Table 4.
Relationship of Patient Safety Climate to Readmission Rates for Acute Myocardial Infarction (AMI) and Heart Failure (HF) by Work Role
| Physician | Nurse | |||
|---|---|---|---|---|
| AMI | HF | AMI | HF | |
| Senior management engagement | 0.0626*** | 0.0443* | 0.0247 | 0.0368 |
| (0.0318–0.0934) | (−0.0012 to 0.0898) | (−0.0125 to 0.0618) | (−0.0104 to 0.0840) | |
| Organizational resources | 0.0374 | 0.0379 | 0.0267 | 0.0414* |
| (−0.0136 to 0.0883) | (−0.0193 to 0.0952) | (−0.0146 to 0.0680) | (−0.0062 to 0.0889) | |
| Overall emphasis on safety | 0.0540*** | 0.0401* | 0.0272 | 0.0583*** |
| (0.0280–0.0801) | (−0.0056 to 0.0858) | (−0.0191 to 0.0735) | (0.0151–0.1015) | |
| Problem responsiveness | 0.0429** | 0.0403* | 0.021 | 0.0348 |
| (0.0036–0.0822) | (−0.0078 to 0.0883) | (−0.0269 to 0.0689) | (−0.0237 to 0.0932) | |
| Unit safety norms | 0.0800*** | 0.027 | 0.0828* | 0.155*** |
| (0.0222–0.1379) | (−0.0383 to 0.0923) | (−0.00904 to 0.17456) | (0.0599–0.2498) | |
| Unit recognition and support | 0.0317 | 0.0429* | 0.00503 | 0.0484 |
| (−0.0190 to 0.0824) | (−0.0053 to 0.0912) | (−0.0463 to 0.0564) | (−0.0126 to 0.1095) | |
| Unit manager support | 0.0524*** | 0.0377* | 0.0195 | 0.00971 |
| (0.0159–0.0888) | (−0.0068 to 0.0823) | (−0.0237 to 0.0627) | (−0.0413 to 0.0607) | |
| Collective learning | 0.0682*** | 0.0341 | 0.0299 | 0.0761** |
| (0.0306–0.1059) | (−0.0188 to 0.0870) | (−0.0324 to 0.0923) | (0.0107–0.1414) | |
| Psychological safety | 0.0191 | −0.0103 | −0.0199 | 0.0179 |
| (−0.0547 to 0.0929) | (−0.0749 to 0.0544) | (−0.0957 to 0.0560) | (−0.0687 to 0.1046) | |
| Fear of shame | 0.0388 | 0.0699** | −0.0845 | −0.160* |
| (−0.0673 to 0.1450) | (0.0024–0.1373) | (−0.247 to 0.078) | (−0.344 to 0.024) | |
| Fear of blame | −0.00236 | 0.0196 | 0.036 | 0.0569** |
| (−0.0418 to 0.0371) | (−0.0156 to 0.0548) | (−0.0131 to 0.0851) | (0.0009–0.1128) | |
| Provision of safe care | −0.0107 | −0.00709 | −0.0179 | 0.0279 |
| (−0.0630 to 0.0415) | (−0.0475 to 0.0333) | (−0.0720 to 0.0361) | (−0.0299 to 0.0858) | |
| Overall | 0.0829*** | 0.0652* | 0.0407 | 0.0832** |
| (0.0284–0.1373) | (−0.0089 to 0.1393) | (−0.0351 to 0.1165) | (0.0003–0.1661) | |
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.