Nonpunitive response to errors top list of hospital concerns

Hospitals are struggling with finding ways to address errors without punishing those responsible, according to the Hospital Survey on Patient Safety Culture by the Agency for Healthcare Research and Quality (AHRQ) in Rockville, MD.

In response to requests from hospitals interested in comparing their results with those of other hospitals, AHRQ established the Hospital Survey on Patient Safety Culture comparative database. The first user comparative database report, released in 2007, included data from 382 U.S. hospitals. The 2014 user comparative database report displays results from 653 hospitals and 405,281 hospital staff respondents.

The report also includes a chapter on trending that presents results showing change over time for 359 hospitals that administered the survey and submitted data more than once.

The three areas of strength or composites with the highest average percent positive responses were:

• teamwork within units (81% positive response) — the extent to which staff support each other, treat each other with respect, and work together as a team;

• supervisor/manager expectations and actions promoting patient safety (76% positive response) — the extent to which supervisors/managers consider staff suggestions for improving patient safety, praise staff for following patient safety procedures, and don’t overlook patient safety problems;

• organizational learning and continuous improvement (73% positive response) — the extent to which mistakes have led to positive changes and changes are evaluated for effectiveness.

The three areas that showed potential for improvement, or with the lowest average percent positive responses, were:

• nonpunitive response to error (44% positive response) — the extent to which staff feel that their mistakes and event reports are not held against them and that mistakes are not kept in their personnel file;

• handoffs and transitions (47% positive response) — the extent to which important patient care information is transferred across hospital units and during shift changes;

• staffing (55% positive response) — the extent to which there are enough staff to handle the workload and work hours are appropriate to provide the best care for patients.

The full report is available online at http://tinyurl.com/pma6pqw.