Strong cultures of workplace safety and patient safety are both critical for advancing safety in healthcare and eliminating harm to both the healthcare workforce and patients. However, there is ...currently minimal published empirical evidence about the relationship between the perceptions of providers and staff on workplace safety culture and patient safety culture.
This study examined cross-sectional relationships between the core Surveys on Patient Safety Culture™ (SOPS®) Hospital Survey 2.0 patient safety culture measures and supplemental workplace safety culture measures. We used data from a pilot test in 2021 of the Workplace Safety Supplemental Item Set, which consisted of 6,684 respondents from 28 hospitals in 16 states. We performed multiple regressions to examine the relationships between the 11 patient safety culture measures and the 10 workplace safety culture measures.
Sixty-nine (69) of 110 associations were statistically significant (mean standardized β = 0.5; 0.58 < standardized β < 0.95). The largest number of associations for the workplace safety culture measures with the patient safety culture measures were: (1) overall support from hospital leaders to ensure workplace safety; (2) being able to report workplace safety problems without negative consequences; and, (3) overall rating on workplace safety. The two associations with the strongest magnitude were between the overall rating on workplace safety and hospital management support for patient safety (standardized β = 0.95) and hospital management support for workplace safety and hospital management support for patient safety (standardized β = 0.93).
Study results provide evidence that workplace safety culture and patient safety culture are fundamentally linked and both are vital to a strong and healthy culture of safety.
This article discusses the potential effects of a shortened fielding period on an employee survey’s item and index scores and respondent demographics. Using data from the U.S. Office of Personnel ...Management’s 2011 Federal Employee Viewpoint Survey, we investigate whether early responding employees differ from later responding employees. Specifically, we examine differences in item and index scores related to employee engagement and global satisfaction. Our findings show that early responders tend to be less positive, even after adjusting their weights for nonresponse. Agencies vary in their prevalence of late responders, and score differences become magnified as this proportion increases. We also examine the extent to which early versus late responders differ on demographic characteristics such as grade level, supervisory status, gender, tenure with agency, and intention to leave, noting that nonminorities and females are the two demographic characteristics most associated with responding early.
A number of private and public companies calculate and publish proprietary hospital patient safety scores based on publicly available quality measures initially reported by the U.S. federal ...government. This study examines whether patient safety culture perceptions of U.S. hospital staff in a large national survey are related to publicly reported patient safety ratings of hospitals.
The Agency for Healthcare Research and Quality Hospital Survey on Patient Safety Culture (Hospital SOPS) assesses provider and staff perceptions of hospital patient safety culture. Consumer Reports (CR), a U.S. based non-profit organization, calculates and shares with its subscribers a Hospital Safety Score calculated annually from patient experience survey data and outcomes data gathered from federal databases. Linking data collected during similar time periods, we analyzed relationships between staff perceptions of patient safety culture composites and the CR Hospital Safety Score and its five components using multiple multivariate linear regressions.
We analyzed data from 164 hospitals, with patient safety culture survey responses from 140,316 providers and staff, with an average of 856 completed surveys per hospital and an average response rate per hospital of 56%. Higher overall Hospital SOPS composite average scores were significantly associated with higher overall CR Hospital Safety Scores (β = 0.24, p < 0.05). For 10 of the 12 Hospital SOPS composites, higher patient safety culture scores were associated with higher CR patient experience scores on communication about medications and discharge.
This study found a relationship between hospital staff perceptions of patient safety culture and the Consumer Reports Hospital Safety Score, which is a composite of patient experience and outcomes data from federal databases. As hospital managers allocate resources to improve patient safety culture within their organizations, their efforts may also indirectly improve consumer-focused, publicly reported hospital rating scores like the Consumer Reports Hospital Safety Score.
Given rising costs and changing payment models, healthcare organisations are increasingly focused on value and efficiency. The goal of our study was to develop survey items to assess clinician and ...staff perspectives about the extent to which the organisational culture in hospitals and medical offices supports value and efficiency.
Development began with a literature review and interviews with experts and clinicians and staff from hospitals and medical offices. We identified key areas of value and efficiency culture, drafted survey items and conducted cognitive testing. Using purposive sampling to select sites, the 36-item surveys were pilot tested in 47 hospitals and 96 medical offices. Psychometric analysis was conducted on data from 3951 hospital respondents (42% response) and 1458 medical office respondents (63% response).
Factor loadings, multilevel confirmatory factor analysis model fit and reliability estimates were acceptable for the 13 items grouped into 4 composite measures:
(3 items),
(3 items),
(3 items) and
(4 items). All composite measures were significantly intercorrelated and related to the four
, indicating adequate conceptual convergence among the measures. Eight items assessing
were also included.
We developed psychometrically sound survey items measuring value and efficiency culture. When added to the Agency for Healthcare Research and Quality Surveys on Patient Safety Culture, the item sets extend those surveys by assessing additional dimensions of organisational culture that affect care delivery. Healthcare organisations can use these item sets to assess how well their organisational culture supports value and efficiency and identify areas for improvement.
