freely speak up if they see something that may negatively affect patient care.	Most Recent	64%	74%	72%	79%	73%	83%	87%	82%	79%	80%	88%	84%
		Previous	85%	70%	70%	73%	66%	81%	71%	86%	76%	76%	86%	83%
		Change	-21%	4%	2%	6%	7%	2%	16%	-4%	3%	4%	2%	1%
	C4—Staff feel free to question the decisions or actions of those with more authority.	Most Recent	47%	47%	41%	47%	42%	56%	60%	64%	54%	48%	60%	57%
		Previous	58%	45%	46%	44%	35%	56%	48%	53%	42%	45%	56%	54%
		Change	-11%	2%	-5%	3%	7%	0%	12%	11%	12%	3%	4%	3%
	C6 R—Staff are afraid to ask questions when something does not seem right.	Most Recent	53%	62%	58%	69%	56%	65%	76%	76%	71%	69%	72%	70%
		Previous	78%	58%	65%	71%	55%	68%	64%	77%	59%	62%	74%	69%
		Change	-25%	4%	-7%	-2%	1%	-3%	12%	-1%	12%	7%	-2%	1%
8. Freq- uency of Events Report- ed	D1—When a mistake is made, but is caught and corrected before affecting the patient, how often is this reported?	Most Recent	45%	50%	44%	48%	56%	60%	50%	55%	58%	47%	54%	58%
		Previous	48%	47%	50%	47%	49%	50%	53%	54%	61%	44%	57%	52%
		Change	-3%	3%	-6%	1%	7%	10%	-3%	1%	-3%	3%	-3%	6%
	D2—When a mistake is made, but has no potential to harm the patient, how often is this reported?	Most Recent	56%	58%	57%	54%	66%	57%	56%	68%	56%	51%	57%	66%
		Previous	42%	62%	64%	50%	60%	63%	60%	63%	56%	43%	58%	59%
		Change	11%	-4%	-7%	4%	6%	-6%	-4%	5%	0%	8%	-1%	7%
	D3—When a mistake is made that could harm the patient, but does not, how often is this reported?	Most Recent	61%	75%	71%	78%	80%	78%	69%	85%	74%	73%	71%	82%
		Previous	52%	74%	75%	77%	74%	81%	80%	80%	73%	67%	76%	80%
		Change	9%	1%	-4%	1%	6%	-3%	-11%	5%	1%	6%	-5%	2%
9. Team- work Across Units	F2 R—Hospital units do not coordinate well with each other.	Most Recent	30%	43%	34%	48%	47%	41%	41%	47%	34%	51%	48%	47%
		Previous	34%	47%	36%	44%	45%	45%	36%	48%	33%	48%	50%	41%
		Change	-4%	-4%	-2%	4%	2%	-4%	5%	-1%	1%	3%	-2%	6%
	F4—There is good cooperation among hospital units that need to work together.	Most Recent	69%	59%	50%	65%	62%	57%	64%	58%	54%	65%	66%	59%
		Previous	52%	57%	52%	59%	58%	58%	49%	61%	47%	63%	65%	59%
		Change	17%	2%	-2%	6%	4%	-1%	15%	-3%	7%	2%	1%	0%
	F6 R—It is often unpleasant to work with staff from other hospital units.	Most Recent	55%	54%	56%	61%	65%	59%	60%	60%	61%	62%	61%	67%
		Previous	80%	55%	47%	60%	61%	62%	51%	57%	57%	62%	62%	61%
		Change	-25%	-1%	9%	1%	4%	-3%	9%	3%	4%	0%	-1%	-4%
	F10—Hospital units work well together to provide the best care for patients.	Most Recent	71%	67%	61%	72%	70%	64%	74%	69%	68%	74%	69%	69%
		Previous	61%	69%	58%	69%	68%	65%	57%	70%	54%	71%	71%	70%
		Change	10%	-2%	3%	3%	2%	-1%	17%	-1%	14%	3%	-2%	-1%
10. Staff- ing	A2—We have enough staff to handle the workload.	Most Recent	69%	45%	52%	55%	48%	54%	69%	58%	41%	66%	57%	59%
		Previous	58%	46%	50%	61%	47%	50%	49%	58%	54%	66%	58%	61%
