Data show staff don't always speak

The Hospital Survey on Patient Safety Culture: 2007 Comparative Database Report from the Agency for Healthcare Research and Quality (AHRQ) in Rockville, MD, cites "nonpunitive response to error" as one of the areas with potential for improvement for most hospitals.

"This score — 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 — was the patient safety culture composite with the lowest average percent positive response (43%), indicating this is an area with potential for improvement for most hospitals," the report said. "The survey item with the lowest average percent positive response (35%) was: 'Staff worry that mistakes they make are kept in their personnel file,' (an average of only 35% strongly disagreed or disagreed with this item)." (Editor's note: To obtain the complete report, go to the group's web site at www.ahrq.gov and search for the report's title: "Hospital Survey on Patient Safety Culture: 2007 Comparative Database Report.")

Another study suggests that only one in 10 nurses and other health care professionals speak up when safety is at risk. According to the study "Silence Kills: Seven Crucial Conversations for Healthcare," 80% of health care professionals regularly witness their co-workers break rules, make mistakes, or demonstrate incompetence. Yet, less than one in 10 says anything about it. Nurses are especially timid when the issue is with a physician or superior, the data suggest. The survey was conducted by VitalSmarts, a staff training company in Provo, UT, and The American Association of Critical-care Nurses in Aliso Viejo, CA. (Editor's note: See the complete research results at www.silencekills.com.)