Healthcare News & Insights

Perception doesn’t always match reality with safety culture surveys

Many hospitals pride themselves on having a culture that promotes patient safety. But this mindset may not be as effective in keeping patients safe from harm as it seems on the surface. According to new research, outcomes may not be much better in hospitals with a self-proclaimed safety culture after all. 

78405917A news release from the University of Michigan discusses the analysis. Researchers from the university’s medical school and the VA Ann Arbor Healthcare System reviewed survey data from the Hospital Survey on Patient Safety Culture, and their findings were published in BMJ Quality & Safety.

The surveys were distributed to hospital staff at facilities across the country that were participating in a national patient safety project. Staff were asked how well they felt their hospitals did with preventing adverse events in patients.

Their answers show a disconnect between staff members’ perceptions and the reality of patient safety in their facilities.

Performance gap

Hospital units’ own perception of their facilities’ patient safety culture didn’t match up with their actual performance in reducing the likelihood of two common hospital-acquired infections: central-line associated bloodstream infections (CLABSI) and catheter-associated urinary tract infections (CAUTI).

As part of the patient safety project they participated in, hospital staff received extra training and tools to help reduce the occurrence of CLABSIs and CAUTIs, including learning new procedures to care for patients with central lines and catheters. Participating hospitals also promoted teamwork, and staff were encouraged to speak up if they noticed a situation that could put patients in danger.

The initiative was successful as a whole – hospital units saw rates of CLABSIs drop by 47%, while CAUTIs dropped by 23%.

But there was no real difference between the safety culture ratings from the surveys and any actual reductions in infections. Hospitals with higher patient safety culture scores didn’t have better infection rates. And in some cases, hospitals that earned lower patient safety culture scores from staff had more success in reducing infections.

Alternate approach

Some of the difference between perception and reality with safety culture surveys and performance might be attributed to the fact that few staff members completed the surveys – only about half the staff of units that participated in the project actually took the survey.

But considering the surveys that were taken, researchers said their results may indicate that a survey evaluating a hospital’s safety culture may not be the way to go when measuring a hospital’s commitment to keeping patients safe.

A better way to measure a hospital’s success might be to analyze the specific steps the hospital took in an attempt to reduce infection – and whether staff thought they made the situation better, keeping the outcomes of their efforts in mind.

This news is also relevant to hospitals regarding their own efforts toward better patient safety. While it’s key to foster an environment where safety is a priority, hospitals may find the best improvements by making sure staff follow specific evidence-based protocols that boost patient outcomes, rather than placing all their effort into creating a safety-based culture.

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