The Relationship of Safety Culture and Patient Outcomes in U.S. Academic Health Science Centers.

摘要

Safety culture within healthcare organizations has been implicated, based on other high risk industries, as a contributor to patient outcomes. While the healthcare industry is exploring the possibility of that relationship, little empirical evidence exists to date. The purposes of this study were to determine (a) the relationship between safety culture and patient outcomes in United States (U.S.) academic health science centers (AHSCs) and, (b) the ability of safety culture to predict patient outcomes.;This descriptive exploratory study was conducted using a cross-sectional, correlational design. The independent variable was safety culture as measured by the Hospital Survey On Patient Safety Culture (HSOPS). The dependent variables were mortality indicators in academic health science centers: death among surgical patients with serious treatable complications and death in low mortality DRGs. During the design of the study, it was recognized that a robust sample size was not achievable; therefore, the decision was made to continue with a pilot study to examine feasibility and methodological issues of the original study.;The results of this pilot study suggest the research question and initial design were in accordance with the primary purpose of the study. Due to the challenges associated with sampling and data collection, it is suggested that AHSCs conduct case studies with their own HSOPS safety culture data and patient outcome data using this pilot study as a guide. Furthermore, the exploration of outcome measures that occur more frequently than mortality indicators may yield data more amenable to statistical analyses. The HSOPS tool has been tested extensively and appears to be a valid and reliable tool for measuring patient safety culture for an organization. The proposed analyses---correlational analyses and linear regression were appropriate to answer the research question.;A full scale exploratory study is needed to analyze the relationships among safety culture dimensions and patient outcomes. Employing the experience learned from this pilot study in a full scale exploratory study could provide useful empirical evidence for healthcare leaders in their efforts to improve patient safety.