Improved Safety Culture and Teamwork Climate Are Associated With Decreases in Patient Harm and Hospital Mortality Across a Hospital System. Issue 2 (June 2020)

• Record Type: Journal Article
• Authors: Berry, Janet C.; Davis, John Terrance; Bartman, Thomas; Hafer, Cindy C.; Lieb, Lindsay M.; Khan, Nadeem; Brilli, Richard J.
• Is Part Of: Journal of patient safety. Volume 16:Issue 2(2020)
• Publication Date: 2020-06
• Subjects: Safety Attitudes Questionnaire -- culture metrics -- patient safety -- quality improvement -- inpatient harm; Patients -- Safety measures -- Periodicals; Medicine -- Practice -- Safety measures -- Periodicals; Medical errors -- Prevention -- Periodicals; 610.289
• DOI: 10.1097/PTS.0000000000000251
• Languages: English
• ISSNs: 1549-8417

Abstract

Abstract : Objectives: Improved safety and teamwork culture has been associated with decreased patient harm within specific units in hospitals or hospital groups. Most studies have focused on a specific harm type. This study's objective was to document such an association across an entire hospital system and across multiple harm types. Methods: The Safety Attitudes Questionnaire (SAQ) was administered to all clinical personnel (including physicians) before, 2 years after, and 4 years after establishing a comprehensive patient safety/high-reliability program at a major children's hospital. Resultant data were analyzed hospital-wide as well as by individual units, medical sections, and professional groups. Results: Safety attitude scores improved over the 3 surveys ( P < 0.05) as did teamwork attitude scores ( P = nonsignificant). These increases were accompanied by contemporaneous statistically significant decreases in all-hospital harm ( P < 0.01), serious safety events ( P < 0.001), and severity-adjusted hospital mortality ( P < 0.001). Differences were noted between physicians' and nurses' views on specific safety and teamwork items within individual units, with nursing scores often lower. These discipline-specific differences decreased with time. Conclusions: Improved safety and teamwork climate as measured by SAQ are associated with decreased patient harm and severity-adjusted mortality. Discrepancies in SAQ scores exist between different professional groups but decreased over time.