Actual patient outcomes not representative of staffers' culture perceptions
Hospitals often will have employees fill out surveys to gauge how well they protect patients from harmful infections. A new study published in BMJ: Quality & Safety found that there was no connection between the survey scores and the actual decline in infection rates.
Researchers at the University of Michigan Medical School and VA Ann Arbor Healthcare System had hospitals from around the country sign on to a national patient safety project. Each of the hospitals had a common goal to reduce central line-associated bloodstream infections (CLABSI) and catheter-associated urinary tract infections (CAUTI).
The staff members were given tools, training, new procedures and other support to help them reduce those infections. In order to change the culture in the hospital, they were also encouraged to speak up to stop an unsafe scenario and to work as a team.
Each employee was surveyed about patient safety at the start and then again toward the end of the project. The researchers assumed that those who did better on the survey measures of safety culture would have lower infection rates.
But after analyzing the data, they found that their assumption was wrong. There was, in fact, no correlation between safety culture scores derived from the surveys and the actual reduction in infection rates.
The hospitals cut their CLABSI rates by 47 percent and CAUTI rates by 23 percent overall, but the changes reflected in the survey scores were only minor. For some hospitals, the survey scores worsened even though they improved their infection rates.
The hospitals put a lot of resources into trying to get their employees to take the surveys, but less than half of them actually took them. The researchers think that since so few employees took the survey, the results might be inaccurate.
They concluded that the results suggest that either the infection rates were better because other aspects of care aside from the safety culture, such as catheter use improvement, or because the surveys don’t reflect safety culture accurately.
They recommend that the patient safety community should evaluate how the patient safety culture surveys are used as part of the larger efforts to improve safety.