		Change	11%	-1%	2%	-6%	1%	4%	20%	0%	-13%	0%	-1%	-2%
	A5 R—Staff in this unit work longer hours than is best for patient care.	Most Recent	33%	54%	54%	52%	47%	54%	57%	58%	43%	67%	60%	56%
		Previous	45%	53%	57%	57%	52%	49%	52%	58%	53%	64%	63%	56%
		Change	-12%	1%	-3%	-5%	-5%	5%	5%	0%	-10%	3%	-3%	0%
	A7 R—We use more agency/temporary staff than is best for patient care.	Most Recent	80%	65%	62%	72%	61%	81%	81%	68%	61%	72%	73%	71%
		Previous	75%	65%	63%	69%	69%	75%	72%	68%	66%	74%	73%	72%
		Change	5%	0%	-1%	3%	-8%	6%	9%	0%	-5%	-2%	0%	-1%
	A14 R—We work in "crisis mode" trying to do too much, too quickly.	Most Recent	38%	48%	47%	53%	51%	50%	57%	57%	48%	66%	65%	62%
		Previous	56%	46%	48%	51%	48%	52%	51%	55%	53%	63%	68%	54%
		Change	-18%	2%	-1%	2%	3%	-2%	6%	2%	-5%	3%	-3%	8%
11. Hand- offs & Transiti- ons	F3 R—Things "fall between the cracks" when transferring patients from one unit to another.	Most Recent	18%	52%	39%	36%	54%	47%	38%	29%	28%	48%	43%	49%
		Previous	28%	57%	36%	36%	51%	43%	35%	33%	23%	47%	41%	46%
		Change	-10%	-5%	3%	0%	3%	4%	3%	-4%	5%	1%	2%	3%
	F5 R—Important patient care information is often lost during shift changes.	Most Recent	29%	60%	54%	40%	53%	65%	60%	32%	42%	54%	48%	47%
		Previous	32%	59%	63%	47%	53%	64%	51%	37%	42%	52%	47%	48%
		Change	-3%	1%	-9%	-7%	0%	1%	9%	-5%	0%	2%	1%	-1%
	F7 R—Problems often occur in the exchange of information across hospital units.	Most Recent	18%	54%	40%	40%	50%	50%	39%	33%	33%	48%	44%	46%
		Previous	45%	53%	36%	38%	44%	43%	40%	38%	28%	43%	48%	45%
		Change	-27%	1%	4%	2%	6%	7%	-1%	-5%	5%	5%	-4%	1%
	F11 R—Shift changes are problematic for patients in this hospital.	Most Recent	30%	51%	50%	45%	58%	64%	40%	35%	31%	50%	40%	42%
		Previous	23%	50%	50%	47%	56%	63%	46%	41%	33%	50%	42%	40%
		Change	7%	1%	0%	-2%	2%	1%	-6%	-6%	-2%	0%	-2%	2%
12. Nonpuni- tive Response to Error	A8 R—Staff feel like their mistakes are held against them.	Most Recent	55%	48%	49%	57%	48%	51%	51%	68%	48%	53%	63%	63%
		Previous	58%	41%	47%	53%	45%	46%	50%	70%	50%	54%	69%	56%
		Change	-3%	7%	2%	4%	3%	5%	1%	-2%	-2%	-1%	-6%	7%
	A12 R—When an event is reported, it feels like the person is being written up, not the problem.	Most Recent	36%	43%	37%	44%	43%	44%	38%	59%	53%	47%	55%	55%
		Previous	42%	36%	45%	43%	38%	38%	42%	61%	42%	47%	58%	50%
		Change	-6%	7%	-8%	1%	5%	6%	-4%	-2%	11%	0%	-3%	5%
	A16 R—Staff worry that mistakes they make are kept in their personnel file.	Most Recent	29%	29%	33%	40%	36%	38%	24%	54%	42%	44%	55%	43%
		Previous	14%	28%	37%	40%	26%	33%	30%	51%	37%	38%	58%	43%
		Change	15%	1%	-4%	0%	10%	5%	-6%	3%	5%	6%	-3%	0%

Note: ICU = Intensive Care Unit; Pediatr. = Pediatrics; Pharm. = Pharmacy.

Note: 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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