Patient Safety/Quality

Hospital workers worry about patient safety at their hospitals and look to hospital leaders for a commitment to safety

Hospital workers embrace patient safety as an essential part of their job, according to a study led by Saul N. Weingart, M.D., Ph.D., of Beth Israel Deaconess Medical Center, and supported by the Agency for Healthcare Research and Quality (HS11644).

Two-thirds of workers surveyed at four hospitals worried at least once a day about making a mistake that could injure a patient. This worry was likely driven, in part, by their heavy work load. About 43 percent said that their work load hindered their ability to keep patients safe. Overall, workers who considered their hospital leaders committed to patient safety were three times more likely to view their hospital as safer than other local hospitals.

Nearly one-third (32 percent) of the 455 hospital workers surveyed expressed concern about their ability to provide safe care, 11 percent were concerned about the commitment of senior leaders to patient safety goals, and 33 percent were concerned about the likelihood of being disciplined for making mistakes. A majority (64 percent) agreed that senior managers regarded patient safety as a high priority. Nevertheless, leaders did not meet workers' expectations for sharing information about adverse events. Nearly half (48 percent) disagreed that the hospital regularly provided staff with information about errors and injuries.

Ninety-six percent of workers agreed that ensuring patient safety was an essential part of their job. Forty-six percent rated the quality of care at their hospital better than at other local hospitals, 33 percent rated patient safety better, and 81 percent agreed that reasonable precautions were in place to create a safe workplace. The findings were based on a written survey of front-line hospital workers in 1998 at three community hospitals and an academic medical center that were members of a Massachusetts health care delivery system.

See "Using a multihospital survey to examine the safety culture," by Dr. Weingart, Ken Farbstein, M.P.P., Roger B. Davis, Sc.D., and Russell S. Phillips, M.D., in the March 2004 Joint Commission Journal on Quality and Safety 30(3), pp. 125-132.

Editor's Note: Another AHRQ-supported study on a related topic examined the benefits of appointing a hospital medication safety manager. For more details, see Kowiatek, J.G., Weber, R.J., Skledar, S.J., and Sirio, C.A. (2004, January). "Medication safety manager in an academic medical center." (AHRQ grant HS11926). American Journal of Health-System Pharmacies 61, pp. 58-64.

In addition, an AHRQ-supported study on hospital quality of care found that well-publicized report cards have a modest, transient impact on consumer use of individual hospitals for the procedures for which outcomes are publicized. For more details, see Romano, P.S., and Zhou, H. (2004, April). "Do well-publicized risk-adjusted outcomes reports affect hospital volume?" (AHRQ grant HS08574) Medical Care 42(44), pp. 367-377.

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