Teamwork Climate Research Articles

Evaluating patient safety culture at a private hospital

ABSTRACT Objectives: To evaluate the patient safety culture perception of a private hospital staff in a less developed region, to compare these perceptions according to socio-demographic and professional characteristics of the staff, and to investigate the effects of these characteristics on the patient safety culture. Methods: The Turkish version of the Safety Attitudes Questionnaire (SAQ) was administered to all staff members (340 people) of a private hospital in the less developed eastern region of Turkey. Data was analysed by independent samples t-test, ANOVA, Welch statistics and multiple linear regression analyses. Results: The response rate was 76%. Among six dimensions of the SAQ (teamwork climate, safety climate, job satisfaction, stress recognition, perceptions of management, and working conditions), stress recognition was the dimension with the lowest average. According to multivariate analyses; being younger, having a position as a nurse or technician/technical staff, working day–night and having longer years in the current hospital have an effect on the staff's more negative safety culture perception (p < 0.05). Conclusion: This study provides important information on patient safety attitudes of a private hospital staff in the least developed region of a country. Stress recognition and safety climate dimensions are the areas that primarily need improvement.

Patient safety in Work Environments: Perceptions of Pediatric Healthcare Providers in Taiwan

BackgroundExtensive research on the link between the organizational characteristics of the work environment and patient safety in a healthcare organization has been conducted; yet, only a few studies have concentrated on care providers in a pediatric unit. ObjectivesTo determine the correlation between different work environment factors impacting patient safety in a pediatric care unit from the perspective of registered nurses working in these units. DesignCross-sectional design. Data sources and methodsThe study was conducted with 155 registered nurses from a pediatric unit in a medical center in Taiwan with the Chinese version of the Safety Attitudes Questionnaire (SAQ) 2014–2017. ResultsTeamwork climate, higher job satisfaction, and better working conditions are linked to positive perceptions of patient safety culture. Emotional exhaustion is negatively related to most dimensions of patient safety. ConclusionTeamwork climate, job satisfaction, working conditions, and emotional exhaustion were identified as critical factors impacting the patient safety climate. Implications for nursing or health policyInvestments to improve teamwork climate, job satisfaction, and working conditions and reduce emotional exhaustion may have a positive effect on patient safety in pediatric care units.

Teamwork and Safety Attitudes in Complex Aortic Surgery at a Dutch Hospital: Cross-Sectional Survey Study

BackgroundImproving teamwork in surgery is a complex goal and difficult to achieve. Human factors questionnaires, such as the Safety Attitudes Questionnaire (SAQ), can help us understand medical teamwork and may assist in achieving this goal.ObjectiveThis paper aimed to assess local team and safety culture in a cardiovascular surgery setting to understand how purposeful teamwork improvements can be reached.MethodsTwo cardiovascular surgical teams performing complex aortic treatments were assessed: an endovascular-treatment team (ETT) and an open-treatment team (OTT). Both teams answered an online version of the SAQ Dutch Edition (SAQ-NL) consisting of 30 questions related to six different domains of safety: teamwork climate, safety climate, job satisfaction, stress recognition, perceptions of management, and working conditions. In addition, one open-ended question was posed to gain more insight into the completed questionnaires.ResultsThe SAQ-NL was completed by all 23 ETT members and all 13 OTT members. Team composition was comparable for both teams: 57% and 62% males, respectively, and 48% and 54% physicians, respectively. All participants worked for 10 years or more in health care. SAQ-NL mean scores were comparable between both teams, with important differences found between the physicians and nonphysicians of the ETT. Nonphysicians were less positive about the safety climate, job satisfaction, and working climate domains than were the physicians (P<.05). Additional education on performed procedures, more conjoined team training, as well as a hybrid operating room were suggested by participants as important areas of improvement.ConclusionsNonphysicians of a local team performing complex endovascular aortic aneurysm surgery perceived safety climate, job satisfaction, and working conditions less positively than did physicians from the same team. Open-ended questions suggested that this is related to a lack of adequate conjoined training, lack of adequate education, and lack of an adequate operating room. With added open-ended questions, the SAQ-NL appears to be an assessment tool that allows for developing strategies that are instrumental in improving quality of care.

