Hospital safety survey results are not as accurate as many health care leaders might think. A study from ScienceDaily details the results.
It seems that all of health care is focused on improving the patient experience and patient safety, but with all of these buzzwords flying around, it’s worth asking whether hospital safety and the surrounding culture at your organization is as effective as it could be. Many facilities use surveys to determine the effectiveness of patient safety initiatives or plan out new approaches, but the results may not be as reliable as many health care leaders might think.
How Safety Is Evaluated
While safety at a hospital can be evaluated objectively, one of the primary methods of doing so is still the employee survey. Any member of a hospital staff is likely familiar with the questionnaires that examine elements including how well they or their team are doing when it comes to protecting patients from harm, and how empowered they feel to take action when necessary. It’s generally accepted that these surveys are effective, but a new study by a team of researchers out of the University of Michigan Medical School and VA Ann Arbor Healthcare System (available via ScienceDaily) paints a different picture.
A Set of Surprising Results
The research team found that overall, hospital units’ patient safety culture scores diverged from actual safety results. This was particularly clear in a significant area: reducing two major infections that can be acquired while in the hospital: CLABSI (central line-associated bloodstream infection) and CAUTI (catheter-associated urinary tract infection).
Hospital staff were given technical help in the form of training, tools, new procedures and other support resources to meet this goal. They were also included in efforts to foster cultural change and improve teamwork as well as staff willingness to speak out about unsafe situations.
The results though, surprised even the research team. According to lead author Jennifer Meddings, M.D., “We hypothesized that those that did better on survey measures of safety culture would achieve better infection rates, especially given that there had been so much effort put into trying to improve safety culture in these collaboratives.”
However, this isn’t what they found. She continued, “In the data from both collaboratives, there was no connection between the safety culture scores derived from the surveys, and the actual decline in infection rates on the units. We think this indicates it’s much more difficult to detect and measure safety culture than has been thought.”
Meddings and her fellow researchers found that CLABSI and CAUTI rates were reduced by 47 and 23 percent respectively — however, at the same time, the Hospital Survey on Patient Safety Culture (HSOPS) score remained relatively unchanged. In a few instances, the HSOPS scores actually dropped, even as infection rates improved.
Implications for Hospitals
The study found that less than half the hospital staff took the surveys (a fact that is possibly attributable to the form’s 42-question length). This means that results only came from a portion of employees, and, in turn, could be inaccurate. It’s worth noting that the researchers recommend that leaders evaluate how hospital safety culture surveys are used in relation to safety initiatives. It’s completely possible that, simply because of survey design or use, your insights into the reality of hospital safety at your organization might be skewed.
As health care moves forward, the question of patient safety will become increasingly foundational for the entire industry. Any entity interested in providing their patients the best care experience possible will need to consider prioritizing and promoting a culture of safety across their organization.