The AHRQ Hospital Survey on Patient Safety Culture: A Tool to Plan and Evaluate Patient Safety Programs

Abstract

Objectives: We used results from our rural-adapted version of the Hospital Survey on Patient Safety Culture (HSOPSC) to plan, execute, and evaluate a 2-year patient safety program in 24 Critical Access Hospitals (CAHs). Methods: Use of sound survey methodology at baseline and reassessment produced valid results. We used a generalized estimating equations approach to account for the correlation of respondents within CAHs. Results: Implementing a systematic voluntary medication error reporting program supported by specific patient safety practices was associated with improved perceptions of safety culture. Safety culture varied by work area, position, and extent of participation in a patient safety program. Conclusions: The HSOPSC detected changes in safety culture over time when managers used a change strategy to execute specific practices that support the four components of an informed, safe culture. The execution and evaluation of organizational practices led to changes in respondents ’ beliefs about safety culture.