Assessing and improving safety culture throughout an academic medical centre: a prospective cohort study.

Published

Journal Article

OBJECTIVES: To describe the authors' hospital-wide efforts to improve safety climate at a large academic medical centre. DESIGN AND SETTING: A prospective cohort study used multiple interventions to improve hospital-wide safety climate. 144 clinical units in an urban academic medical centre are included in this analysis. INTERVENTIONS: The comprehensive unit-based safety programme included steps to identify hazards, partner units with a senior executive to fix hazards, learn from defects, and implement communication and teamwork tools. Hospital-level interventions were also implemented. MAIN OUTCOME MEASURES: Safety climate was assessed annually using the safety attitudes questionnaire. The safety culture goal was to meet or exceed the 60% minimum positive score or improve the score by ≥10 points. RESULTS: Response rates were 77% (2006) and 79% (2008). For safety climate, 55% of units in 2006 and 82% in 2008 achieved the culture goal. For teamwork climate, 61% of units in 2006 and 83% in 2008 achieved the culture goal. The mean safety climate improvement (difference score) for 79 units at or above 60% in 2006 was 0.201 in 2008; the mean improvement for the 65 units below the threshold was 18.278. The mean teamwork climate improvement (difference score) for the 89 units at or above 60% in 2006 was 0.452 in 2008; the mean improvement for the 55 units below the threshold was 16.176. Climate scores improved significantly from 2006 to 2008 in every domain except stress recognition. CONCLUSIONS: Hospital-wide interventions were associated with improvements in safety climate at a large academic medical centre.

Full Text

Duke Authors

Cited Authors

  • Paine, LA; Rosenstein, BJ; Sexton, JB; Kent, P; Holzmueller, CG; Pronovost, PJ

Published Date

  • December 2010

Published In

Volume / Issue

  • 19 / 6

Start / End Page

  • 547 - 554

PubMed ID

  • 21127113

Pubmed Central ID

  • 21127113

Electronic International Standard Serial Number (EISSN)

  • 1475-3901

Digital Object Identifier (DOI)

  • 10.1136/qshc.2009.039347

Language

  • eng

Conference Location

  • England