Formal Assessment of Teamwork Among Cancer Health Care Professionals in Three Large Tertiary Centers in Nigeria.

PURPOSEThere are strategies to bring quality cancer care to underserved patients, but poor use of the principles of teamwork is a major barrier to achieving quality services. The intent of this study was to assess teamwork as perceived by health care workers caring for patients with cancer.METHODSWe conducted a survey among health care professionals in cancer care at 3 tertiary centers in southwestern Nigeria from July to November 2016. Respondents rated teamwork using the Safety Attitudes Questionnaire; we focused on the teamwork climate subscale comparing health care providers and institutions using analysis of variance and on collaboration using logistic regression.RESULTSThree hundred seventy-three professionals completed the survey: 177 physicians (47%), 51 nurses (14%), 21 pharmacists (6%), 31 laboratory technicians (8%), and 88 others (24%); 5 (1%) participants had missing professional information. The average teamwork climate score across all professionals in the study was 70.5 (SD = 24.2). Pharmacists rated the teamwork climate the lowest, with a mean score of 63.9 (SD = 29.5); nurses and laboratory technicians rated teamwork higher, with means of 74.5 (SD = 21.7) and 74.2 (SD = 27.1), respectively; and physicians rated teamwork 66.0 (SD = 23.6). Collaboration with other health care providers was reported as poorer by physicians compared with nurses and pharmacists.CONCLUSIONAlthough overall teamwork scores were consistent with ambulatory studies in the United States, important subgroup variations provide targets for intervention. Physicians rated collaboration as poor both intra- and interprofessionally. Pharmacists rated interprofessional teamwork with nurses as poor. Efforts to transform cancer care must focus on building trust among the key stakeholders. This is critical in low-resource settings, which must maximize the use of limited resources to improve patient outcomes.

Assuring safe patient care in a level III NICU in anticipation of hospital closure.

Hospital closures promote latent factors putting patients at risk for medical errors. Our goal was to maintain safe patient care in our Neonatal Intensive Care Unit (NICU) by preventing any increase in neonatal mortality or hospital-based complications prior to hospital closure. Interventions included expanding TeamSTEPPS huddles and Leadership WalkRoundsTM. Measurements of safety domains were conducted using the Safety Attitudes Questionnaire. A run chart tracked neonatal mortality. We compared hospital-based complications for all neonatal admissions in 2019 with our own past outcomes. Teamwork climate scores increased from an average score of 24.6-28.3 (maximum score 30, P < 0.05, CI 6.7-0.9). Quarterly neonatal mortality and neonatal outcomes did not worsen. The frequency of transfer did not increase. A strong teamwork climate with resilient leadership may mitigate safety concerns under calamitous circumstances.

Clima de segurança dos profissionais da saúde em um hospital universitário

Analisar os preditores e fatores associados à cultura de segurança do paciente no ambiente hospitalar. Estudo quantitativo com delineamento transversal, realizado com 263 profissionais selecionados aleatoriamente e submetidos à aplicação do Instrumento Safety Attitude Questionnaire. Realizou-se análise estatística descritiva, correlação de Pearson, análise de variância e regressão linear. Nesse contexto, o constructo que obteve a maior média foi o de Satisfação no trabalho, já a menor foi o da Percepção da atuação da gerência da unidade e da organização sob olhar do profissional. Quando comparadas as médias dos constructos, houve significância estatística entre o Clima de trabalho em equipe e a unidade de atuação, bem como o mesmo constructo com a atuação profissional; Percepção e influência do estresse na execução do trabalho e os cargos dos profissionais; Satisfação no trabalho e gênero. Na regressão linear o constructo que mais apresentou impacto foi o da Percepção da atuação da gerência da unidade e da organização sob olhar do profissional. Conclui-se que o fator preditor mais relevante foi a percepção da atuação da gerência da unidade e organização sob olhar do profissional. Tais resultados poderão servir de subsídio para novos estudos que levem em consideração a influência da cultura nas ações de segurança do paciente.