Workplace safety is critical for advancing patient safety and eliminating harm to both the healthcare workforce and patients. The purpose of this study was to develop and test survey items that can ...be used in conjunction with the Agency for Healthcare Research and Quality (AHRQ) Surveys on Patient Safety Culture™ (SOPS
) Hospital Survey to assess how the organizational culture in hospitals supports workplace safety for providers and staff. After conducting a literature review and background interviews with workplace safety experts, we identified key areas of workplace safety culture (workplace hazards, moving/transferring/lifting patients, workplace aggression, supervisor/management support for workplace safety, workplace safety reporting, and work stress/burnout) and drafted survey items to assess these areas. Survey items were cognitively tested and pilot tested with the SOPS Hospital Survey 2.0 among providers and staff in 28 U.S. hospitals. We conducted psychometric analysis on data from 6684 respondents. Confirmatory factor analysis results (item factor loadings and model fit indices), internal consistency reliability, and site-level reliability were acceptable for the 16 survey items grouped into 6 composite measures. Most composite measures were significantly correlated with each other and with the overall rating on workplace safety, demonstrating conceptual convergence among survey measures. Hospitals and researchers can use the Workplace Safety Supplemental items to assess the dimensions of organizational culture that support provider and staff safety and to identify both strengths and areas for improvement.
Experts in patient safety stress the importance of a shared culture of safety. Lack of consensus may be detrimental to patient safety. This study examines differences in patient safety culture ...perceptions among providers, management and staff in a large national survey of safety culture in ambulatory practices in the USA.
The US Agency for Healthcare Research and Quality Medical Office Survey on Patient Safety Culture (SOPS) assesses perceptions about patient safety issues and event reporting in medical offices (ie, ambulatory practices). Using the 2014 data, we analysed responses from medical offices with at least five respondents. We calculated differences in perceptions of patient safety culture across six job positions (physicians, management, nurse practitioners (NPs)/physician assistants (PAs), nurses, clinical support staff and administrative/clerical staff) for 10 survey composites, the average of the 10 composites and an overall patient safety rating using multivariate hierarchical linear regressions.
We analysed data from 828 medical offices with responses from 15 523 providers and staff, with an average 20 completed surveys per medical office (range: 5-367) and an average medical office response rate of 65% (range: 3%-100%). Management had significantly more positive patient safety culture perceptions on nine of 10 composite scores compared with all other job positions, including physicians. The composite that showed the largest difference was Communication Openness; Management (85% positive) was 22% points more positive than other clinical and support staff and administrative/clerical staff. Physicians were significantly more positive than PAs/NPs, nursing staff, other clinical and support staff and administrative/clerical staff on four composites: Communication About Error, Communication Openness, Staff Training and Teamwork, ranging from 3% to 20% points more positive.
These findings suggest that managers need to pay attention to the training needs of office staff, since this was an area with one of the greatest gaps in perceptions. In addition, both office managers and physicians need to encourage more open communication. As medical offices innovate to improve value, efficiency and patient-centred care, it is important that they continue to foster shared perceptions about what organisational members need, understanding that those perceptions may differ systematically by job position.
There is limited evidence on the associations between patient safety culture and measures of health care quality in nursing homes. This study examines the relationship between scores on the Agency ...for Healthcare Research and Quality (AHRQ) Surveys on Patient Safety Culture™ (SOPS®) Nursing Home Survey (NH SOPS) and Centers for Medicare and Medicaid Services Nursing Home Five-Star Quality Ratings. Using data from 186 nursing homes, we conducted multiple regression analyses predicting the Five-Star Quality Ratings from the NH SOPS survey measures. Five NH SOPS measures were related to the Overall, Health Inspections, and Quality Five-Star Ratings. Four NH SOPS measures were related to at least two of the four Five-Star Quality Ratings and three SOPS measures were related to one Five-Star Rating. None of the NH SOPS measures were significantly associated with the Staffing Five-Star Rating. Findings generally indicated that stronger patient safety culture is associated with higher quality ratings.
This article presents results from an experiment conducted during the web-based 2017 Federal Employee Viewpoint Survey (FEVS) to evaluate an automated refusal conversion strategy whereby a sample of ...individuals was given the opportunity to opt out from the survey and stop receiving additional e-mail reminders. Before being added to the unsubscribe list, however, the individual was asked to cite the primary reason for choosing not to take the FEVS. A randomly assigned subset was given a last-moment appeal, tailored to the reason provided, at which point the individual could either confirm desiring to opt out or navigate to the start of the survey. Because the complementary subset did not receive the appeal, we are able to report on the efficacy of the strategy in convincing individuals who may not have been initially inclined to participate to do so.
Abstract
Workplace safety is important for advancing resident safety and eliminating harm to both nursing home staff and residents. The goal of this study was to develop and test survey items to ...assess how the organizational culture in nursing homes supports workplace safety for staff. After conducting a literature review and background interviews with nursing home staff and workplace safety experts, we identified important areas of workplace safety culture (i.e., workplace hazards; moving/transferring/lifting residents; inappropriate resident behavior toward staff; interactions among staff; supervisor/management support for workplace safety; workplace safety reporting; and, work stress/burnout) and drafted survey items to assess each area. These draft items were administered with the AHRQ Surveys on Patient Safety Culture (SOPS) Nursing Home Survey to staff in 48 U.S. nursing homes. We conducted psychometric analysis on data from 2,468 respondents. Confirmatory factor analysis results and internal consistency and site-level reliability coefficients were acceptable for the 18 survey items grouped into 6 composite measures. All composite measures were significantly correlated (p< 0.05) with each other and with the overall rating on workplace safety, indicating adequate conceptual convergence among survey measures. On average, 33% of respondents reported symptoms of burnout. Higher burnout was significantly correlated with lower job satisfaction (rs=-0.42) and greater intent to leave the nursing home (rs=0.37). Nursing homes and researchers can use the Workplace Safety Supplemental Item Set to assess nursing home staff burnout and the dimensions of organizational culture that support staff safety, and to identify both strengths and areas for improvement.
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