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The AHRQ Surveys on Patient Safety
Culture
Setting the Standard for Patient Safety Culture Around
the Globe
AHRQ Annual Meeting
September 19, 2011
Joann Sorra, Ph.DSenior Study [email protected]
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Objectives
Define patient safety culture Discuss reasons to assess patient
safety culture Discuss international use of the AHRQ
Surveys on Patient Safety Culture
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What is Patient Safety Culture?
“The way we do things around here”
Shared by staff
Beliefs, values & normsExists atmultiplelevels:
System
Organization
Department
Unit
What is
• Rewarded• Supported• Expected
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AHRQ SOPS Surveys
Assess provider & staff opinions about patient safety culture in
Hospitals (2004) Nursing homes (2008) Medical offices (2009) Retail pharmacies (Expected Summer 2012)
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Dimensions Assessed
Teamwork Staffing Training Handoffs Communication Organizational learning Management support for patient safety Nonpunitive response to mistakes Overall perceptions of patient safety
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Why Assess Patient Safety Culture?
Raise staff awareness
Diagnose & assess the status of patient safety culture
Identify strengths & areas for improvement
Evaluate the impact of patient safety initiatives
Examine trends & track change over time
Satisfy directives or regulatory requirements
Compare with other organizations
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Free Toolkit Materials User’s guide Survey feedback report PPT template Resource list of patient safety initiatives Reference list (coming soon—includes international
publications) Data entry & analysis tool Comparative database reports Research data sets (for de-identifiable data) Translation guidelines International users contact the User Network
To connect with other international users Obtain information about existing translations
www.ahrq.gov/qual/patientsafetyculture
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41 Countries
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Australia Bahrain Belgium Brazil Canada China Croatia Denmark El Salvador Finland France Germany Greece Iceland
India Italy Iran Japan Jordan Lebanon Malaysia Malta Netherlands New Zealand Norway Pakistan Portugal Saudi Arabia
Serbia Singapore Slovenia South Korea Spain Sudan Sweden Switzerland Taiwan Turkey United Kingdom United Arab Emirates Qatar
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22 Languages
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Arabic Chinese—Mandarin Croatian Danish Dutch Finnish Flemish French
German Greek Icelandic Italian Japanese Norwegian Persian Portuguese
Serbian Slovene Spanish Swedish Thai Turkish
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International Initiatives
The European Network for Patient Safety (EUNetPaS)
World Health Organization (WHO) High 5s Patient Safety Initiative
Other regional collaboratives
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EUNetPaS
78% of EU citizens consider medical errors to be an important issue in their country
Officially launched in 2008 in Utrecht, Netherlands
Aims to establish an umbrella network of all 27 EU Member States to encourage collaboration in patient safety
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EUNetPaS Goals
1) Establish common principles at the EU level Integrating knowledge, experiences and
expertise from Member States
2) Facilitate the development of patient safety programs in Member States
3) Support countries less advanced in patient safety
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Key Topic Areas
Promoting a culture of patient safety Structuring education and training in patient
safety in Member States Proposing a core European curricula for
patient safety in higher education Implementing reporting and learning systems Piloting the implementation of medication
safety programs in hospitals
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AHRQ Survey Endorsement
EUNetPaS published a two-volume report in 2010 reviewing patient safety culture instruments
AHRQ Hospital SOPS—One of only 3 patient safety culture instruments
officially recommended after an extensive review of available tools
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WHO High 5s
Launched in 2006 to reduce the frequency of 5 challenging patient safety problems in 5 countries over 5 years
Focus has been on 3 initiatives Medication reconciliation at transitions in care
Performing correct site surgery
Managing concentrated injectable medicines
Seven countries UK, France, Netherlands, Germany, Singapore ,
Australia & Canada
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High 5s & HSOPS
Administered the HSOPS in 2009 and 2010
23,520 respondents from 59 hospitals in 6 countries
Produced feedback reports For participating hospitals, countries, and an
international comparative report
Hope to examine relationships between patient safety culture and implementation of the High 5s patient safety initiatives
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Other Regional Collaboratives
Middle East Regional Network For Patient Safety Culture & Human Factors
Egypt, Jordan, Kuwait, Libya, Qatar, Saudi Arabia, United Arab Emirates
Over 20 researchers and representatives from hospitals and health systems
Goals: Obtain WHO & AHRQ support; hold regional meetings; establish a patient safety culture database for comparative purposes; adopt standard Arabic translations of the AHRQ SOPS surveys
PaSCAL—Patient Safety Culture Alliance in Italy Organized by the European Institute of Oncology
(Instituto Europeo di Oncologia--IEO) 23 participating hospitals Held a Quality Week conference in November 2010
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International Comparisons
The general finding: The U.S. typically scores higher on
most dimensions Notable exceptions where other
countries have much higher scores than the U.S.
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Challenges of International Comparisons
Quality and comparability of translations Translations have shown variable
psychometric properties (factor structure & reliability)
Differences in the structure and delivery of healthcare
Cultural influences on how respondents interpret and answer survey questions
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AHRQ SOPS: Setting the Standard
• 2011 Hospital SOPS Comparative Database Report • 1,032 hospitals and 472,397 staff
• Largest non-proprietary, free in the public domain, patient safety culture database in the world
• The Nursing Home and Medical Office SOPS surveys are likely to follow
• NH SOPS Database report released August 2012• MO SOPS Database open for data submission through Oct
ober15—Report available Spring 2012
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