Table 3.
Comparing Selected Safety Culture Responses by Subgroup and AHRQ Benchmark, From a Study of Perceptions of Safety Culture in Clinical Experiences, University of California, San Francisco (UCSF), 2011
| No. (%) of positive responses* |
||||
|---|---|---|---|---|
| Domain | Overall | Internal medicine | Surgery | % AHRQ positive responses† |
| Overall perceptions of patient safety | ||||
| It is by chance that mistakes don't happen on this rotation‡ | 52 (49) | 24 (44) | 28 (53) | 62 |
| Patient safety is never sacrificed to get more work done | 43 (40) | 22 (41) | 21 (39) | 65 |
| Patient safety is a problem on this rotation‡ | 53 (50) | 28 (53) | 25 (46) | 65 |
| This service has procedures that are good at preventing errors | 63 (58) | 32 (59) | 31 (57) | 72 |
| Teamwork within units | ||||
| People support one another on this rotation§ | 84 (79) | 49 (91) | 35 (66) | 86 |
| On this rotation, people treat each other with respect§ | 76 (71) | 48 (91) | 28 (52) | 78 |
| Organizational learning | ||||
| This service is actively doing things to improve patient safety | 70 (65) | 39 (72) | 31 (57) | 84 |
| Event disclosure to patients | NA | |||
| Patient safety events should be disclosed to patients | 84 (80) | 42 (79) | 42 (81) | |
| Physicians are encouraged to disclose patient safety events to patients | 44 (42) | 26 (49) | 18 (35) | |
| Supervisor promoting patient safety | ||||
| Whenever pressure builds up, residents want students to take shortcuts‡ | 54 (52) | 29 (55) | 25 (50) | 74 |
| Residents overlook patient safety problems‡ | 73 (71) | 36 (68) | 37 (74) | 76 |
| Attendings overlook patient safety problems‡ | 78 (76) | 38 (72) | 40 (80) | 76 |
| Feedback about error | ||||
| Teams discussed ways to prevent errors from happening again | 62 (59) | 30 (57) | 32 (62) | 71 |
| Staffing | ||||
| There is enough staff to handle the workload§ | 66 (61) | 41 (76) | 25 (46) | 56 |
| Work is done in “crisis mode,” trying to do too much too quickly‡ | 69 (64) | 38 (70) | 31 (58) | 50 |
| Students work longer hours than is safe for patient care‡ | 51 (50) | 30 (57) | 21 (42) | 53 |
| Supervision of trainees | NA | |||
| Students receive sufficient clinical supervision | 72 (70) | 40 (75) | 32 (64) | |
| Patient safety would be improved if students received more supervision | 31 (30) | 16 (30) | 15 (30) | |
| Good communication flow exists up and down the chain of command§ | 57 (55) | 34 (64) | 23 (45) | |
| Asking for help is a sign of incompetence‡ | 60 (58) | 29 (55) | 31 (62) | |
| Physician-to-physician handoffs | NA | |||
| Physician shift changes are problematic for patients‡ | 48 (46) | 21 (40) | 27 (52) | |
| Problems occur in the exchange of patient information during sign-outs‡ | 41 (40) | 23 (43) | 18 (36) | |
| Nonpunitive response to error | ||||
| Students feel like mistakes will be held against them‡ | 33 (32) | 13 (25) | 20 (40) | 50 |
| Communication openness | ||||
| Students speak up if they see something that may negatively affect patient care | 21 (21) | 11 (21) | 10 (20) | 76 |
| Students are afraid to ask questions when something does not seem right‡ | 24 (23) | 13 (25) | 11 (22) | 63 |
*
The denominator for each question may vary because not every student responded to every question in the survey.
†
Agency for Healthcare Research and Quality (AHRQ) 2011 Comparative User database average percent positive results.
‡
Negatively worded item, where percent positive response is based on those who responded “strongly disagree” or “disagree.”
§
Questions with statistically significant differences between the internal medicine and surgery groups (chi-square; P < .05).