Do quality management systems influence clinical safety culture and leadership? A study in 32 Australian hospitals.

This study aimed to explore the associations between the organization-level quality arrangements, improvement and implementation and department-level safety culture and leadership measures across 32 large Australian hospitals. Quantitative observational study, using linear and multi-level modelling to identify relationships between quality management systems and clinician safety culture and leadership. Thirty-two large Australian public hospitals. Quality audit at organization level, senior quality manager at each participating hospital, 1382 clinicians (doctors, nurses and allied health professionals). Associations between organization-level quality measures and department-level clinician measures of teamwork climate, safety climate and leadership for acute myocardial infarction (AMI), hip fracture and stroke treatment conditions. We received 1332 valid responses from participants. The quality management systems index (QMSI, a questionnaire-based measure of the hospitals' quality management structures) was 'positively' associated with all three department-level scales in the stroke department, with safety culture and leadership in the emergency department, but with none of the three scales in the AMI and hip fracture departments. The quality management compliance index (QMCI, an external audit-based measure of the quality improvement activities) was 'negatively' associated with teamwork climate and safety climate in AMI departments, after controlling for QMSI, but not in other departments. There was no association between QMCI and leadership in any department, after controlling for QMSI, and there was no association between the clinical quality implementation index (CQII, an external audit-based measure of the level of implementation of quality activities) and any of the three department-level scales in any of the four departments, after controlling for both QMSI and QMCI. The influence of organization-level quality management systems on clinician safety culture and leadership varied depending on the hospital department, suggesting that whilst there was some consistency on patient safety attitudes and behaviours throughout the organizations, there were also other factors at play.

The relationships between quality management systems, safety culture and leadership and patient outcomes in Australian Emergency Departments.

We aimed to examine whether Emergency Department (ED) quality strategies, safety culture and leadership were associated with patient-level outcomes, after controlling for other organization-level factors, in 32 large Australian hospitals. Quantitative observational study, using linear and multi-level modelling to identify relationships between quality management systems at organization level; quality strategies at ED level for acute myocardial infarction (AMI), hip fracture and stroke; clinician safety culture and leadership and patient-level outcomes of waiting time and length of stay. Thirty-two large Australian public hospitals. Audit of quality management processes at organization and ED levels, senior quality manager at each of the 32 participating hospitals, 394 ED clinicians (doctors, nurses and allied health professionals). Within the multi-level model, associations were assessed between organization-level quality measures and ED quality strategies; organization-level quality measures and ED quality strategies and ward-level clinician measures of teamwork climate (TC), safety climate (SC) and leadership for AMI, hip fracture and stroke treatment conditions; and organization-level quality measures and ED quality strategies and ward-level clinician measures of TC, SC and leadership, and ED waiting time and length of stay (performance). We found seven statistically significant associations between organization-level quality systems and ED-level quality strategies; four statistically significant associations between quality systems and strategies and ED safety culture and leadership; and nine statistically significant associations between quality systems and strategies and ED safety culture and leadership, and ED waiting time and length of stay. Organization-level quality structures influence ED-level quality strategies, clinician safety culture and leadership and, ultimately, waiting time and length of stay for patients. By focusing only on time-based measures of ED performance we risk punishing EDs that perform well on patient safety measures. We need to better understand the trade-offs between implementing safety culture and quality strategies and improving patient flow in the ED, and to place more emphasis on other ED performance measures in addition to time.

Psychometric properties of the Georgian version of the Safety Attitudes Questionnaire: a cross-sectional study

ObjectiveTo study the psychometric properties of the Georgian version of the Safety Attitudes Questionnaire short version.DesignCross-sectional study.SettingThree Georgian hospitals.ParticipantsPersonnel of participating hospitals (n=305 responses, estimated response rate 30%).InterventionsNone.Primary and secondary...

Improvements in patient safety culture: a national Taiwanese survey, 2009-16.

