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“The culture of safety: results of an organization-wide survey in 15 California Hospitals” Article Critique and Discussion

In the research report “The culture of safety: results of an organization-wide survey in 15 California Hospitals,” Singer et al discuss and review the results of a survey conducted at 15 different hospitals that was designed to measure the extent to which a “culture of safety” existed in each facility. According to the report, the nature of the survey covered a more extensive range of personnel than previous studies; respondents included senior management and hospital officials, physicians, nurses, and other employees.  The report indicated that a significant number of facilities demonstrated the need for making improvements in developing a culture of safety in their respective hospitals.

The criteria by which a culture of safety is defined are offer in the report. These criteria include a commitment to safety at the highest levels of the organization that is translated through shared values to all members of the organization; the resources necessary to ensure safety in the organization; safety as a primary concern within the organization, even over concerns related to the costs of ensuring safety; unsafe acts being reported and responded to appropriately; openness about errors and problems in the organization; and a commitment to ensuring that learning is valued in the organization (Singer et al, 2003). The survey questions were designed with these attributes of a culture of safety as the primary considerations.

The research for this project was conducted in stages; a series of three surveys was sent out to a number of different hospitals, and the overall response rates were weighted to ensure that the results accurately reflected the percentage of respondents to each survey. The overall results indicated that 18% of the total number of respondents indicated that their organization had a “problematic” culture of safety, with another 18% offering “neutral” responses. The remaining overall total indicated that their organizations had a positive culture of safety.

The results of this study showed that some of the most significant problems where safety is concerned were related to the lack of appropriate rewards for maintain a high level of safety coupled with an ineffective or inefficient means of reporting safety problems without fear of punishment or retribution. Concerns about safety in the context of hospitals can, of course, be translated to the structures of a number of other types of organizations. Other health care-related facilities, such as nursing homes, also need to establish and maintain a culture of safety. In a time when health care costs, such as those for hospital care and long-term care are soaring, it is more important than ever to make safety a priority. When a culture of safety fails to thrive, it can affect not only the profitability, but also the survival, of the organization. When a culture of safety is made the top priority, the rest of the organizational systems will have a better chance of function properly.

Reference

Singer, S. J., Gaba, D. M., Geppert, J. J., Sinaiko, A. D., Howard, S. K., & Park, K. C. (2003). The culture of safety: results of an organization-wide survey in 15 California Hospitals. Quality and Safety in Health, 12, 112-118