title: Perceptions of hospital safety climate and incidence of readmission.
abstract: OBJECTIVE
  To define the relationship between hospital patient safety climate (a measure of hospitals' organizational culture as related to patient safety) and hospitals' rates of rehospitalization within 30 days of discharge.
  
  
  METHODS
  A safety climate survey administered to a random sample of hospital employees (n=36,375) in 2006-2007 and risk-standardized hospital readmission rates from 2008.
  
  
  METHODS
  Cross-sectional study of 67 hospitals.
  
  
  METHODS
  Robust multiple regressions used 30-day risk-standardized readmission rates as dependent variables in separate disease-specific models (acute myocardial infarction [AMI], heart failure [HF], pneumonia), and measures of safety climate as independent variables. We estimated separate models for all hospital staff as well as physicians, nurses, hospital senior managers, and frontline staff.
  
  
  RESULTS
  There was a significant positive association between lower safety climate and higher readmission rates for AMI and HF (p ≤ .05 for both models). Frontline staff perceptions of safety climate were associated with readmission rates (p ≤ .01), but senior management perceptions were not. Physician and nurse perceptions related to AMI and HF readmissions, respectively.
  
  
  CONCLUSIONS
  Our findings indicate that hospital patient safety climate is associated with readmission outcomes for AMI and HF and those associations were management level and discipline specific.
authors.affiliation: Division of Hospital Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA. l-hansen@northwestern.edu
authors.forename: Luke O
authors.initials: LO
authors.lastname: Hansen
authors.forename: Mark V
authors.initials: MV
authors.lastname: Williams
authors.forename: Sara J
authors.initials: SJ
authors.lastname: Singer
mesh_terms: D003430:Cross-Sectional Studies; D006333:Heart Failure / Q000628:therapy; D006739:Hospital Administration / Q000592:standards; D006761:Hospitals / Q000592:standards* / Q000706:statistics & numerical data; D006801:Humans; D015994:Incidence; D009203:Myocardial Infarction / Q000628:therapy; D015279:Organizational Culture; D010043:Outcome and Process Assessment, Health Care; D010359:Patient Readmission / Q000706:statistics & numerical data*; D010465:Perception; D011014:Pneumonia / Q000628:therapy; D012044:Regression Analysis; D017751:Safety Management / Q000592:standards / Q000706:statistics & numerical data; D014481:United States