title: Exploring relationships between hospital patient safety culture and adverse events.
abstract: OBJECTIVE
  There has been very limited research linking staff perceptions of hospital patient safety culture with rates of adverse clinical events. This exploratory study examined relationships between the Agency for Healthcare Research and Quality's (AHRQ) Hospital Survey of Patient Safety Culture and rates of in-hospital complications and adverse events as measured by the AHRQ Patient Safety Indicators (PSIs). The general hypothesis was that hospitals with a more positive patient safety culture would have lower PSI rates.
  
  
  METHODS
  We performed multiple regressions to examine the relationships between 15 patient safety culture variables and a composite measure of adverse clinical events based on 8 risk-adjusted PSIs from 179 hospitals, controlling for hospital bed size and ownership. All patient safety culture data were collected in 2005 and 2006 (except 1 late 2004 hospital), and all PSI data were collected in 2005.
  
  
  RESULTS
  Nearly all of the relationships tested were in the expected direction (negative), and 7 (47%) of the 15 relationships were statistically significant. All significant relationships were of moderate size, with standardized regression coefficients ranging from -0.15 to -0.41, indicating that hospitals with a more positive patient safety culture scores had lower rates of in-hospital complications or adverse events as measured by PSIs.
  
  
  CONCLUSIONS
  Our findings support the idea that a more positive patient safety culture is associated with fewer adverse events in hospitals. Further research is needed to determine the generalizability of these results to larger sets of hospitals and to examine the causal relationship between patient safety culture and clinical patient outcomes.
authors.affiliation: Westat, Rockville, Maryland 20850, USA. russmardon@westat.com
authors.forename: Russell E
authors.initials: RE
authors.lastname: Mardon
authors.forename: Kabir
authors.initials: K
authors.lastname: Khanna
authors.forename: Joann
authors.initials: J
authors.lastname: Sorra
authors.forename: Naomi
authors.initials: N
authors.lastname: Dyer
authors.forename: Theresa
authors.initials: T
authors.lastname: Famolaro
mesh_terms: D064420:Drug-Related Side Effects and Adverse Reactions / Q000453:epidemiology*; D019538:Health Care Surveys; D006761:Hospitals / Q000592:standards*; D006801:Humans; D019300:Medical Errors / Q000517:prevention & control* / Q000706:statistics & numerical data; D015999:Multivariate Analysis; D015279:Organizational Culture; D005791:Patient Care / Q000379:methods / Q000592:standards*; D010465:Perception; D010865:Pilot Projects; D019984:Quality Indicators, Health Care; D012044:Regression Analysis; D018570:Risk Assessment; D017751:Safety Management / Q000379:methods / Q000592:standards*; D014481:United States / Q000453:epidemiology