What is patient safety culture? A review of the literature.
OBJECTIVE
To organize the properties of safety culture addressed by many studies and to develop a conceptual culture of safety model.


METHODS
A comprehensive review of the culture of safety literature within the U.S. hospital setting. The review was a qualitative meta-analysis from which we generated a conceptual culture of safety framework and developed a typology of the safety culture literature.


RESULTS
Seven subcultures of patient safety culture were identified: (a) leadership, (b) teamwork, (c) evidence-based, (d) communication, (e) learning, (f) just, and (g) patient-centered.


CONCLUSIONS
Safety culture is a complex phenomenon that is not clearly understood by hospital leaders, thus making it difficult to operationalize. We found senior leadership accountability key to an organization-wide culture of safety.


CONCLUSIONS
Hospital leaders are increasingly pressured by federal, state, regulatory, and consumer groups to demonstrate an organizational safety culture that assures patients are safe from medical error. This article defines a safety culture framework that may support hospital leadership answer the question "what is a patient safety culture?"
Sammer
Christine E
CE
Clinical Care Transformation, Office of Clinical Effectiveness, Adventist Health System, 1035 Greenwood Boulevard, Lake Mary, FL 32746, USA. christine.sammer@ahss.org
Lykens
Kristine
K
Singh
Karan P
KP
Mains
Douglas A
DA
Lackan
Nuha A
NA
D001291:Attitude of Health Personnel; D003142:Communication; D003299:Cooperative Behavior; D055317:Evidence-Based Practice / Q000458:organization & administration; D007722:Health Knowledge, Attitudes, Practice; D006739:Hospital Administration / Q000379:methods; D006801:Humans; D007857:Leadership; D019300:Medical Errors / Q000517:prevention & control*; D017146:Models, Organizational; D015969:National Academies of Science, Engineering, and Medicine, U.S., Health and Medicine Division; D015279:Organizational Culture; D018802:Patient-Centered Care / Q000458:organization & administration*; D010564:Personnel, Hospital / Q000193:education / Q000523:psychology; D036301:Qualitative Research; D017751:Safety Management / Q000458:organization & administration*; D013597:Systems Analysis; D014481:United States