AHRQ: Hospitals rate themselves high in teamwork

U.S. hospitals rated themselves strongly in three areas—teamwork, supervisor/manager expectations and actions promoting patient safety, and patient safety—in the Agency for Healthcare Research and Quality (AHRQ)'s "Hospital Survey on Patient Safety Culture: 2011 User Comparative Database Report."

An average of 80 percent of responding hospitals reported having teamwork within their units. About 75 percent of respondents positively noted supervisor/manager expectations and actions promoting patient safety, and 75 percent, on average, of respondents graded their work area or unit with either “A—Excellent” (29 percent) or “B—Very Good” (46 percent) in patient safety.

The 2011 database included data from 466 hospitals that were in the previous database report (in 2004) and the 566 hospitals that submitted data for the 2011 report. Seventy-six percent of respondents from the 1,032 hospitals indicated that they had direct interaction with patients.

The top three areas with potential for improvement in the 2011 survey were:

• Nonpunitive Response to Error (44 percent)—the extent to which staff believe their mistakes and event reports are not held against them and that mistakes are not kept in their personnel file. This composite had the lowest average percent positive response.
• Handoffs and Transitions (45 percent)—the extent to which important patient care information is transferred across hospital units and during shift changes. This composite had the second-lowest average percent positive response.
• Number of Events Reported (54 percent)—on average, most respondents within hospitals reported no events in their hospital during the past 12 months. It is likely that events were under-reported. This is an area for improvement for most hospitals because under-reporting of events means potential patient safety problems may not be recognized or identified and therefore may not be addressed," AHRQ stated.

Very small hospitals (six to 24 beds) had the highest overall average positive response on the patient safety culture composites while small hospitals (25 to 49 beds) had the highest percentage of respondents who gave their work area/unit a patient safety grade of "Excellent" or "Very Good."

Among the 466 hospitals with trending data:

• The average percent positive scores on the patient safety culture composites increased by 2 percentage points.
• The average percentage of respondents who gave their work area/unit a patient safety grade of "A—Excellent" or "B—Very Good" increased by 3 percentage points.
• The average number of respondents reporting one or more events increased by only 1 percentage point.

AHRQ recommended seven steps hospitals can take to improve their patient safety culture:

1. Understand your survey results.
2. Communicate and discuss the survey results.
3. Develop focused action plans.
4. Communicate action plans and deliverables.
5. Implement action plans.
6. Track progress and evaluate impact.
7. Share what works.

Read the full report here.