Using Staff Perceptions on Patient Safety as a Tool for Improving Safety Culture in a Pediatric Hospital System

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Abstract

Objective:

This article presents a case study highlighting a pediatric health care system's use of the Agency for Healthcare Research and Quality staff patient safety survey as a tool to both identify areas in need of improvement and measure the impact of projects initiated to improve patient safety in particular areas.

Methods:

The Agency for Healthcare Research and Quality Hospital Survey on Patient Safety was used to measure safety culture at both the baseline (January 2005) and after implementation of safety culture improvement initiatives (April 2006). Initiatives undertaken to improve safety culture included conducting monthly and ad hoc safety rounds, enhancing the self-report system, and new processes for communications regarding patients.

Results:

Baseline surveys highlighted teamwork within units and organizational learning as safety culture strengths and nonpunitive response to error and handoffs and transitions as areas needing improvement. Follow-up surveys revealed significant improvements in staff's perceptions of safety dimensions related to nonpunitive response to error, communicating and creating an open environment in which people learn from events to proactively avoid future safety events. Increased concerns regarding handoffs and transitions were also perceived in the follow-up surveys, possibly related to process changes required to implement an electronic medical record that included electronic medication administration.

Conclusions:

Surveys on patient safety are an effective tool for measuring and monitoring safety culture. They enable identifying areas in need of improvement and measuring the impact of implemented initiatives and other events on safety culture in the hospital.

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