Examination of How a Survey Can Spur Culture Changes Using a Quality Improvement Approach: A Region-Wide Approach to Determining a Patient Safety Culture

The objective of this study was to investigate safety climates within a cohort of regional hospitals to assess health care workers’ perceptions of their hospitals’ safety reporting, feedback, and problem-solving systems, and to examine how regional initiatives and health care organizations use safety climate information to improve patient safety outcomes. A purposive sample of staff at 25 western Pennsylvania hospitals was surveyed using Likert scale questions. The instrument studied provided foci on which regional efforts and hospitals could base interventions to improve patient safety culture. Significant differences in perceived patient safety climate existed between hospitals, respondents, and departments. The differences in responses suggest that such instruments may be useful to identify and reinforce aspects of safety, culture, and organizational characteristics, which may need to be targeted to improve patient safety outcomes across and within hospitals. Due to the complex nature of safety culture within health care systems, determining how these surveys can be used will require further investigation. (Am J Med Qual 2009;24:374-384)