To assess national trends in patient safety culture in Taiwan. A safety attitudes questionnaire (SAQ) was distributed to 144 hospitals from 2009 to 2016 (n=392341). Taiwan's medical centers, regional hospitals and community hospitals. Hospital staff in Taiwan. None. 5-point Likert scale to assess changes in patient safety culture dimensions (teamwork, safety climate, job satisfaction, stress recognition, management and working conditions) converted to positive response rate (percentage of respondents who answered slightly agree or strongly agree on Likert scale). Dimensions for patient safety culture significantly increased in Taiwan over a period of 8years, with an all-composite improvement in positive response rate of 4.6% (P<0.001). Regional hospitals and community hospitals registered an all-composite improvement of 6.7 and 7.0%, respectively, while medical centers improved by 4.0%. Improvements for regional and community hospitals primarily occurred in teamwork (regional hospitals, 10.4% [95% confidence interval [CI], 10.2-10.6]; community hospitals, 8.5% [95% CI, 8.0-9.0]) and safety climate (regional hospitals, 11.1% [95% [CI], 10.9-11.4]; community hospitals, 11.3% [95% CI, 10.7-11.8]) (P<0.001, all differences). Compared with nurses (5.1%) and pharmaceutical staff (10.6%), physicians improved the least (2.0%). Improvements for nurses and pharmacists were driven by increases in perceptions of teamwork (nurses, 9.8% [95% CI, 9.7-10.0]; pharmaceutical staff, 14.2% [95% CI, 13.4-14.9]) and safety climate (nurses, 9.0% [95% CI, 8.8-9.1]; pharmaceutical staff, 16.4% [95% CI, 15.7-17.2]) (P<0.001, all differences). At study end, medical centers (55.1%) had greater all-composite measurements of safety culture than regional hospitals (52.4%) and community hospitals (52.2%) while physicians (63.7%) maintained greater measurements of safety culture than nurses (52.1%) and pharmaceutical staff (56.6%). These results suggest patient safety culture improved in Taiwan from 2009 to 2016.

Impact of a safety and quality improvement program on the safety climate among ICU professionals in a Brazilian university hospital

Introduction: The assessment of patient safety culture plays a key role in promoting safe care, aiming at areas that need improvement, and thus help guide actions and attitudes towards better overall performance. Objectives/Aims: To evaluate the impact of the implementation of a safety and quality improvement program and safety culture among intensive care professionals. Methods: Prospective study, multifaceted intervention: using strategies such as stimulation to report adverse events, dissemination of clinical and quality results, implementation of action plans, training, in addition to the stimulation of family members participation. The safety culture was measured anonymously with an electronic version of the Safety Attitudes Questionnaire (SAQ) (7 domains / 36 questions / with responses Likert scale) previously and 9 months after implementation. Fully / partially agreeing responses were interpreted as positive; the amount of positive answers of each question determined the performance of the respective domain, expressed as a percentage of the maximum grade reached. Results expressed as median (25-75% percentile) used the Mann-Whitney test. Results: The SAQ of the professionals was answered (pre-intervention: 115, 56%, post-intervention: 123, 60%). The answers were predominantly from physicians (pre: 38%, post: 38%) and nurses (pre: 22%, post: 28%). There was a significant increase in the total SAQ score (pre-intervention: 59.0 (46.1 -78.5) after the intervention (72.7 (52.5-88.3), p = 0.001). (66.6 (50-66.6) x 66.6 (50 - 100) p = .001) and a safety climate (37.5 (12.5 - 75.0) x 62.5 (37.5-87.5) p = 0.002). Conclusion: The implementation of a safety and quality improvement program was associated with an improvement in the overall security climate, enhancing the safety and teamwork climate. These factors may be implicated in safer care.

Nursing safety attitudes: relationship with time of experience and intention to leave the job.

To evaluate the safety attitudes of the nursing staff and their relationship with staff adequacy and material resources, time of experience and intention to leave the job. A descriptive and cross-sectional study in a teaching hospital, sampled by convenience, with the application of the Safety Attitudes Questionnaire, collected from January to April 2016. 262 professionals participated, of whom 98 were nurses and 164 technicians. They reported a positive safety attitude for job satisfaction. The adequacy of staff and material resources positively influenced safety attitudes. There was a negative correlation between time of experience and perception of management, safety climate, working conditions and safe behaviors and, between the intention to leave the job and the teamwork climate, job satisfaction, and safe behaviors. The negative perception of safety attitudes was related to the time of experience and to the intention to leave the job.

