Evaluating Patient Safety Culture in Hospital

We all have participated in different surveys and some of us might even have conducted a survey.

What are the few survey types that come to your mind when I say the word ‘Survey’?

It might be a customer satisfaction survey, brand awareness survey, product feedback survey, and many more.

But have you heard about the word ‘Patient Safety Culture Survey’?

If not, don’t worry in this article we will understand the term ‘patient safety culture survey’, its importance and how can we conduct a similar survey in our organization.

So, let’s start with understanding patient safety culture first.

Photo on Nova university

Patient safety culture is the extent to which an organization’s culture supports and promotes patient safety. It refers to the values, beliefs, and norms that are shared by healthcare practitioners and other staff throughout the organization that influences their actions and behaviors

Advantages of evaluating patient safety culture in a hospital:

· To raise staff awareness about patient safety

· To assess the current status of patient safety culture

· To identify strengths & areas for patient safety culture improvement

· To understand the parameters affecting patient safety

The survey conducted to evaluate the patient safety in your organization/hospital is called as ‘Patient Safety Culture Survey’

Now the question comes how to conduct a similar survey in your organization?

You can find a few resources for conducting this survey. I have selected the reference of AHRQ (Agency for Healthcare Research & Quality). Under this reference, you can find the user’s guide to help you with understanding the methodology and other concepts regarding the survey and a ready-made questionnaire to conduct the survey.

Here is the link to find both.

I would suggest you read the entire user guide as I won’t be able to cover every doubt and concept in one article.

In this article, I will focus on the following areas:

1. Survey Questionnaire:

The questionnaire contains a few background questions and 6 core sections which are not advised to modify. There are a total of 34 sectional questions and other background questions. The Likert scale has been used to answer the questions.

2. Data collection and sample size:

You can either opt for a paper survey or a web survey (google questionnaire) based on the feasibility of the end users and the hospital. To conduct the survey, you can either go with the census or sample method. Again, for the sampling method, you have two options that are simple random or systematic sampling.

Always remember to conduct a pilot test before running your Survey!

Refer to the below image to determine the sample size based on the number of staff members.

Selection of sample size

3. Data cleaning

After a rigorous amount of effort when you finally receive the targeted response from your staff members now you can proceed with your data cleaning. If you had opted for the paper survey method you first need to make data entry of the responses (suggestion: use Microsoft Excel, it will be beneficial in data analysis). Data cleaning will be vastly required for the paper survey as some respondents might write an answer in between two response options (Read the user guide for more clarification on identifying incomplete & ineligible responses). If you are using a google questionnaire you can by default select all questions as compulsory to attempt as this will help you to get rid of incomplete responses.

4. Data Analysis:

There are three ways to conduct your data analysis:

a. Break out of the number of responses received based on the staff position, work area & other background questions asked in the survey

To protect the confidentiality of individual respondents, do not provide any type of survey feedback report if fewer than 10 respondents complete the survey

a. Analysis based on positively & negatively worded items (questions)

The bifurcation of positive and negative questions is given in the PDF available on the reference link shared previously. PDF link

If you will look at the reference you will understand that there are 19 positive questions and 13 negative questions.

Analysis of positive and negative questions should be done in a different manner to calculate a positive score. Refer below image to understand about the calculation of a positive score for a positive question

Positive score calculation of positively worded question

Refer below image to understand about the calculation of a positive score for the negative question

Positive score calculation of negatively worded question

Always remember that to calculate a positive score for a positive statement you will consider ‘Agree’ & ‘Strongly Agree’ and for a negative statement you will consider ‘Disagree’ & ‘Strongly Disagree’

a. Analysis based on composite measures:

AHRQ has identified 10 measures to evaluate the patient safety culture in the hospital, refer to the PDF I mentioned in the previous paragraph.

Please follow the below image to understand about the calculation for the positive score of a composite measure

Positive score calculation of composite score

You can see in the above example that the total positive score for ‘Teamwork’ measure is 70%.

Similarly, you can proceed with rest of the other composite measures and complete the analysis for the Patient Safety Culture Survey.

I hope you are clear with the concept of the Patient Safety Culture and how you can evaluate it by conducting the survey.

I have written another article on how to conduct the analysis of this survey using Excel. You can check that out here

Conducting a survey and providing the analysis is just the first step towards understanding the culture of your hospital, working on the survey results is the real step towards improving patient safety culture…

If in case you have any doubt, you can connect with me on LinkedIn

Thank You!