[Analysis of the patient safety culture in hospitals of the Spanish National Health System].
OBJECTIVE
A safety culture is essential to minimize errors and adverse events. Its measurement is needed to design activities in order to improve it. This paper describes the methods and main results of a study on safety climate in a nation-wide representative sample of public hospitals of the Spanish NHS.


METHODS
The Hospital Survey on Patient Safety Culture questionnaire was distributed to a random sample of health professionals in a representative sample of 24 hospitals, proportionally stratified by hospital size. Results are analyzed to provide a description of safety climate, its strengths and weaknesses. Differences by hospital size, type of health professional and service are analyzed using ANOVA.


RESULTS
A total of 2503 responses are analyzed (response rate: 40%, (93% from professionals with direct patient contact). A total of 50% gave patient safety a score from 6 to 8 (on a 10-point scale); 95% reported < 2 events last year. Dimensions "Teamwork within hospital units" (71.8 [1.8]) and "Supervisor/Manager expectations and actions promoting safety" (61.8 [1.7]) have the highest percentage of positive answers. "Staffing", "Teamwork across hospital units", "Overall perceptions of safety" and "Hospital management support for patient safety" could be identified as weaknesses. Significant differences by hospital size, type of professional and service suggest a generally more positive attitude in small hospitals and Pharmacy services, and a more negative one in physicians.


CONCLUSIONS
Strengths and weaknesses of the safety climate in the hospitals of the Spanish NHS have been identified and they are used to design appropriate strategies for improvement.
Saturno
P J
PJ
Unidad Docente de Medicina Preventiva y Salud Pública, Facultad de Medicina, Universidad de Murcia, Murcia, España. psaturno@um.es
Da Silva Gama
Z A
ZA
de Oliveira-Sousa
S L
SL
Fonseca
Y A
YA
de Souza-Oliveira
A C
AC
Castillo
Carmen
C
López
M José
MJ
Ramón
Teresa
T
Carrillo
Andrés
A
Iranzo
M Dolores
MD
Soria
Victor
V
Saturno
Pedro J
PJ
Parra
Pedro
P
Gomis
Rafael
R
Gascón
Juan José
JJ
Martinez
José
J
Arellano
Carmen
C
Gama
Zenewton A Da Silva
ZA
de Oliveira-Sousa
Silvana L
SL
de Souza-Oliveira
Adriana C
AC
Fonseca
Yadira A
YA
Ferreira
Marta Sobral
MS
D003695:Delivery of Health Care / Q000592:standards*; D006779:Hospitals, Public / Q000592:standards*; D006801:Humans; D015279:Organizational Culture; D010361:Patients; D017751:Safety Management; D013030:Spain