Turkish surgical nurses' attitudes related to patient safety: A questionnaire study.

Surgical nurses work in demanding environments and play a vital role in maintaining and promoting patient safety due to the nature of their work. Hence it is important to know their attitudes toward patient safety. This research aimed to evaluate the patient safety attitudes of Turkish surgical nurses. This was a descriptive cross-sectional and questionnaire research. Data were collected from August 2015-January 2016 using the staff information form and the safety attitudes questionnaire (SAQ). The study population included 231 nurses who work in operating rooms, surgical intensive care, and surgical wards of four hospitals in western Turkey. Data were analyzed with frequency, percentage, mean, standard deviation, the Mann Whitney U test, and Kruskal Wallis tests using the SPSS 18. The teamwork and safety climate scores of operating room nurses were higher than the scores of surgical intensive care and ward nurses. The stress recognition scores of surgical ward nurses were the highest, followed by the scores of the operating room and surgical intensive care nurses. The perception of management scores of operating room nurses was higher than those of surgical ward nurses, and nurses ages 18-30 were higher than those of nurses ages 31-40. None of the six domains of safety culture, including job satisfaction, teamwork, safety climate, the perception of management, stress recognition, and working conditions achieved a positive mean score over 75. This research paper provides an evaluation of the safety attitudes of surgical nurses. Findings can provide information for healthcare leaders to improve the safety culture.

Patient safety climate from the nursing perspective.

To analyze the patient safety climate in intensive care units from the nursing perspective. Cross-sectional study developed with 87 nursing professionals working in three Intensive Care Units of a public hospital for emergency services in Piauí from October to November 2018. The study used a validated Safety Attitudes Questionnaire (SAQ). In the inferential analysis, the Student's t-test, Mann-Whitney, and Kruskal-Wallis were performed. The total SAQ score obtained a mean of 68.57. In analyzing the scores obtained for each domain in the general SAQ, the Job Satisfaction, and Teamwork Climate domains were those that obtained the highest scores, and the lowest score was for the Perception of Hospital Management domain. The safety attitudes assessed from the perspective of the nursing team proved to be unfavorable.

A comparative study on patient safety attitude between nurses and doctors in operating rooms.

ObjectiveTo investigate and compare the attitudes of operating room nurses and doctors regarding patient safety, performance of surgical time-out and recognition of count error.MethodsThis cross-sectional study recruited operating room nurses, surgeons and anaesthesiologists between 1 August 2015 and 5 February 2016. A Safety Attitude Questionnaire was used to analyse the three elements in both groups of operating room staff (nurses and doctors).ResultsThe study analysed the questionnaires from 171 participants; 95 nurses (55.6%) and 76 doctors (44.4%). Differences exist between doctors and nurses regarding teamwork climate, working conditions, perception of management and the recognition of stress. On the performance of surgical time-out, nurses showed higher scores on way of counting, while doctors showed higher scores on the time-out procedure itself. Also, doctors believed they actively cooperated with the nurses, while nurses believed they did not receive cooperation. Scores for the recognition of count error were higher in nurses than in doctors. More experienced operating room staff showed higher scores than younger less experienced staff.ConclusionsPerceptual differences among doctors and nurses need to be minimized for the safety of the patient in the operating room.

