Table 2.
Mean Percent Problematic Response (PPR) among All Respondents by Item and Dimension: U.S. and VA*
| Problematic Response Rate (Cronbach's α Coefficient) |
||
|---|---|---|
| Dimensions† and Text of Item | U.S. | VA |
| Hospital contributions to safety climate | ||
| Senior managers' engagement | 14.7(0.80) | 18.6(0.82) |
| Senior management has a clear picture of the risks associated with patient care. | 14.2 | 17.7 |
| Senior management has a good idea of the kinds of mistakes that actually occur in this facility. | 17.6 | 20.4 |
| Senior management supports a climate that promotes patient safety. | 9.6 | 12.2 |
| Senior management considers patient safety when program changes are discussed. | 10.8 | 14.6 |
| Patient safety decisions are made by the most qualified people, regardless of rank or hierarchy. | 22.1 | 29.7 |
| Good communication flow exists up and down the chain of command regarding patient safety issues. | 13.8 | 17.2 |
| Organizational resources for safety | 13.6(0.65) | 16.4(0.63) |
| I have enough time to complete patient care tasks safely. | 18.1 | 20.5 |
| I am provided with adequate resources (personnel, budget, and equipment) to provide safe patient care. | 17.9 | 24.4 |
| I have received sufficient training to enable me to address patient safety problems. | 6.9 | 8.1 |
| This facility devotes sufficient resources to follow up on identified safety problems. | 11.4 | 12.5 |
| Overall emphasis on patient safety | 9.0(0.57) | 9.7(0.57) |
| Compared with other facilities in the area, this facility cares more about the quality of patient care it provides. | 10.6 | 11.0 |
| Overall, the level of patient safety at this facility is improving. | 7.4 | 8.4 |
| Work-unit contributions to safety climate | ||
| Unit managers' support | 18.8(0.59) | 21.7(0.59) |
| Management in my unit helps me overcome problems that make it hard for me to provide safe patient care. | 19.4 | 25.1 |
| In my unit, management puts safety at the same level of importance as meeting the schedule and productivity. | 19.8 | 19.6 |
| Whenever pressure builds up, management in my unit wants us to work faster, even if it means taking shortcuts that might negatively affect patient safety. | 17.2 | 20.5 |
| Unit safety norms | 9.9(0.57) | 10.6(0.61) |
| My unit takes the time to identify and assess risks to ensure patient safety. | 6.7 | 7.9 |
| My unit does a good job managing risks to ensure patient safety. | 5.7 | 6.9 |
| In my unit, there is significant peer pressure to discourage unsafe patient care. | 23.2 | 20.6 |
| In my unit, anyone found to intentionally violate standards or safety rules is corrected. | 7.2 | 10.0 |
| Deliberate violations of standard operating procedures are rare in my unit. | 6.6 | 7.5 |
| Unit recognition and support for safety efforts | 28.7(0.63) | 31.0(0.64) |
| My unit recognizes safety achievement through rewards and incentives. | 47.8 | 48.3 |
| I am rewarded for taking quick action to identify a serious mistake. | 34.8 | 39.1 |
| My unit provides training on teamwork in order to improve patient care performance and safety. | 22.0 | 24.4 |
| My performance is evaluated against defined safety standards. | 10.8 | 12.0 |
| Collective learning | 8.9(0.69) | 10.3(0.70) |
| Mistakes have led to positive changes in my unit. | 9.8 | 11.7 |
| On my unit, we identify and fix safety problems before an incident actually occurs. | 9.4 | 11.3 |
| Our process of accident and incident investigation is effective at identifying root causes. | 9.6 | 10.7 |
| In my unit, patient safety problems and errors are communicated to the right people so that the problem can be corrected. | 6.9 | 7.4 |
| Psychological safety | 12.2(0.63) | 14.4(0.65) |
| Staff feel comfortable questioning the actions of those with more authority when patient safety is at risk. | 19.0 | 22.1 |
| Staff freely speak up if they see something that may negatively affect patient care. | 10.3 | 11.2 |
| I am comfortable reporting safety concerns without fear of being punished by management. | 7.3 | 9.7 |
| Problem responsiveness | 12.5(0.69) | 15.2(0.70) |
| Bringing patient safety concerns to management's attention usually results in the problem being addressed. | 13.8 | 17.4 |
| When I take the time to communicate about patient safety problems there is appropriate follow-up. | 11.1 | 13.0 |
| Interpersonal contributions to safety climate | ||
| Fear of shame | 4.8(0.44) | 5.3(0.41) |
| Asking for help is a sign of incompetence. | 5.9 | 6.1 |
| If I make a mistake that has significant consequences and nobody notices, I do not tell anyone about it. | 3.6 | 4.4 |
| Fear of blame and punishment | 32.2(0.54) | 23.1(0.53) |
| If people find out that I made a mistake, I will be disciplined. | 35.6 | 25.9 |
| Clinicians who make serious mistakes are usually punished. | 28.8 | 20.4 |
| Other aspects of safety climate | ||
| Provision of safe care | 36.4(0.67) | 36.0(0.63) |
| In the last year, I have witnessed a coworker do something that appeared to me to be unsafe for the patient. | 31.1 | 29.7 |
| I have never witnessed a coworker do something that appeared to me to be unsafe patient care. | 41.7 | 42.2 |
| Overall average‡ | 15.9 | 17.2 |
*
All means were calculated using weights.
†
Mean of all items in dimension averaged to calculate dimension mean.
‡
Overall means for U.S. and VA not significantly different from each other (t-test, p=.83).
VA, Veterans Health Administration.