Analysis of the MEDCOM Patient Safety Climate Survey: Implications for Implementation of the AMEDD Patient Safety Program

摘要

In response to emphasis on patient safety following publication, in November 1999, of the Institute of Medicine's report To Err Is Human, U.S. Army Medical Command (MEDCOM) established a Patient Safety Program for the Army Medical Department (AMEDD). MEDCOM Regulation 40-41 directs each Medical Treatment Facility to implement a Patient Safety Program dedicated to avoiding harm and enhancing patient safety. As part of a comprehensive strategy to improve safety by first assessing the magnitude of the problem, MEDCOM administered a 'Patient Safety Climate Survey' to staff of all U.S. Army Military Treatment Facilities (MTFs) in August/September 2001. Nineteen Likert scale items and one open-ended question assessed perceptions about three conceptual components of an effective patient safety program: willinguess to report errors, organizational problem-solving process, and perceptions about leadership concern for patient safety. The purpose of this study was to analyze the 10,768 responses to assess the corporate climate, identify respondents' perceptions of barriers to reporting errors, prioritize safety issues identified, and make recommendations for improving patient safety throughout the AMEDD. Although a 'culture of blame' exists in Army MTFs, respondents perceive that leadership is concerned about patient safety and that problem solving processes to reduce medical error are being implemented.