54 Patient Safety Culture at a Teaching Hospital in Kuala Lumpur

Abstract Introduction Patient safety, such as inpatient falls, is a global problem, accounting for increasing compensation costs from our healthcare facilities. The aim of this study was to evaluate the patient safety culture among healthcare providers. Method An online survey was developed within the hospital staff portal at the University of Malaya Medical Centre, with a dialogue box appearing on the launching of the portal website inviting the members of staff to participate in the survey. The survey contained a safety assessment questionnaire (SAQ) which measures the patient safety culture. The SAQ consists of 36 items measuring the six domains: teamwork climate, job satisfaction, safety climate, stress recognition, working conditions, and perception of management. Each domain is assigned a percentage score, and comparisons of scores according to healthcare disciplines were then made. Results 5275 (80%) responded to the online SAQ which was sent out to all 6562 healthcare professionals employed, by the hospital. The teamwork and safety climate was poor among supporting staff, with scores of 56.7 and 59.8 respectively. Job satisfaction (62.9), perception of ward management (56.8), and hospital management (53.2), and working conditions (44.7) were less among the clinicians. Stress recognition (36.5) was in alarmingly low among the nurses. Conclusion A comprehensive unit-based safety programme will be conducted in response to the SAQ findings, and should incorporate objective falls the outcome in order to convince the hospital hierarchy of the need for urgent solutions to lower the rates of inpatient falls.

Safety Culture at Primary Healthcare Level: A Cross-Sectional Study Among Employees with a Leadership Role.

IntroductionAn effective leadership is critical to the development of a safety culture within an organization. With this study, the authors wanted to assess the self-perceived level of safety culture among the employees with a leadership function in the Ljubljana Community Health Centre.MethodsThis was a cross-sectional study in the largest community health centre in Slovenia. We sent an invitation to all employees with a leadership role (N=211). The Slovenian version of the SAQ – Short Form as a measurement of a safety culture was used. The data on demographic characteristics (gender, age, role, work experience, working hours, and location of work) were also collected. An electronic survey was used.ResultsThe final sample consisted of 154 (69.7%) participants, out of which 136 (88.3%) were women. The mean age and standard deviation of the sample was 46.2±10.5 years. The average scores for the safety culture domains on a scale from 1 to 5 were 4.1±0.6 for Teamwork Climate, Safety Climate, and Working Conditions and Satisfaction, 3.7±0.5 for Perception of Management, 3.6±0.4 for Communication, and 3.5±0.6 for Stress Recognition.ConclusionThe safety culture among leaders in primary healthcare organizations in Slovenia is perceived as positive. There is also a strong organizational culture. Certain improvements are needed, especially in the field of communication and stress recognition with regards to safety culture.

Evaluation of safety attitudes of hospitals and the effects of demographic factors on safety attitudes: a psychometric validation of the safety attitudes and safety climate questionnaire

BackgroundThe objectives of this study are to test the psychometric properties of the safety attitudes and safety climate questionnaire Chinese simplified version (SAQ-CS), to test the safety attitudes of health professionals in tertiary hospitals in the Liaoning province and to explore the effects of demographic factors on safety attitudes.MethodsThe SAQ-CS was used to conduct a cross-sectional survey in nine tertiary hospitals in Liaoning province.ResultsCronbach’s alpha of each subscale of SAQ-CS were > 0.7, the values of GFI, TLI, and CFI were > 0.8, and RMSEA values ranged from 0.048–0.199. The mean of the safety attitudes of 2157 health professionals was 4.00, indicating a good safety attitude, with a positive response rate (% of items that scored ≥4) of 51.1%. The stress recognition subscale had the lowest score, with a mean of 2.73 and a positive response rate of 17.8%. A multiple linear regression equation revealed that demographic factors like gender, age, and training participation significantly affected the scores (βgender > 0.06, βage < − 0.08, βtraining < − 0.07, p < 0.05).ConclusionsThe psychometric properties of SAQ-CS are good and stable. Health professionals rate teamwork climate, safety climate, perception of management, and work conditions in Liaoning province are perceived as good; however, the stress of the health professionals is poor. To improve safety attitudes, it is necessary to not only reduce the stress of health professionals, but also to pay more attention to men, older health professionals, and health professionals who have not participated in safety training.

