Table 3.
Relationship of Patient Safety Climate to Readmission Rates for Acute Myocardial Infarction (AMI) and Heart Failure (HF) by Management Level
| Frontline Staff | Senior Management | |||
|---|---|---|---|---|
| AMI | HF | AMI | HF | |
| Senior management engagement | 0.0873*** | 0.0831* | 0.0074 | 0.0422 |
| (0.0278–0.147) | (−0.00101 to 0.167) | (−0.0456 to 0.0604) | (−0.0208 to 0.105) | |
| Organizational resources | 0.0754*** | 0.0732* | −0.0182 | 0.0123 |
| (0.0205–0.130) | (−0.00291 to 0.149) | (−0.0659 to 0.0296) | (−0.0443 to 0.0689) | |
| Overall emphasis on safety | 0.0881*** | 0.105*** | 0.0311 | 0.0718*** |
| (0.0356–0.141) | (0.0396–0.170) | (−0.0173 to 0.0795) | (0.0325–0.111) | |
| Problem responsiveness | 0.0798** | 0.0938** | 0.0441 | 0.0719** |
| (0.00821–0.151) | (0.00134–0.186) | (−0.0132 to 0.101) | (0.00493–0.139) | |
| Unit safety norms | 0.124*** | 0.200*** | 0.0262 | 0.0655*** |
| (0.0549–0.194) | (0.0801–0.320) | (−0.0178 to 0.0701) | (0.0223–0.109) | |
| Unit recognition and support | 0.0428 | 0.0497 | 0.0001 | 0.0304 |
| (−0.0153 to 0.101) | (−0.0237 to 0.123) | (−0.0468 to 0.0470) | (−0.0178 to 0.0786) | |
| Unit manager support | 0.0478 | 0.0331 | 0.0372 | 0.0513* |
| (−0.0209 to 0.117) | (−0.0421 to 0.108) | (−0.0248 to 0.0993) | (−0.00364 to 0.106) | |
| Collective learning | 0.113*** | 0.127*** | −0.00707 | 0.0378 |
| (0.0300–0.196) | (0.0348–0.219) | (−0.0825 to 0.0683) | (−0.0503 to 0.126) | |
| Psychological safety | 0.0715 | 0.0719 | 0.000883 | 0.0343 |
| (−0.0273 to 0.170) | (−0.0323 to 0.176) | (−0.0739 to 0.0757) | (−0.0518 to 0.120) | |
| Fear of shame | 0.0147 | 0.0317 | 0.0283 | 0.0334 |
| (−0.157 to 0.187) | (−0.134 to 0.197) | (−0.0880 to 0.145) | (−0.161 to 0.228) | |
| Fear of blame | 0.0415 | 0.0961*** | 0.0524 | 0.0498 |
| (−0.0176 to 0.101) | (0.0405–0.152) | (−0.0158 to 0.121) | (−0.0151 to 0.115) | |
| Provision of safe care | 0.00919 | 0.00575 | −0.0233 | −0.0237 |
| (−0.0656 to 0.0840) | (−0.0763 to 0.0878) | (−0.0626 to 0.0160) | (−0.0668 to 0.0194) | |
| Overall | 0.128*** | 0.163*** | 0.0144 | 0.0646 |
| (0.0345–0.221) | (0.0407–0.286) | (−0.0546 to 0.0835) | (−0.0133 to 0.143) | |
Note. Values represent standardized β coefficients, 95% confidence interval in parentheses. Models adjusted for census region where the hospital is located; whether the hospital was for-profit, nonprofit, or government owned; the ratio of full time nurse equivalent hours to inpatient days.
***
p<.01;
**
p<.05;
*
p<.1.