Associations Between a New Disruptive Behaviors Scale and Teamwork, Patient Safety, Work-Life Balance, Burnout, and Depression

Disruptive and unprofessional behaviors occur frequently in health care and adversely affect patient care and health care worker job satisfaction. These behaviors have rarely been evaluated at a work setting level, nor do we fully understand how disruptive behaviors (DBs) are associated with important metrics such as teamwork and safety climate, work-life balance, burnout, and depression. Using a cross-sectional survey of all health care workers in a large US health system, this study aimed to introduce a brief scale for evaluating DBs at a work setting level, evaluate the scale's psychometric properties and provide benchmarking prevalence data from the health care system, and investigate associations between DBs and other validated measures of safety culture and well-being. One or more of six DBs were reported by 97.8% of work settings. DBs were reported in similar frequencies by men and women, and by most health care worker roles. The six-item disruptive behavior scale demonstrated an internal consistency of α = 0.867. DB climate was significantly correlated with poorer teamwork climate, safety climate, job satisfaction, and perceptions of management; lower work-life balance; increased emotional exhaustion (burnout); and increased depression (p < 0.001 for each). A 10-unit increase in DB climate was associated with a 3.89- and 3.83-point decrease in teamwork and safety climate, respectively, and a 3.16- and 2.42-point increase in burnout and depression, respectively. Disruptive behaviors are common, measurable, and associated with safety culture and health care worker well-being. This concise DB scale affords researchers a new, valid, and actionable tool to assess DBs.

CROSS-SECTIONAL SURVEY ASSESSING A CULTURE OF SAFETY AT A LARGE PUBLIC HOSPITAL

SESSION TITLE: Wednesday Abstract Posters SESSION TYPE: Original Investigation Posters PRESENTED ON: 10/23/2019 09:45 AM - 10:45 AM PURPOSE: High-risk industries with a narrow tolerance for errors such as healthcare pay considerable attention to studying safety. Such research has expanded from focus on morbidity and mortality to recognition of ways in which organizational structure, team dynamic, and working conditions impact a climate of patient safety within an institution. The Safety Assessment Questionnaire (SAQ) solicits employee perceptions of teamwork, safety, job satisfaction, stress recognition, management, and working conditions. Validation studies suggest this tool is reliable and responsive to interventions. This study was designed to identify baseline gaps in safety culture among various provider disciplines within our institution. METHODS: The study was conducted in a large public teaching hospital. We used the abbreviated Short Safety Assessment Questionnaire (sSAQ), which explores the same domains as the SAQ via 36 questions graded on a 5-point Likert scale. The survey was distributed over a month-long period to all housestaff rotating on the inpatient medicine floor and in the medical and cardiac intensive care units (MICU and CCU respectively), as well as to medicine floor attendings, MICU and CCU nurses, and inpatient respiratory therapists. Response to the survey was voluntary and anonymous. RESULTS: Responses were obtained from 86% of the rotating housestaff, 91% of floor attendings, 41% of MICU nurses, 24% of CCU nurses, and 33% of respiratory therapists. Housestaff overall responded positively to job satisfaction, stress recognition, and working conditions, while ICU-based housestaff were additionally positive regarding teamwork and patient safety climate. Attendings answered favorably to job satisfaction and stress recognition. CCU nurses scored highest in the domains of safety climate and job satisfaction, while MICU nurses were most satisfied with stress recognition. Nursing units also differed in negative perceptions; CCU nurses expressed that communication breakdown commonly interfered with delivery of patient care, and MICU nurses felt burdened by insufficient staffing for patient volume. Respiratory therapists scored low in stress recognition, perception of management, and working condition domains. They looked favorably on collaboration with nurses but were neutral toward collaboration with physicians. CONCLUSIONS: Responses to the sSAQ revealed discrepancies between provider disciplines regarding perception of safety culture across six different domains. CLINICAL IMPLICATIONS: Improvement in scores across domains in the SAQ has shown association with shorter ICU stays, decreased rates of ventilator-associated pneumonias and blood-stream infections, and lower mortality. Our survey demonstrates a clear opportunity within our institution for targeted quality improvement initiatives which can be tailored to different provider disciplines in order to improve safety culture and optimize patient outcomes. DISCLOSURES: My spouse/partner as a Advisory Committee Member relationship with CORECEPT Please note: $1001 - $5000 Added 03/15/2019 by Vikramjit Mukherjee, source=Web Response, value=Consulting fee No relevant relationships by Maria Sunseri, source=Web Response No relevant relationships by Amit Uppal, source=Web Response No relevant relationships by Brandon Walsh, source=Web Response